We still have a long way to go, but the good news is that the Centers for Disease Control and Prevention (CDC) recently released an updated Clinical Practice Guidelines for Prescribing Opioids for Pain. In this 2022 revision, there is a very strong emphasis on the use of nonopioid and noninvasive, nonpharmacologic approaches. In fact, the CDC recommends that, “Clinicians should maximize use of nonpharmacologic and nonopioid pharmacologic therapies as appropriate for the specific condition and patient and only consider opioid therapy if benefits are anticipated to outweigh risks.” I’m not certain how that decision is going to be made and if it is left up to the clinician, one can only hope that there are ways to determine if the benefits will outweigh the risks.
Additionally, the CDC acknowledges the barriers to prescribing nonpharmacologic approaches due to the lack of coverage by insurance companies for these services. The CDC notes that, “Public and private payers can support a broader array of nonpharmacologic interventions such as exercise, multidisciplinary rehabilitation, mind-body interventions, cognitive behavioral therapy, and certain complementary and integrative medicine therapies (e.g., acupuncture and spinal manipulation) that increasingly are known to be effective.” There needs to be acknowledgement and support for these services by the health insurers and health systems to allow greater access to noninvasive, effective therapies.
We are certainly moving in the right direction. I suppose that’s the most those of us who know the long-term benefits of nonopioid nonpharmacologic therapies can expect. One big plus is that there are no side effects and no danger of addiction that could lead to overdose with chiropractic, massage, acupuncture, yoga or any of the other therapies used to manage pain. I’m including the link to the updated CDC Guidelines to help bolster your position when asking for prescriptions for nonopioid treatments for your pain management.