A survey out of the National Safety Council released this week showed that 99 percent of physicians are prescribing opioid medications for longer than the initial three-day period that is recommended by the Centers for Disease Control and Prevention (CDC).

Almost a quarter, 23 percent, said they prescribe at least a month’s worth of these opioids for acute pain. That is about 10 times as much as the CDC recommends. Acute pain can be intense, but it typically does not last all that long which is why the CDC’s recommendation of three-days is reasonable. The survey also found that about three-fourths, 74 percent, of responding physicians believed that morphine and oxycodone were the most effective ways to treat pain even though research has shown that ibuprofen and acetaminophen were more effective to treat acute pain. Unlike opioids, these drugs can be obtained over the counter and are much less dangerous when it comes to addiction and overdose risks.

Dr. Donald Teater, who is the Medical Advisor to the National Safety Council and presented the findings said, “Studies have shown that once we get beyond seven days of these opiate prescriptions for acute pain, the outcomes become much worse.”

The survey was taken between March 5-13 of this year, and 201 family and internal medicine physicians who see most of their patients in an office-based environment were surveyed. That is a relatively small sample size and may not be entirely representative, says Dr. Deborah Clements, the chair of family and community medicine for Northwestern Medicine who says that country has roughly 200,000 primary care doctors.

The survey comes right after the CDC recommendations for chronic pain treatment were released, which encourage doctors to start with the lowest possible effective doses for patients. The survey shows many doctors do not begin with the lowest dose patients might be able to start out with. Fast-acting opioids make up 90 percent of opioid prescriptions.

The amount of opioid overdoses has more than tripled in the past 15 years; in 2014 there were 18,893 opioid related overdoses. While most doctors in this survey said they screen patients for a history of opioid abuse before they wrote a script, just over half checked the state’s prescription drug monitoring program (PDMP), and 32 percent checked for a family history of abuse which can be a big factor in a person’s risk of addictive behavior. While 99 percent of them say they have had a patient come in who was looking for pills, just 38 percent of those doctors referred them to treatment for abuse. A majority of doctors said that it was difficult for them to refer patients for treatment because the patient refused, or were not covered for treatment by their insurance, or there were no treatment doctors nearby and even if there were doctors close by, there were long wait lists for treatment.