The Blue Cross and Blue Shield Association has adopted a new standard that opioids should not be the first or second treatment options to manage pain, mirroring guidelines set by the Centers for Disease Control and Prevention.In most cases, ibuprofen and acetaminophen can treat pain more effectively than opioids, said Dr. Trent Haywood, chief medical officer for the Blues association, which has about 106 million members.It's not an absolute decree. In many cases, particularly related to cancer treatment or end-of-life care, opioids may be the best remedy, said Haywood, adding that the association will aid physicians in making the best clinical decision."The opioids are half as effective but two to four times more harmful," he said.