Still not an exact practice change with pain being extremely subjective. Vast majority of first fill counseling for opioids are for those already doing ATC NSAID & usually picking up Oxycodone or Hydrocodone/APAP combo (as opposed to giving just flat oxycodone IR -> incentive/potential to sell unused drug since not combined with APAP). Also reserving for severe BTP (7-10) per directions. It's a very complicated dilemma without a clear solution.
Still boils down to how well an ER MD can use tools (drugs) most efficiently. Opioid Rx'ing is still going to be necessary (no ceiling effect unlike NSAIDs & APAP) & should APAP & NSAIDs not cut it, that will just be another ER visit (even more costly).
