Opioid War & Supporting Research

Opioids don’t work well for many back pain suffers (and they’re addicting)

• The new FDA blueprint or prescriber education add non-pharmacologic options of assessment and treatment to the previous opioid pain management principles.

Potentially this is good news for those of us treating back and spine pain naturally, with the added opportunity for CPEPs and other posture professionals to engage MDs in the spine care world with non-pharm alternatives.

Back pain is a frequent reason for opioid use, but according to the American Society of Anesthesiologists’ opioids aren’t terribly effective for many patients. A recently published study in their official journal found patients who were prescribed opioids for chronic lower back pain had significantly less pain relief and were more likely to abuse their medication when there’s a psychological issue like depression or anxiety. With opioid use, patients with a history of mental illness experienced a mere 21% improvement in back pain, and those who were not (yet) showing signs of depression or anxiety showed just a 39% improvement.

According to study author Ajay Wasan, M.D., professor of anesthesiology and psychiatry at the University of Pittsburgh School of Medicine, “Learning that we are able to better predict treatment success or failure by identifying patients with these conditions is significant. This is particularly important for controlled substances such as opioids, where if not prescribed judiciously, patients are exposed to unnecessary risks and a real chance of harm, including addiction or serious side effects.”

BOTTOM LINE:
Treat low back pain conservatively at first, and always address posture. Communicate this message to other health care providers with intelligence, and you may be surprised at the referrals.

PosturePractice Insight: In addition to relieving pain, teaching people to find and strengthen lost motion patterns with StrongPosture® exercise protocols engages and then empowers them for self-managment. And empowering someone to better control their bodies can can be a powerful antidote for depression.

Cited Study

Wasan, A. D., Michna, E., Edwards, R. R., Katz, J. N., Nedeljkovic, S. S., Dolman, A. J., . . . Jamison, R. N. (2015). Psychiatric comorbidity is associated prospectively with diminished opioid analgesia and increased opioid misuse in patients with chronic low back pain. Anesthesiology, 123(4), 861-72. doi:10.1097/ALN.000000000000076. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26375824