Alternatives to Opioids Do Exist — We Just Need to Use Them

According to The New York Times, more Americans were killed in 2015 from drug overdoses than from car accidents and gun homicides combined. This crisis is devastating families and tearing communities apart. It is a crisis that must be solved.

While combating opioid addiction is one of the most important challenges facing our country, we must not lose sight of another crisis that must be solved: helping Americans living with pain. Pain has become such a debilitating condition that it is costing the American economy $635 billion per year in medical costs and lost productivity. The Institute of Medicine estimates that approximately 100 million Americans live with pain. A staggering 40 percent of Americans experiences pain every day.

This includes people suffering from acute pain that is caused by something specific such as surgery, broken bones, dental work or childbirth as well as those suffering from chronic pain from conditions like rheumatoid arthritis, Crohn’s disease and cancer. It also includes millions of Americans working in physically demanding jobs. These men and women spent decades sacrificing their physical health to build our nation. They repair and build our roads and bridges, construct new buildings, and climb utility poles to restore power after a natural disaster. We owe it to them to do everything we can to help them manage the pain they now live with every day as a result of their tireless work.

Unfortunately, pain is often misunderstood and undiagnosed despite being the most common reason Americans access the health care system, contributing to skyrocketing health care costs. People living with pain can often feel isolated and depressed. The good news is that we can help these Americans without putting people already dealing with pain at risk of also facing addiction. Advances in medical technology provide many alternatives to opioids when it comes to treating pain.

For acute pain, cryotherapy — or cold therapy — uses the body’s natural response to cold to treat peripheral nerves, immediately reducing pain and the need for opioids following surgery. Peripheral nerve stimulation involves the use of a small, wearable stimulator to deliver tiny electrical pulses providing targeted pain relief without drugs, implants, anesthesia or incisions.

For those suffering from chronic pain, spinal cord stimulators are devices that use electrical signals to block out pain signals to the brain. This treatment is minimally invasive and specifically targeted, rather than affecting the entire body. Another non-opioid treatment for chronic pain is neuroablation, a procedure that blocks pain signals to the brain using heat on specific nerves that are causing pain.

In cases where drugs may be necessary to treat chronic pain, implantable drug pumps are an effective means of delivering pain medication directly to the spinal cord area. This method reduces the amount of opioids needed to treat pain, because the medicine is delivered in a more efficient and targeted manner, reducing the risk of addiction and overdose.

Medical technology also enables minimally invasive surgery — laparoscopic surgery, video assisted thoracoscopic surgery, and robotic surgery — which delivers safe and effective treatment while reducing the size of a surgical incision, resulting in less trauma and therefore less pain.

These are just a few of the treatments available. In fact, at a recent hearing before the House Energy and Commerce Committee, Dr. Scott Gottlieb, commissioner of the Food and Drug Administration, testified that there are currently more than 200 different medical device alternatives to treat pain.

Many people living with pain also find complementary and integrative therapies, such as acupuncture, massage and cognitive behavioral therapy, to be helpful treatment options. These alternative methods have fewer side effects and long-term risks than other conventional treatments. Unfortunately, many insurers don’t cover the costs of these therapies, forcing patients to pay out of pocket or skip these beneficial treatments altogether. Expanding coverage to include complementary and integrative therapies will help more Americans alleviate pain without opioids.

These options are available to help people living with pain right now. But, in order to ensure that these treatments are made available to as many people as possible, we must change the way we talk about pain. The president’s opioid commission is a good start. Their final report recommends these alternative treatments for pain and encourages the research and development of new technologies and devices to assist in the opioid crisis. It can’t stop there.

As lawmakers consider ways to address opioid addiction as a public health matter in 2018, the conversation must also focus on treating pain as a public health crisis. The media has done tremendous work telling the tragic personal stories of families suffering from losses caused by opioids. I encourage them to also tell the personal stories of the tens of millions of Americans whose lives have been derailed by living with pain.

We must also educate physicians and patients about these alternative treatments. Physicians are rightly concerned about the impact of overprescribing opioids to their patients. However, that concern can’t result in pain going untreated. Neither doctors nor their patients should be put in a situation where the only options to treat pain are opioids or nothing.

Our country cannot afford to see 59,000 people die from drug overdoses, like we experienced in 2016. We also can’t allow the 100 million Americans who live with pain to go untreated. Time and resources invested in advancing medical technology are bearing fruit in the form of alternative treatments for pain. These treatments have the potential to save thousands of lives and improve the quality of life of millions more. Let’s make sure we don’t waste that potential.


Paul Gileno is president of the U.S. Pain Foundation, a nonprofit organization dedicated to serving those who live with pain conditions and their care providers.

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