NEWS
19/03/2018 2:31 AM IST

Chronic Pain Patients Need -- And Want -- Non-Opioid Options

Philip Curtis / EyeEm via Getty Images

Approximately11.5 million U.S. adults misused prescription painkillers in the past year ― and for more than half of them, the reason for the misuse was physical pain.  

We hear a lot about opioid-related deaths and overdoses in the news, but we rarely talk about the underlying issues that lead so many to look for any and all options available. Many opioid users suffer from chronic illness and are prescribed opioids because other treatments grant them no relief.

Attorney General Jeff Sessions recently said that chronic pain sufferers should “take some aspirin … and tough it out.” Unfortunately, his insensitivity and ignorance surrounding chronic pain is not unique. Chronic pain is a complex condition and, in many cases, is unsolvable, longstanding and misunderstood.  

Like nearly 100 million other U.S. adults, I too suffer from chronic pain. I have systemic lupus and advanced osteoarthritis, and the combination of these two diseases means I live with almost daily aches and pains, ranging from minor to extreme, and from slight achiness to total immobility.

I know how difficult it is to live a full, rich life while experiencing unending throbbing, stabbing and burning.I’ve also learned to work around my limitations and ignore my pride. I use a wheelchair in the airport when I need it. I “chair dance” at parties when my spirit is willing but my body is weak. But I worry about the social events with too few chairs, about the happy hours, the fundraisers and the buildings without elevators. I’ve even had cab drivers reprimand me for hailing a ride to the train station only a few blocks away.

No one can say they are forever immune to chronic pain; it eventually affects many of us after surgery, after injury, after illness or simply as we age. And all Americans pay the price; according to a 2011 report from the Institute of Medicine, chronic pain costs the nation an estimated $565 billion to $635 billion in treatment costs and lost productivity.

Few good treatment options exist for chronic pain patients ― believe me, I’ve tried my share. Knee braces. Canes. Anti-inflammatories. Steroids. Aqua therapy. Physical therapy. Acupuncture. Infusions and shots in my knees. (Yes, in my knees.) Once a skeptic of alternative therapies, I even went vegan, slopped on some arnica and capsaicin cream, digested turmeric and completed a Mindfulness Based Stress Reduction class. Twice. Many of these alternative treatments are prohibitively costly and not covered by insurance, limiting services for the uninsured or those who are on a fixed or limited income.

However, I’m considered one of the lucky ones. I live in a college town with a nationally recognized university hospital and a wonderful and humane team of doctors who are attentive to my concerns and respected in their fields. I have good health insurance and am able to attend my appointments. I respect and heed my doctors’ recommendations and take my medications as prescribed.

Still, this is often not enough. When pain wakes me up in the middle of the night and renders me unable to fall back asleep ― and none my remedies, patches, ointments, deep breaths and meditation options are working ― I understand, deep in my core, that desire to get relief in any way possible. I empathize with the desperation, the panic, the futility and the deep longing for a life without pain.

Chronic pain is a complex condition and, in many cases, is unsolvable, longstanding and misunderstood.

Last Tuesday, the Journal of the American Medical Association released a much-anticipated study that compared opioid and non-opioid medications for patients with moderate to severe chronic pain. The randomized clinical trial followed 240 patients over 12 months and found that opioids were not as effective as non-opioid medications in treating back pain and osteoarthritis in the knee and hip.

When you live with chronic pain, you long for the “you” that existed before the disease: to experience a day where you’re not consumed by your symptoms; to not have pain be your constant companion. This study is the first of its kind to reveal that opioids might not be the most effective treatment for patients with pain. It gives all of us with chronic pain hope that the field — the research, the medications, the treatments — will respond accordingly. It gives us hope that one day, we will live pain-free.

More research needs to be done on alternative treatments for chronic pain. A few studies, including this recent one, have shown progress. But funding for this work is not keeping pace and, as a result, research into these treatments is inadequate. Innovation is desperately needed in pain management to develop more non-opioid options for patients. We need to evolve in our understanding of what pain is, how it impacts individuals and communities, and how it is assessed and treated. Currently, the ways in which we measure pain and treatment effectiveness are limited.

I remember the “me” who lived without pain. And I miss her. I want to live a vibrant, self-determined life without limitations. I want to mature into a blissful old lady. I want both a rich present and future. I don’t think that’s too much to ask.

Janna Wagner is co-founder and chief learning officer at All Our Kin. She is a lecturer in Education Studies at Yale University and a Public Voices Fellow at Yale. She is also a Pahara-Aspen Education Fellow.

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