Why Doctors Don’t Use Alternatives To Opioids
As Congress deliberates how to respond to the surging opioid epidemic, a number of bills have been introduced to support the development and Food and Drug Administration approval of a non-opioid pain medication. But the problem in American medicine is not a lack of alternatives to opioids, but the minimal utilization of the many non-opioid treatments for pain that already exist.
Beyond medications, many psychological and behavioral interventions have a substantial ability to reduce pain and improve function. Yet treatments such as physical therapy, cognitive-behavioral psychotherapy and yoga are prescribed far less commonly than opioids.
If Congress simply supports the development of a new non-opioid pain treatment that, like all the others, rarely gets prescribed, it will do little to ameliorate the simultaneous problems of poorly managed pain and opioid overprescribing. It could have a much bigger effect by enhancing insurance benefits (e.g., in Medicaid and Medicare) for psychological and behavioral pain care services provided by interdisciplinary pain management clinics as well as funding training for pain management in medical schools and continuing education programs serving physicians and other health-care professionals.
