“We need to maintain a balance,” said Adm. Brett P. Giroir, the department’s assistant secretary for health, adding that “it is a false choice to say we could only limit opioid use disorder or addiction or have pain control.”

Annual opioid prescriptions in the United State peaked at 255 million in 2012 after increasing every year for more than a decade — a rise that fueled the epidemic of overdose deaths that continues to plague the nation. But by 2017, the number of opioid prescriptions had fallen to 191 million, a drop that President Trump has pointed to as a victory, even as his administration has begun responding to chronic pain patients angry about being forced off the drugs.

While deaths from prescription opioids have fallen — they are the main reason why fatal overdoses dipped slightly overall last year for the first time since 1990 — the number of people dying from illicit fentanyl, another opioid, continues to rise. Prescription painkillers were the main cause of overdose deaths until heroin, and then fentanyl, surpassed them over the last decade. Critics have argued that curbing prescriptions for legal painkillers drove some people to seek illegal opioids, like heroin and fentanyl.

The tapering guide was written by a work group led by Admiral Giroir, with members from the C.D.C., the National Institutes of Health, the Substance Abuse and Mental Health Services Administration and other federal agencies that fall under the health and human services department. Admiral Giroir and two others who helped lead the group — including Dr. Deborah Dowell of the C.D.C., the lead author of the 2016 guidelines — also published an article about the guide Thursday in the medical journal JAMA. The C.D.C. had already published its own “pocket guide” for doctors on tapering.

The new guide states that doctors “should never abandon” pain patients, and warns of risks including “acute withdrawal, pain exacerbation, anxiety, depression, suicidal ideation, self-harm, ruptured trust, and patients seeking opioids from high-risk sources.”