As I mentioned in last week’s column, OxyContin and similar opium-based drugs, called opioids, are becoming a huge problem. They now cause more deaths than any other prescription drug and are a “gateway drug” fueling the increase in heroin abuse.
Partly because of the manufacturer falsifying research on just how addictive these drugs are (for which they have paid over $654 million in fines to date, with more cases pending), the medications have gained a foothold in our society that we are now struggling to control.
So what is to be done with patients with chronic pain? This is an important question, because it is such a common problem. According to the American Academy of Pain Medicine, about 100 million Americans suffer with chronic pain — more than heart disease, cancer and diabetes combined.
It seems a few medical providers are looking at what was the best alternative all along: wellness care.
Consider the military. Veterans have a huge problem with addiction to opioids. One Veterans Affairs hospital earned the name “Candy Land” because the doctors were giving opioids out like candy. But there is one facility where that doesn’t happen: the Integrated Service Network in the Bronx.
They have the lowest opioid prescribing rate of any of the VA offices, largely because of the efforts of Dr. Heidi Klingbeil, chief of physical medicine and rehab. Her approach is considered innovative and a fresh, effective look at the problem of chronic pain: diagnose the problem and treat it, rather than mask it with painkillers. She refers patients for acupuncture, chiropractic, (most prescriptions for chronic pain are given for back and neck pain), physical therapy (especially exercise), even Reiki, a form of energy healing.
Painkillers are not considered a valid treatment for chronic pain, because of the side effects.
The state of Florida also began using an integrated model for treatment of their chronic pain patients covered by Medicaid. They found this group had among the highest overall health expenses, rising faster than the rest of the population. Also increasing, of course, was their painkiller use, and resultant overdoses and deaths.
They began offering natural, wellness-based providers — especially doctors of chiropractic, acupuncturists, and massage therapists — and compared outcomes after two years. These providers managed to reduce the overall costs of the program by about 9 percent, while the patients who continued with medical care saw their expenses increase by 15 percent, which had been the case for the previous few years. Also, the integrated patients averaged a 20 percent improvement in both their mental and physical health, compared with 5 percent for the patients who saw medical providers only.
From my viewpoint as a wellness provider, the sooner we change our attitudes and behaviors towards chronic pain, the better. We need to realize drugs are only a short-term solution for pain and cause more problems in the long run; that the patient has to participate in their care, beyond just taking their pills on time; and there are very effective, safe, natural treatments that do not rely on pills. These changes need to happen among the public as well as our health care providers. Our addiction to painkillers, as well as many other drugs, cannot be addressed by a health care system that only knows how to medicate these problems and a public that expects a pill to fix their chronic, difficult health issues.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at firstname.lastname@example.org.