To counter the rising number of opioid addictions and deaths, Bay Area physicians and therapists are using alternative methods to manage and reduce chronic pain.

The Bay Area is not immune from the opioid crisis. However, our medical community is responding with innovative solutions that treat chronic pain without relying on opioid or narcotic medications — and Canopy Health alliance members are at the forefront of this fight. Keep reading to learn more about exciting options for treating chronic pain that reduce your risks of opioid addiction.

The Bay Area and the Opioid Epidemic

Chronic pain and opioid dependence are major public health challenges. Chronic pain costs over half a trillion dollars annually in medical costs, disability programs, and lost productivity. A recent study by the CDC revealed that 50 million Americans, just under 20% of the age-adjusted adult population, suffer from chronic pain. Nearly 20 million experience high-impact chronic pain that limits their life or work activities on most days. Pain patients often rely on powerful drugs such as opioids to cope. Sometimes, the consequences are deadly.

Opioids are a class of drugs that include illegal street drugs like heroin as well as prescription pain relievers like oxycodone, hydrocodone, codeine, morphine, fentanyl, and others. As a class of drugs, opioids are all chemically related and interact with opioid receptors on nerve cells in the brain and nervous system. Using these substances can produce pleasurable feelings and relieve pain.

Prescription opioids are used to treat moderate to severe pain, although some opioids are used to treat coughing and diarrhea. They can also make people feel very relaxed and "high," which is why they are sometimes abused. Because opioids are highly addictive, overdoses and death are common.

According to a 2016 report from the American Society of Addiction Medicine, drug overdose is the leading cause of accidental death in the United States, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic with 20,101 overdose deaths related to prescription pain relievers and 12,990 overdose deaths related to heroin in 2015.

Closer to home, 2,196 people in California died from opioid overdoses and more than 4,280 others visited the ER due to an overdose in 2017.

There Is No Typical Opioid Abuser

Opioid addiction impacts people from every walk of life, and there is no typical opioid user. However, there are some worrying trends for certain populations.

Adolescents and Young Adults

In 2015, an estimated 276,000 adolescents between the ages of 12 and 17 were current nonmedical users of pain relievers, and 122,000 had an addiction to prescription pain relievers. An estimated 21,000 adolescents had used heroin in the past year, and an estimated 5,000 were current heroin users. In 2017, 30 people between the ages of 10 and 19 died from an overdose in California.

Every opioid death is a tragedy, but the deaths of these young people are truly heartbreaking. Utilizing alternative treatments can help limit the availability of opioids and curb the effects of this trend on younger individuals.

Women

Women are more likely to have chronic pain, receive prescription pain relievers, be given higher doses, and take them for greater lengths of time than men. Because of this, women may become dependent on prescription pain relievers more quickly than men.

Heroin overdose deaths among women have tripled in the last few years. Four in five new heroin users started out misusing prescription painkillers. In fact, 94% of respondents in a 2014 survey of people in treatment for opioid addiction said they chose to use heroin because prescription opioids were too expensive and hard to obtain.

Privately Insured Individuals

An estimated 37% of adults who struggle with opioid addiction have private insurance. In 2016, employer-sponsored health plans covered roughly $2.6 billion of addiction and overdose-related care.

Alternative Pain Treatments to Avoid Opioid Use

Other methods of managing chronic pain do not include the use of opioids. Examples include:

  • Acetaminophen is a common and effective pain reliever, and the American College of Rheumatology recommends it as the first line of treatment.
  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) include ibuprofen, aspirin, and naproxen. More potent than acetaminophen, most NSAIDs are available as over-the-counter medications. Higher doses are available with a prescription. However, some adverse side effects include a higher risk of kidney or liver toxicity and ulcers.
  • Corticosteroids reduce swelling and provide pain relief. Drawbacks include the potential to accelerate joint destruction, immune system suppression, gastrointestinal toxicity, and psychiatric effects.
  • Serotonin and Norepinephrine Reuptake Inhibitors (SSRIs) are a form of anti-depressants, and some can also treat nerve, muscular, and skeletal pain. They may also be prescribed to help people sleep.

Both exercise and physical therapy can also help relieve chronic pain and maximize function. Although an intensive therapy schedule and home-based program may demand more effort, it is an effective option for improving physical healing and relieving pain over the long-term.

Behavioral Medicine: Another Form of Pain Management

Behavioral medicine aims to modify the overall pain experience, help restore functioning, and improve the quality of life of patients who suffer from chronic pain. The most common interventions include acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT).

CBT recognizes that our emotions can impact our pain levels and behavior. It is highly effective in the treatment of several chronic pain conditions, including fibromyalgia, headaches, low back pain, osteoarthritis, and rheumatoid arthritis. A primary goal of treatment is for the patient to suffer less by becoming actively involved in what matters most to them despite having and experiencing pain.

ACT treatment is difficult, as there are no simple solutions to chronic pain. Patients might feel a range of emotions, such as sadness, anger, anxiety, and hopelessness during the intervention, but this response is natural and perfectly normal. The role of the therapist is to help patients accept whatever discomfort exists, both physical and emotional, while continuing to live their lives. Doing so can help patients make meaningful changes in their lives and reduce suffering.

Many of Canopy Health’s carrier partners’ health plans cover behavioral health treatment. To learn more, talk to your primary care physician (PCP) about your mental and behavioral health needs.

Canopy Health’s Alliance Offers Innovative Care Options for Chronic Pain

Canopy Health’s alliance of hospitals, physicians, and care centers offers many treatment options that may reduce or eliminate your need for opioids. UCSF Health and others are researching ways to control pain without addictive medications. And UCSF Benioff Children’s Hospital has experimented with virtual reality (VR) to treat pain from sickle cell anemia and other conditions.

The Canopy Health alliance is working toward providing a means to stop and reduce opioid addiction. If you’re having a difficult time finding the right physician or care center for treatment and support, contact Canopy Health by completing our online form or calling us at 888-8-CANOPY. Our team will help you find refreshingly clear, human care.

References

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Dahlhamer, J., Lucas, J., Zelaya, C., Nahin, R., Mackey, S., DeBar, L., Kerns, R.,... Helmick, C. (2018, September 14). Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults — United States, 2016. Morbidity and Mortality Weekly Report 67(36), pp. 1001-1006. Retrieved from https://www.cdc.gov/mmwr/volumes/67/wr/mm6736a2.htm

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