Natural Awakenings: Dr. Maiers on Improving Pain Management

Three Ways to Improve Pain Management and Combat Opioid Misuse in the U.S.
Dr. Michele Maiers for Natural Awakenings Twin Cities

The global pandemic has affected our lives in so many ways. One concerning trend is that pain sufferer, who may rely on regular in-person care from healthcare practitioners to manage their conditions have instead had to modify or forego treatment to accommodate pandemic restrictions. This, in addition to increased feelings of isolation and depression has driven an increase in substance use disorders.

According to provisional data released by the Centers for Disease Control and Prevention, more than 93,000 people died of a drug overdose in 2020 alone. This is a record number for a 12-month period, skyrocketing nearly 30 percent from 2019.

Back pain and other musculoskeletal conditions are the most frequent cause of pain for Americans and have been a leading cause of opioid prescriptions. In fact, the National Institutes of Health states over half of the people using opioids report back pain. This is especially concerning because the evidence suggests that opioids are not only addictive but are also not effective for treating these conditions.

As the opioid epidemic is once again brought to light, researchers are calling for new standard approaches to pain management. The reality is alternative treatments have been available for decades and are now coming into greater focus as Americans face the crisis head-on. Complementary and integrative healthcare (CIH) providers—including chiropractors, acupuncturists, and massage therapists—offer an effective and safe treatment for pain.

CIH providers are heavily engaged in the healthcare delivery system to improve patients’ lives and combat the opioid crisis from a variety of angles. Here are three ways to improve pain management and combat the opioid crisis through integrative care:

1.Beginning with a non-pharmacological approach. Non-pharmacological treatments, including exercise, chiropractic, acupuncture, and massage therapy, are now recommended as first-line treatments for pain in numerous best practice guidelines, including from the American College of Physicians. Treating pain and related conditions with non-pharmacological options first have the potential to reduce drug dependencies, overdoses, and deaths.

For For example, research shows that when people with back pain receive care from doctors of chiropractic, the likelihood of patients filling a prescription for an opioid analgesic is reduced by 55 percent. When CIH professionals are prioritized over more invasive treatments, patients benefit.

2. Increasing access to opioid alternatives, especially for high-risk populations. Although safer alternatives to pain management exist, many are left without access to these services. Building integrative pain management teams in hospitals and clinics remove barriers to these services. When CIH providers play a significant role in the care team for post-surgery and pain management cases, care coordination is enhanced, and patients have expanded options that meet their individual needs.

Over 21 million Americans have a substance use disorder and in the wake of the pandemic, more people are struggling, deemed at-risk for addiction or considered vulnerable populations at higher-than-average risk. Integrative care wraps a team of healthcare professionals and support services around patients, coordinating individualized pain management across providers and addiction specialists, preventing relapse or increased risk of exposure to opioids.

3. Supporting those suffering from substance use disorders. Back pain sufferers report higher rates of illicit drug use, such as marijuana, cocaine, methamphetamine, and heroin, compared to adults without back pain. For those with a substance use disorder, many continue to experience pain.

Increasing awareness and access to non-drug pain treatment options may help some initiate rehabilitation, support those in rehabilitation and provide additional measures to prevent relapse. CIH providers are an important part of addiction teams, taking a multi-modal approach to addiction recovery and pain management.

Americans deserve access to adequate pain management that is safe, effective, and non-addictive. Through policy considerations for opioid misuse, financial incentives to triage pain patients at risk of opioid misuse toward CIH care, and continuing medical education programs for healthcare professionals, society can change the trajectory of pain management and make this vision a reality.

Across the country, CIH providers are increasingly found in hospitals, health systems, federally qualified community clinics, VA hospitals, and clinics, and other healthcare settings. By integrating these professionals throughout the healthcare system, they can more readily support those with chronic pain without leaning on prescription medicine and, as a result, ease the burden of the opioid epidemic.

While the current emphasis on reducing the use of opioids is urgent, physicians should provide treatment through non-pharmacologic interventions that address the root problem of chronic pain. Managing musculoskeletal pain can be ineffective if addressed with a single mode of treatment. By working together across the healthcare system, we can provide effective pain relief to patients and minimize the burden of the opioid epidemic.