For decades, opioids have been prescribed for pain management – from acute injury and post-surgery pain to chronic and cancer-related pain. They have been touted as one of the best ways to treat pain, and many doctors look to them first to give their patients relief.
With opioid and heroin addiction on the rise, however, doctors are increasingly exploring alternative treatments for pain in their patients, and researchers are constantly seeking new and different ways to treat pain. Fortunately for people who don’t want to take opioids or who are at risk for addiction, there are many other effective ways to manage pain.
Pain Management Programs
Amid rising addiction rates and increased skepticism about opioid prescription approaches, pain management programs have become more and more common. Researchers are still learning about the complexity of pain and its causes and effects, which means there is no one-size-fits-all approach to managing pain.
Enter pain management programs. These interdisciplinary programs aim to educate people about the nature of pain and its treatments while offering alternatives to opioid use — all within an integrated setting where patients can receive several forms of care in one place.1 This is key for effective pain management, as one of the main obstacles to proper care is coordination between practitioners.
Pain management programs are often offered in hospitals and treatment centers and commonly include the following practitioners:
- Doctors, primary care physicians
- Clinical pharmacists
- Mental health therapists
- Physical and occupational therapists
- Pain specialists, such as neurologists, rheumatologists, orthopedists, physiatrists, anesthesiologists
- Nutritionists, dietitians 1,2
One such program at Kaiser Permanente offers an eight-week course that aims to educate high-risk opioid patients about pain management with classes about how drugs work and integrated in-house care from a team of doctors and nurses. These practitioners are specialists who know all the latest research on pain management and what’s most effective, so patients receive the best of the best in terms of care.
Program attendees learn to employ holistic practices like exercise, meditation, acupuncture and mindfulness to manage pain as they slowly wean off opioids. This gradual decrease in medication helps prevent any negative reactions from cutting off medication before patients are ready.
Over the course of a year, researchers at Kaiser Permanente saw ER visits decrease 25 percent, inpatient admissions drop 40 percent and opioid use decrease greatly for the group of 80 patients in the study. While some patients need medication-assisted treatment to recover from dependency, many are able to gradually decrease the amount of opioids they take with the help of integrated complementary therapy, physical therapy, behavioral therapy and medical care.1
In fact, studies have shown that this integrative form of care is superior to the standard piecemeal medical treatment most people receive.2 And when patients have access to a variety of options to handle pain, they will be less likely to turn to opioids for help.
Other Alternatives to Opioids
Pain management programs are just one of the advancements being made in the realm of pain management. In fact, there are several ways to manage pain without opioids, many of which can be found in a variety of settings.
Here’s a list of some of the alternatives to opioids:
Alternative Pain Medications
According to The New York Times, a randomized trial found that a combination of Tylenol and Advil worked just as well as opioids, on average, for pain relief in the ER.3 While opioids have been seen as the gold standard for pain relief, non-opioids cannot be discounted as viable options, particularly given opioids’ potential for addiction. Anti-seizure medications can also be helpful for certain kinds of nerve pain, while muscle relaxants can help with acute pain from muscle spasms. There are even some antidepressants that have been shown to help with chronic pain.4
Video games, you ask? Yes, video games. Two doctors at the University of Washington School of Medicine have developed an immersive video game called “SnowWorld” that patients can play during painful procedures like burn debridement. The theory behind the use of immersive virtual reality to relieve pain is that pain requires attention, and if the brain is paying attention to something else, it can effectively be distracted from pain. Apparently, diving into the computer world takes a lot of attentional resources, which makes it the perfect distraction from pain. Studies have shown a 30-50 percent reduction in pain with the use of virtual reality.5
Mind Over Matter
Several mind-focused practices can be effective in the management of pain too. Cognitive Behavioral Therapy alone has been shown to reduce pain, and hypnosis, yoga and mindfulness can be beneficial as well. Ongoing research is shining increasing light on the complexity of pain, particularly the role our brains play in it. Sensory inputs shape our experience of it – to the point that one patient saw a nail enter his foot through his shoe, felt excruciating pain and later found that the nail had completely missed his foot, at which point the pain completely dissipated.
Conversely, a doctor who interviewed 200 injured troops during World War II reported that most of them turned down morphine due to lack of pain. Strong emotion or stress can block pain, in the same way that focusing on nothing but pain can amplify its effects.5 If the connection between our brains and pain is that closely related, it’s only natural that brain-focused therapies would help.
According to the American Society of Regional Anesthesia and Pain Medicine, exercises performed under the direction of a physical therapist, acupuncture and nerve stimulation can all be effective in easing pain. There are also interventional techniques involving injections into or around the spinal region that can reduce pain.4
The American College of Physicians issued new guidelines last year for the management of chronic low back pain that included a strong recommendation that patients try alternative therapies before turning to medication.5 Even if opioids are effective at treating pain, the risk of dependence and abuse is too great to ignore, and thankfully doctors and researchers are constantly seeking new and innovative ways to treat pain.
If you’re looking for an alternative to opioids, know that there are many healthy, effective ways to treat your pain. If you or someone you know is addicted to opioids, Michael’s House offers addiction treatment that is tailored to meet the specific physical and psychological needs of each patient.
Don’t hesitate to take action – treating pain is important, but it’s not worth the risks that come with addiction.
By Wesley Gallagher
1 Daley, John. “Pain Management Program Offers an Alternative to Opioids.” NPR, December 29, 2017.
2 Thompson, Dennis, Jr. “Multidisciplinary Programs for Pain Management.” Everyday Health, Accessed January 29, 2018.
3 Bakalar, Nicholas. “Alternatives to Opioids for Pain Relief.” The New York Times, November 8, 2017.
4 “Treatment Options for Chronic Pain.” American Society of Regional Anesthesia and Pain Medicine, Accessed January 29, 2018.
5 Hellerman, Caleb. “Finding Alternatives to Opioids.” PBS, August 31, 2017.