Validating Opioid-Sparing Pain Management Regimens, with Angel Goenawan, MD

The opioid crisis has pushed clinicians to rethink how they manage pain—especially in hospitals, where acute pain is common and the pressure to treat it quickly can lead to overprescribing. New research is beginning to show that non-opioid regimens—including medications like acetaminophen, NSAIDs, gabapentin, and certain antidepressants—can effectively manage pain while reducing opioid use in hospitalized patients.

Angel Goenawan, MD, a hospitalist at Bayhealth in Delaware, presented a meta-analysis of 8 randomized clinical trials (2 nonsurgical, 6 surgical) evaluating opioid-sparing regimens compared with opioid-prescribing regimens at the American College of Physicians (ACP) Internal Medicine (IM) Meeting 2025, held April 3-5, in New Orleans, Louisiana.

“I think this opens an opportunity for us as IM physicians to do more studies, especially in hospitalized settings, if we can introduce protocols in the hospital that are based more on opioid sparing regimens compared to the ones that we are doing currently with opioid prescribing regimens, it will be much better for patients in terms of outcome, controlling pain, and also reducing the opioid utilization,” Goenawan told HCPLive during the meeting.

HCPLive spoke with Goenawan to learn more about the meta-analysis and its findings. He touched on some concerns that physicians may have in terms of opioid-sparing regimens but noted that there are a number of alternatives to opioids that have been shown to be effective in controlling pain. He also discussed future studies he would like to do and shared his outlook on opioid prescribing in the last several years and continuing into the near future.

“Definitely more physicians are aware now in terms of opioid prescribing… there's actually a growing trend that physicians prescribe less opiates, which is a good thing, but I think we still have a long uphill battle in terms of opiate use. And I think we can work more on that, definitely, in the future,” Goenawan said.

Goenawan had no relevant disclosures to report.

REFERENCE

Goenawan A. Opioid-Sparing Multimodal Analgesia Regimen Efficacy in Hospitalized Surgical and Non-Surgical Patients: A Meta Analysis of Randomized Clinical Trials. Presented at: ACP IM Meeting 2025; April 3-5; New Orleans, Louisiana.