Never Only Opioids
When it comes to managing pain, it is past time to move integrative therapies to a position of treatment parity with prescription drugs. That message – “Never Only Opioids” — is the core of a policy brief just released by the Pain Action Alliance to Implement a National Strategy (PAINS), a consortium of 41 of nation’s leading health and pain management organizations.
The brief, “Never Only Opioids: The Imperative for Early Integration of Non-Pharmacological Approaches and Practitioners in the Treatment of Patients with Pain,” draws together for the first time now well-documented and substantial positive clinical outcomes from successful integrative treatments for pain like acupuncture, massage therapy and chiropractic.
In particular since the onset of the wars in the Middle East, the openness of US military medicine to non-pharmaceutical pain management options has established a track record for integrative therapies that continues to influence many quarters of the US healthcare establishment. Military care providers were perhaps the first to see the devastating effects of addiction that has now reached near epidemic proportions in the US population.
The brief notes the rapidly developing commitment among the nation’s senior institutions of medical practice, research and policy to confront pain, which affects as many as 100 million Americans, and will require serious and innovate ways to change how it is treated. The Institute of Medicine, the National Institutes of Health and a consortium of federal health agencies including the US military health establishment have all organized initiatives and assembled resources to reverse the destructive outcomes that have come from over-prescribed opioid-based pain medication.
The brief is a very helpful compilation of the policy background and the work done by many organizations, many in the PAINS consortium. It cites research showing a cost advantage for integrative therapies for some treatments, and it proposes that an “integrative pain workforce” exists among the many hundreds of thousands of trained and credentialed practitioners whose skills (which often resolve pain issues for their own clients), could contribute to the greater national pain imperative.
The Affordable Care Act created new positions in the US health system for integrative practice and professionals, including in defining the healthcare workforce. This of course includes the provisions of Section 2706, “Non-discrimination in healthcare” written to rectify the imbalance in the insurance market where coverage does not reflect the large public preferences for the services of licensed integrative disciplines.
The brief also notes: “Research into non-pharmacological care is vastly underfunded on the federal level compared to industry funding for drugs and high cost procedures. Despite this disparity, present evidence is more than sufficient to support integration of these strategies and providers in multiple settings.”
The positive experience of military healthcare providers – with good outcomes coming even from the treatment of combat wounded with acupuncture in forward areas – has been so consistent that the Surgeon General of the Army, Lt. Gen. Eric B. Schoomaker, MD, PhD said:
“This is a unique, historic moment to capitalize on what we know works to effectively treat pain. It marks the beginning of a cultural shift in how health care is practiced in the military.”
Gen. Schoomaker who retired in 2012, made those remarks in 2009. Today he is a member of the Advisory Council for the National Center for Complimentary and Integrative Health, NCCIH (formerly NCCAM), where he participates on a special pain research panel. At a fall 2014 conference he expanded the idea of the imperative for integrative therapies in the military to say that the imperative now clearly extends into the mainstream of American care itself.
Use these links to reach more information:
See PAINS member organizations
The October Huffington Post article from its section The Chronicles of Health Creation, by John Weeks, a member of the PAINS author team.
“‘Never Only Opioids’ Urges Imperative for Integrative Medicine in Pain Care”
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