Opioid Prescribing Has Come a Long Way, According to Stanford Pain Expert Edward Mariano, MD, MAS

"Right now, in 2025, I think we're somewhat in the middle, after a range of extremes," Edward Mariano, MD, MAS, replied to the question, "Would you describe the pain management environment that you and your colleagues work in now, in January 2025?" In a recent interview with Patient Care,© Mariano, professor and vice chair, department of anesthesiology, perioperative and pain management at the Stanford University School of Medicine, referred to the pendulum swing in opioid prescribing between the early- to mid-2000s when surgeons, podiatrists, and dentists were encouraged to prescribe to 2016 when the CDC published its highly restrictive and problematic guidelines for use of the analgesics to the agency's revised 2022 recommendations that reflected a far more nuanced and patient-centric approach.

In the short video above, Mariano traces shifting perspectives around the concept of pain management, highlighting the challenges and ultimately focusing on the opportunities he sees as we move forward.

Edward R Mariano, MD, MAS, is a professor and vice chair in the department of anesthesiology, perioperative and pain medicine at Stanford University School of Medicine in Stanford, CA and chief of anesthesiology and perioperative care service at the Veterans Affairs Palo Alto Health Care System. Mariano pioneered the use of continuous peripheral nerve blocks for individuals having same-day surgery. He has worked on key national health care initiatives in the US including accreditation of regional anesthesiology and acute pain medicine fellowships, pain management guidelines, and hospital-based standards.