Until recently, opioids have been the go-to choice for physicians treating some types of pain. That has led, at least in part, to high levels of opioid addiction. In turn, this has challenged the healthcare industry to find new, less addictive ways to treat chronic pain. The Centers for Disease Control and Prevention (CDC) found evidence that alternative pain management strategies, including cognitive behavior therapy, acupuncture, medical message and physical therapy, can help patients.
SEEKING RELIABLE ALTERNATIVES TO OPIOIDS
Some studies as well as some doctors say opioids do a poor job of managing common types of pain. While the drugs treat some pain effectively, different kinds of pain require different kinds of treatment. For example, tissue damage is different from nerve damage and therefore requires a different approach to pain management.
In response to the call for better treatments, providers are working to eliminate the use of opioids for certain surgeries and other procedures. This shift is changing decades’ old approaches to managing pain. For example, Cleveland Clinic is using narcotic alternatives before, during and after surgery. Over the last couple years, Cleveland Clinic initiated a postoperative pain management program that looked at the potential for alternatives to narcotics. The results have been positive.
The strategy involves using a regional or local anesthesia, then prescribing a painkiller like acetaminophen or ibuprofen. According to a recent article in Modern Healthcare, the Cleveland Clinic used to prescribe Percocet or Vicodin for C-section patients, then prescribe opioids when the patients were discharged. Now, patients take Tylenol or Motrin, although they can request an opioid for intense pain. Within the first months of making the change, opioid use for post C-section patients dropped by 70%.
“By minimizing and prescribing appropriate amounts of narcotic medicine—that’s how you fight the opioid crises,” Dr. Eric Chiang, an anesthesiologist at Cleveland Clinic, told Modern Healthcare.
Other providers are also moving away from opioids. A recent article in Becker’s ASC Review showcased how three ambulatory surgery centers (ASC) are countering the opioid crisis. The article featured responses sent to the Ambulatory Surgery Center Association, which asked members to share information on their efforts to curb opioid use:
- Shriners Medical Center for Children in Pasadena, California, has a preemptive pain protocol that starts patients on three non-opioid medications 48 hours before surgery. Those meds are continued on the day of surgery and post-surgery. After three years, the facility’s use of post-op opioids dropped by 89% during the patient treatment periods.
- Another ASC created a patient care experience that sets patient expectations. This includes letting patients know that prescriptions for post-surgical pain will be limited. The facility develops individual care plans that include opioid alternatives.
- Another provider often uses less long-acting anesthesia and fewer opioids during surgery and the immediate recovery period than hospitals. Anesthesia providers are often using acetaminophen IV and other non-opioid medications with certain surgery patients at the end of the procedure in the operating room.