Putting Pain in its Place: Safer Treatment Alternatives to Opioids

Topics: Opioids

Fifty million Americans – just over 20 percent of the population – battle chronic pain. About 20 million of those pain sufferers have had high-impact chronic pain, causing discomfort severe enough to frequently limit life or work activities.

For years, the drugs of choice for combating chronic pain have been opioids. Activating opioid receptors on nerve cells, prescription opioids like oxycodone, hydrocodone, codeine and morphine are being used to treat everything from low back pain and migraines to pain linked to multiple sclerosis and different kinds of cancer.


Opioid Alternatives: Different Paths to Pain Management

safer alternatives to prescription opioids

When it comes to treating chronic pain, the Centers for Disease Control and Prevention (CDC) has a clear-cut stance: Opioids should not be first-line therapy. Instead, non-pharmacologic therapy and non-opioid pharmacologic therapy are the preferred treatment options. The CDC recommends several alternatives for managing chronic pain, including:

Physical therapy (PT). There is substantial research supporting PT as a viable treatment option for chronic pain. Through movement, hands-on care and patient education, physical therapists can help their patients not only improve function and range of motion, but also alleviate debilitating pain. To help stem the opioid epidemic, the American Physical Therapy Association launched a national campaign entitled #ChoosePT. Introduced in 2016, the campaign continues to raise awareness among patients and prescribers about PT as a safe alternative for pain management.

Non-opioid medications. Non-opioids like acetaminophen, ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) can control mild to moderate pain. Tylenol, a well-branded version of acetaminophen, relieves pain much like NSAIDs do, although it’s not as effective at reducing inflammation. Whether used alone or with other medications, NSAIDs such as aspirin and ibuprofen can help curb pain and reduce inflammation.

Exercise. Physical activity can help people push through a number of chronic pain conditions, including low back pain, arthritis and fibromyalgia, according to Harvard Medical School. Regular exercise keeps joints moving well, contributes to muscle strength, improves mental health and helps keep a person’s weight in check, all ways to keep pain at bay.

Massage therapy. By relaxing muscle tissue, tendons and joints, therapeutic massage can reduce painful contractions and spasms. Additionally, massage can alleviate pain by stimulating competing nerve fibers and impeding pain messages that travel to and from the brain. In 2018, the Centers for Medicare and Medicaid Services announced that many Medicare Advantage plans would cover massage therapy for pain management. To highlight the health benefits of therapeutic massage, the American Massage Therapy Association recently published a white paper entitled, “Massage Therapy in Integrative Care & Pain Management.

Yoga. Clinical research suggests that yoga may improve pain outcomes and mood in people saddled with persistent pain. Featured on CNN, yoga expert Dana Santas shares eight yoga poses for chronic pain relief at happify.com.

Interventional treatments. Interventional pain management utilizes pain-blocking techniques to help make daily activities less daunting. There are a number of physician-performed treatments, each varying in terms of invasiveness. The more common ones include nerve blocks, infusions, epidural and joint injections, radiofrequency ablation, spinal cord stimulation and peripheral nerve field stimulation.

Cognitive behavioral therapy (CBT). A form of talk therapy, CBT helps people identify and develop skills to change negative thoughts and behaviors. Research shows that this form of psychotherapy can help people cope with depression, panic disorder and other health conditions. Moreover, there is mounting evidence that CBT can help relieve chronic pain. When used to treat chronic pain, CBT is often used in conjunction with other methods of pain management, from medications and physical therapy to weight loss and massage.


Prescription Opioids: A Prescription for Disaster

America’s current struggle with opioid addiction began in the 1990s and intensified through the first part of the new millennium. From 1999 to 2014, the amount of opioids prescribed and sold in the U.S. quadrupled. Tragically, that wasn’t all that skyrocketed. Deaths caused by the most commonly used opioid pain relievers also quadrupled over the same period. From 1999 to 2017, almost 218,000 people died in the U.S. from overdoses related to prescription opioids, per the CDC.

Leading the charge against opioid addiction, the CDC developed a comprehensive guide centered on responsible opioid use. The guide’s recommendations focus on the use of opioids in treating chronic pain outside of active cancer treatment, palliative care and end-of-life care. Touching on everything from opioid selection, dosage and duration to non-opioid therapies, the guide is designed to:
  • Improve communication between primary care clinicians and their patients about the risks and benefits of opioid therapy for chronic pain.
  • Enhance the safety and effectiveness of pain treatment.
  • Lower the risks associated with long-term opioid therapy including opioid use disorder and overdose.


Partners in the Fight Against Opioid-related Risks

Despite a recent decline in fatal opioid overdoses, the opioid crisis continues to plague America. Realizing the risks injured employees face when struggling with pain management, AmTrust partnered with Optum Workers' Comp and Auto No-Fault, a pharmacy care management company, to help stop the dangerous cycle of overprescribing, misuse and addiction.

Launched in 2018, the initiative has had an immediate impact on reducing the volume and duration of opioid prescriptions issued to injured workers covered by AmTrust-insured employers. Since joining forces, the two organizations have prevented the filling of nearly 13,000 prescriptions that could have been deemed unsafe. Additionally, AmTrust has seen a drastic reduction in the percentage of opioid-related claims, dropping from nearly 60 percent to just under 25 percent in Q4 of 2018.

As the nation’s number one workers’ compensation insurance carrier for small businesses, AmTrust has the insight and resources to help protect your insureds and their employees. Our underwriters can create customized workers’ compensation coverage plans designed to meet the specific needs of your insureds.

To become an AmTrust-appointed agent, visit us online today.

This material is for informational purposes only and is not legal or business advice. Neither AmTrust Financial Services, Inc. nor any of its subsidiaries or affiliates represents or warrants that the information contained herein is appropriate or suitable for any specific business or legal purpose. Readers seeking resolution of specific questions should consult their business and/or legal advisors. Coverages may vary by location. Contact your local RSM for more information.
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