A New OPIATE (Optimizing Positive Ibuprofen and Acetaminophen Treatment Expectations) Model: A Brief Comment on "Concurrent and Lagged Associations of Prescription Opioid Use With Pain and Negative Affect in the Daily Lives of Chronic Pain Patients" (Carpenter, Lane, Bruehl, & Trull, 2019)

Objective: This commentary expands upon the clinical implications arising from the Carpenter et al. (2019) negative reinforcement model of opioid use. A new model called OPIATE-which stands for Optimizing Positive Ibuprofen and Acetaminophen Treatment Expectations-is introduced. This commentary highlights possible strategies for reducing the supply and demand of opioids through enhancing expectations for alternative pain medications. Method: This commentary features an integration of concepts from social psychology, cognitive psychology, and consumer psychology with empirical findings from observational studies and randomized trials of opioid and nonopioid medications. Results: Four behavioral strategies are offered for potential enhancing expectations for ibuprofen and acetaminophen. These strategies are (a) altering defaults in electronic medical record systems; (b) highlighting appropriate descriptive social norms to patients; (c) improving the quality of interactions during discharges between patients and their physicians, nurses, and pharmacists; and (d) priming patients to have positive expectations regarding ibuprofen and acetaminophen involving careful selection of language to describe these medications. Conclusions: Instead of creating alternative pharmaceuticals, efforts to prevent opioid misuse may be more fruitful by focusing on behavioral change of prescribers and patients because viable medication options-namely ibuprofen and acetaminophen-already exist. Psychologists have an opportunity to play a leading role in evaluating behavioral strategies for increasing expectations for and use of nonopioid pain medications.