MOVING BEYOND MEDICATIONS
Pain is the most common reason for seeking medical care. It is also a common reason why many people turn to complementary and integrative health approaches. For many of the millions suffering from pain, medications, including opioids, have been the first line approach to pain management. Unfortunately, this has led to what is now referred to as the "opioid crisis." Roughly, 91 Americans die each day from an opioid overdose, whether through the use of prescription pills or illicit drugs such as heroin and fentanyl. Even with significant attention and resources devoted to curbing the crisis, opioid misuse and abuse has only led to more deaths across the country. Opioids were involved in 42,249 deaths in 2016, surpassing 2015's record of 33,091 deaths, and five times higher than 1999 (Centers for Disease Control and Prevention, https://www.cdc.gov).
The Consortium, working closely with strategic partners, is dedicating its efforts to helping health care Move Beyond Medications. Join us by signing up below and follow this page. We will work to continue to provide the latest knowledge and information.
White Paper on Nonpharmacologic Strategies for Pain Now Available
Beginning January 1, 2018, the Joint Commission’s revised pain standard will include nonpharmacologic options for pain as a scorable element of performance. The Consortium’s Pain Task Force has been working for a year on the White Paper: Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care, which is now available for download HERE.
PRINT THE POCKET GUIDE
In response to the current public health crisis of opioid abuse, overdose, and death, many organizations have issued guidelines and recommendations for treating pain, including the former Surgeon General's "Turn the Tide" campaign. Similar to other guidelines, this campaign recommends nonpharmacologic approaches as first line pain treatment, with opioids to be considered only if these and non-opioid pharmacological treatments are ineffective. This document expands upon those recommendations to help primary care clinicians and their patients with this approach.
EVIDENCE SUMMARIES FOR THE TREATMENT OF PAIN
Noninvasive, Nonpharmacological Treatment for Chronic Pain:
A Systematic Review
Draft Comparative Effectiveness Review U.S. Agency for Healthcare Research and Quality (AHRQ)
The Consortium and other pain experts have provided comments as part of the AHRQ call for predissemination peer review of this document. The draft document is posted here as a resource to provide a comparative effectiveness review of the evidence on noninvasive, nonpharmacological treatments for common chronic pain conditions, focusing on whether improvements are seen for at least one month post-intervention. While this results in not including some studies, by doing so it focuses on more sustainable benefits of nonpharmacological approaches.
The Draft Comparative Effectiveness Review is posted HERE.
The final version of the review will be posted on this website as soon as it is available.
Key Messages of the Draft Review:
- A number of nonpharmacological interventions may improve function or pain outcomes 1 month to 1 year after the completion of therapy; evidence for some treatments and conditions is limited.
- Exercise, acupuncture, multidisciplinary rehabilitation, mind-body and mindfulness practices and psychological therapies such as cognitive-behavioral therapy may improve function or pain outcomes for specific chronic pain conditions.
- There was no evidence suggesting serious harms from any of the interventions studied, although data on harms were limited.
- Additional comparative evidence with data on the sustainability of effects on function and pain outcomes is particularly needed for chronic tension headache, as well as for osteoarthritis, chronic neck pain, and fibromyalgia.
ARTICLES OF INTEREST
OTHER NEWS OF NOTE
On September 18, 2017, the National Association of Attorneys General (NAAG) wrote to the America's Health Insurance Plans (AHIP) call for coverage to be revised to support non-opioid approaches to pain management. In the letter below, signed by 37 Attorneys General, NAAG requested that AHIP "take proactive steps to encourage your members to review their payment and coverage policies and revise them, as necessary and appropriate, to encourage healthcare providers to prioritize non-opioid pain management options over opioid prescriptions for the treatment of chronic, non-cancer pain."