Healing Tool Series: Moving Beyond Medications

A one-page pocket guide for primary care physicians highlighting five steps to manage chronic pain without drugs

“Healing Tools” summaries are a collection of evidence-based resources to help providers and patients use integrative health approaches to improve health and wellbeing.

This tool is for:

  • Providers

This tool was created by the:

  • Academic Collaborative for Integrative Health
  • Academic Consortium for Integrative Medicine and Health
  • Academy of Integrative Health & Medicine
  • Integrative Health Policy Consortium

SUMMARY

What is this tool for?

Over 100 million Americans have chronic pain. Nearly 2 million Americans either abused or were dependent on prescription opioids in 2014, and about 91 Americans die every day from an opioid overdose, according to the Centers for Disease Control and Prevention (CDC).[i] Many guidelines and recommendations have been issued in response to the opioid crisis, including the Turn the Tide campaign by former U.S. Surgeon General Vivek H. Murthy, MD, MBA.[ii]

Primary care providers can help end the opioid crisis by offering non-drug approaches for the management of chronic pain that allow patients to reduce the number of opioids while still treating their pain safely and effectively.

A Five-Step Process for Non-Pharmacological Approaches to Pain Management

Moving Beyond Medications: Non-Pharmacological Approaches to Pain Management and Well-Being is a one-page pocket guide that informs primary care providers about non-opioid approaches to pain management and provides a five-step process to follow. These are:

  1. Assess patient’s pain and well-being
  2. Set goals jointly with the patient
  3. Educate the patient about integrative pain management options
  4. Develop a treatment plan with the patient; address potential challenges
  5. Follow up, troubleshoot and modify treatment plan as needed

Step 3 includes a recommendation to educate patients about the evidence behind integrative pain management options such as:

  • Acupuncture
  • Chiropractic, osteopathic and myofascial manipulation
  • Massage therapy and physical therapy
  • Cognitive behavioral therapy, stress management and other psychological therapies
  • Mind-body approaches, meditation, biofeedback and guided imagery
  • Yoga, tai chi and other movement therapies

How does this contribute to an integrative approach?

Combining conventional medicine, self-care, and complementary and alternative medicine can help patients achieve optimal healing, function and wellbeing. The moving beyond medications pocket guide recommends integrative and self-care approaches as the first-line treatment for chronic pain along with conventional medical management.

What does the evidence say about this tool?

The moving beyond medications pocket guide is based on evidence in the Turn the Tide campaign[ii] and the CDC Guideline for Prescribing Opioids for Chronic Pain.[i] Note that this guide is not for cancer patients and patients in palliative or end-of-life care.

The CDC guideline includes the following clinical reminders about when to initiate or continue opioids for chronic pain:

  • Opioids are not first-line or routine therapy for chronic pain
  • Establish and measure goals for pain and function
  • Discuss benefits and risks and availability of non-opioid therapies with the patient

What are the drawbacks to using this tool?

The moving beyond medications pocket guide provides an overview of non-pharmacological approaches to pain management and general advice; it does not, however, provide specifics or information about the evidence behind integrative pain management options.

Additional resources about some integrative pain management options are available on our website.

Who created this tool?

Four organizations collaborated on the moving beyond medications pocket guide:

  • Academic Collaborative for Integrative Health, which represents complementary and alternative medicine (CAM) health and medicine organizations, such as universities and colleges, that focus on integrating those CAM practices and practitioners into education, clinical care, research and policy
  • Academic Consortium for Integrative Medicine and Health, which represents mainstream (non-CAM) academic medical centers and affiliate institutions that seek to advance integrative health care in academic institutions and affiliates
  • Academy of Integrative Health & Medicine, an inter-professional association of clinicians who embrace a person-centered, team-based, integrative approach to health care and provides education, networking and other resources
  • Integrative Health Policy Consortium, an multi-disciplinary, non-partisan organization that works to eliminate barriers to healthcare practices and practitioners through policy change

Sources:

[i] CDC Guideline for Prescribing Opioids for Chronic Pain and Drug overdose deaths in the United States continue to increase in 2015. https://www.cdc.gov/drugoverdose/epidemic/index.html. (Accessed 10/10/17).

[ii] Turn the Tide. (Accessed 10/10/17). https://turnthetiderx.org.

ABOUT THESE INTEGRATIVE HEALTH TOOLS

At Samueli Integrative Health Programs, we believe that achieving optimal health and wellbeing requires an integrative health approach—one that combines and coordinates conventional medicine, self-care, and complementary and alternative medicine.

Translating Evidence into Action

The goal of these summaries is to help providers and patients learn about and access evidence-based integrative health tools. Each featured tool has been vetted by Samueli Integrative Health Programs. Read about more Healing Tools.

Disclosures:

Samueli Integrative Health Programs is a public service of H&S Ventures and does not profit from any of the tools featured in these summaries.

 Patients: Contact your provider before starting any new health program.  Show him/her these resources.