Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

It’s time for a reckoning in pain medicine

Cindy Perlin, LCSW
Conditions
November 17, 2022
165 Shares
Share
Tweet
Share

More than a million Americans have died since the late 1990s from drug overdoses, with the vast majority dying from an opioid overdose. This trend started with the heavy marketing of opioids to physicians as nonaddictive and effective. The number of deaths from overdose has escalated significantly in the past few years. Although many of the recent opioid-related deaths are from fentanyl, substance abuse treatment providers report that 80 percent of illicit opioid users got addicted after being prescribed opioid painkillers.

Opioid overdose deaths are just the tip of a very problematic iceberg. Opioid addiction, which affects millions of patients annually, creates havoc for families and communities and costs the economy over one trillion dollars annually in medical and law enforcement costs and lost productivity.

Despite this, research indicates that physicians and dentists continue to write huge numbers of opioid prescriptions for new patients, many of whom have relatively minor pain issues such as acute low back pain, sprained ankles, or tooth extractions.

When they’re not writing prescriptions for opioids, many physicians are writing prescriptions for other potentially life-threatening or debilitating classes of often ineffective drugs, including anti-inflammatory drugs (NSAIDs), gabapentinoids, immunosuppressive drugs, and antidepressants.

When that fails, physicians refer patients for surgical interventions that have high failure rates, such as spinal fusion surgery, or that have been shown to be no more effective than less invasive treatments, such as arthroscopic knee surgery.

The problem is that pain is not a medication or surgical deficiency. Its possible causes include inflammatory diets, nutritional deficiencies, toxic exposures, muscle imbalances or weaknesses, chronic stress, or unresolved trauma. And the many available safe, effective treatments are being ignored by conventional physicians and denied coverage by insurance companies. This leaves patients suffering unnecessarily and seeking their own solutions, sometimes from dangerous drugs on the streets.

Here are just a few of the options that physicians should be recommending for patients:

Medical marijuana. Most pain patients who have switched from opioids to medical marijuana report more effective pain relief with fewer side effects. In addition, in over 5,000 years of known use, no one has ever died of a marijuana overdose.

Kratom. A Southeast Asian herb that is currently used by millions of Americans. It is not only an effective and safe pain reliever but also effective in relieving opioid withdrawal symptoms, allowing many who have become dependent or addicted to opioids to stop using them without the suffering that usually accompanies opioid withdrawal. Kratom also helps with anxiety and insomnia. The FDA has been very aggressive in trying to ban kratom, and several states have made it illegal as a result.

Low-dose naltrexone. This drug is commonly used to treat alcohol or drug addiction. It has been found to relieve chronic, centralized pain in tiny amounts, sometimes as low as 0.1 mg. It appears to get the body to increase the production of endorphins, the body’s endogenous opioids.

Nutritional interventions. Many Americans’ nutritionally inadequate, pro-inflammatory diet appears to contribute to many kinds of chronic pain, including arthritis, fibromyalgia, and neuropathic pain. An anti-inflammatory diet and supplementation with vitamin D, magnesium, B12, and omega-3 fatty acids have been shown to relieve these types of pain.

Mind/body interventions. Trauma, especially chronic childhood trauma, has been shown to increase the likelihood of all kinds of chronic illnesses, including chronic pain. Chronic stress also is a driver of chronic pain and chronic illness When people live in constant overarousal, muscles remain tense, there is reduced circulation to peripheral tissues, and suppressed digestion, immune response, and bodily repair psychotherapy, especially with rapid trauma release techniques like energy psychology and EMDR, biofeedback, neurofeedback and relaxation training are among the most helpful mind/body therapies for pain relief.

Massage. Ten weekly deep tissue massage sessions or myofascial release have been shown to provide extended pain relief for musculoskeletal pain.

Acupuncture. In 2020, Medicare announced they would pay for acupuncture treatment of low back pain, stating that it was based on evidence that acupuncture is an effective treatment for that condition. Acupuncture has also been shown to be helpful for many other kinds of pain, including acute pain, headaches, neuropathy, and fibromyalgia.

Light therapy. Thousands of studies have shown Red and infrared light therapy with low-level lasers or LEDs to reduce pain and inflammation and promote tissue healing. It does this by increasing the production of ATP, the fuel our cells use for energy, as well as increasing the permeability of cell membranes, which allows waste products to be removed and nutrition and oxygen to be absorbed into the cells more efficiently. It also increases the production of endorphins, the body’s own painkillers. Green light therapy has also been shown to be helpful for migraines and fibromyalgia. Inexpensive devices for home use are now available, as well as more powerful clinical devices.

This is not an exhaustive list. There is much more. A lot of innovation is now occurring in the arena of electrical stimulation therapies, electromagnetic therapies, sound therapies, and more.

Yes, I know that these therapies are not affordable for many patients because they are not covered by insurance. That is why it is time for a massive provider and patient education campaign and spirited advocacy efforts to ensure that these safe and effective treatments are accessible to any patient who can benefit from them. Then we can finally end the dual epidemics of opioid addiction and chronic pain.

Cindy Perlin is a licensed clinical social worker, chronic pain survivor, and author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free. She is founder and CEO, Alternative Pain Treatment Directory and can be reached on Facebook.

Image credit: Shutterstock.com

Prev

The story of a physician, after a year sober

November 17, 2022 Kevin 1
…
Next

Leaving The House of God

November 17, 2022 Kevin 3
…

Tagged as: Pain Management

Post navigation

< Previous Post
The story of a physician, after a year sober
Next Post >
Leaving The House of God

More by Cindy Perlin, LCSW

  • From suffering to healing: the role of trauma in chronic pain

    Cindy Perlin, LCSW
  • The feds say restrict opioid use. Now what?

    Cindy Perlin, LCSW
  • Pain patients are being cut off from their drugs. Here’s why.

    Cindy Perlin, LCSW

Related Posts

  • Merging the wisdom of pain medicine and addiction medicine to optimize outcomes

    Julie Craig, MD
  • 5 hidden consequences of chronic pain

    Toni Bernhard, JD
  • 5 things I wish I had known earlier about chronic pain

    Tom Bowen
  • Using low-dose naltrexone to treat pain

    Alex Smith
  • Blame the pain, not the opioids

    Angelika Byczkowski
  • On the internet, you are looking for something to make you angry

    Judson Ellis

More in Conditions

  • Breaking down barriers: How technology is improving diabetes management in underserved communities

    Anonymous
  • Yoga and self-care won’t cure my Crohn’s disease

    Kristen L. Cole
  • What causes fainting and how to prevent it during needle procedures

    Jean Paul Brutus, MD
  • Healing through love and spirituality

    John T. James, PhD
  • Lifestyle change: the forgotten solution in health care

    Tyler Petersen
  • Breaking the cycle of childhood obesity

    Martin C. Young, MD
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Unintended consequences of Health Care Quality Improvement Act: a violation of physicians’ civil and constitutional rights

      Farid Gharagozloo, MD & Rainer Gruessner, MD & Robert Poston, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
    • From penicillin to digital health: the impact of social media on medicine

      Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson | Social media
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • How to overcome telemedicine’s biggest obstacles

      Harvey Castro, MD, MBA | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
    • Redefining success: a journey of self-discovery and fulfillment [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Small Gains in Cardiorespiratory Fitness Track With Improved Longevity
  • Improved OS With Hyperfractionated RT in Recurrent Nasopharyngeal Carcinoma
  • GPT-4 Is Here. How Can Doctors Use Generative AI Now?
  • Rapid Improvement in Atopic Dermatitis With Topical PDE4 Inhibitor
  • No Benefit to Conventional Ultrafiltration During Cardiac Surgery

Meeting Coverage

  • Rapid Improvement in Atopic Dermatitis With Topical PDE4 Inhibitor
  • New Approaches in the Bladder-Sparing Paradigm
  • Response Rates in Hidradenitis Suppurativa Continue to Climb With New Therapies
  • Another Win for a JAK Inhibitor in Alopecia Areata
  • Biologic Switch Revs Up Response in Plaque Psoriasis
  • Most Popular

  • Past Week

    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Unintended consequences of Health Care Quality Improvement Act: a violation of physicians’ civil and constitutional rights

      Farid Gharagozloo, MD & Rainer Gruessner, MD & Robert Poston, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • From physician to patient: one doctor’s journey to finding purpose after a devastating injury

      Stephanie Pearson, MD | Physician
    • An unspoken truth about non-compete clauses in medicine

      Harry Severance, MD | Policy
    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • Why are doctors sued and politicians aren’t?

      Kellie Lease Stecher, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • Breaking down barriers: How technology is improving diabetes management in underserved communities

      Anonymous | Conditions
    • From penicillin to digital health: the impact of social media on medicine

      Homer Moutran, MD, MBA, Caline El-Khoury, PhD, and Danielle Wilson | Social media
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • How to overcome telemedicine’s biggest obstacles

      Harvey Castro, MD, MBA | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
    • Redefining success: a journey of self-discovery and fulfillment [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

It’s time for a reckoning in pain medicine
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...