To acknowledge that the treatment of chronic and episodic pain using opioid driven pharmacologic interventions as a front line approach would be an understatement with respect to the inextricable contribution to the opioid overdose and addiction epidemic that we are currently confronted with in the United States. The concept of pain as a fifth vital sign originated in the Veterans Affairs system in the 1990’s, and became a Joint Commission standard in 2001. A subsequent, general relaxation of opioid prescribing practices has led to an increased reliance upon opioid driven, pharmaceutical interventions for the treatment of chronic and episodic pain.
Since 2003, the United States has been confronted with an alarming increase in accidental, unintentional deaths related to opioid overdose, some of which can be directly attributed to the very medications that were prescribed to address a legitimate medical concern. In March of 2016, the Center for Disease Control released guidelines for the treatment of chronic pain, including an emphasis on significant adjustment with opioid prescribing practices, and a strong recommendation for the utilization of non-pharmaceutical interventions when clinically appropriate. These types of interventions may include treatments such as exercise/physical therapy, chiropractic manipulation, acupuncture and Cognitive Behavioral Therapy (CBT). Adjusting clinical mindset to consider these options will require a shift in thinking with respect to viable options for various conditions such as low-back pain and chronic migraine headaches, which both have been shown to demonstrate a nominal, positive response to extended opioid intervention.
This session will focus on the emerging best practices for the non-pharmacologic treatment of pain. Some of these methods have been established in the literature as “tried and true” approaches to pain management while others will require more extensive research to fully determine the clinical efficacy of treatment utilization with various conditions. Content will include:
Emerging best practices
Evidence based, Non pharmacologic interventions
Applicable to primary care environments