More than a million Americans have died since the late 1990s from drug overdoses, with the vast majority dying from an opioid overdose. This trend started with the heavy marketing of opioids to physicians as nonaddictive and effective. The number of deaths from overdose has escalated significantly in the past few years. Although many of the recent opioid-related deaths are from fentanyl, substance abuse treatment providers report that 80 percent of illicit opioid users got addicted after being prescribed opioid painkillers.

Opioid overdose deaths are just the tip of a very problematic iceberg. Opioid addiction, which affects millions of patients annually, creates havoc for families and communities and costs the economy over one trillion dollars annually in medical and law enforcement costs and lost productivity.

Despite this, research indicates that physicians and dentists continue to write huge numbers of opioid prescriptions for new patients, many of whom have relatively minor pain issues such as acute low back pain, sprained ankles, or tooth extractions.

When they’re not writing prescriptions for opioids, many physicians are writing prescriptions for other potentially life-threatening or debilitating classes of often ineffective drugs, including anti-inflammatory drugs (NSAIDs), gabapentinoids, immunosuppressive drugs, and antidepressants.

When that fails, physicians refer patients for surgical interventions that have high failure rates, such as spinal fusion surgery, or that have been shown to be no more effective than less invasive treatments, such as arthroscopic knee surgery.

The problem is that pain is not a medication or surgical deficiency. Its possible causes include inflammatory diets, nutritional deficiencies, toxic exposures, muscle imbalances or weaknesses, chronic stress, or unresolved trauma. And the many available safe, effective treatments are being ignored by conventional physicians and denied coverage by insurance companies. This leaves patients suffering unnecessarily and seeking their own solutions, sometimes from dangerous drugs on the streets.

Here are just a few of the options that physicians should be recommending for patients:

Medical marijuana. Most pain patients who have switched from opioids to medical marijuana report more effective pain relief with fewer side effects. In addition, in over 5,000 years of known use, no one has ever died of a marijuana overdose.

Kratom. A Southeast Asian herb that is currently used by millions of Americans. It is not only an effective and safe pain reliever but also effective in relieving opioid withdrawal symptoms, allowing many who have become dependent or addicted to opioids to stop using them without the suffering that usually accompanies opioid withdrawal. Kratom also helps with anxiety and insomnia. The FDA has been very aggressive in trying to ban kratom, and several states have made it illegal as a result.

Low-dose naltrexone. This drug is commonly used to treat alcohol or drug addiction. It has been found to relieve chronic, centralized pain in tiny amounts, sometimes as low as 0.1 mg. It appears to get the body to increase the production of endorphins, the body’s endogenous opioids.

Nutritional interventions. Many Americans’ nutritionally inadequate, pro-inflammatory diet appears to contribute to many kinds of chronic pain, including arthritis, fibromyalgia, and neuropathic pain. An anti-inflammatory diet and supplementation with vitamin D, magnesium, B12, and omega-3 fatty acids have been shown to relieve these types of pain.

Mind/body interventions. Trauma, especially chronic childhood trauma, has been shown to increase the likelihood of all kinds of chronic illnesses, including chronic pain. Chronic stress also is a driver of chronic pain and chronic illness When people live in constant overarousal, muscles remain tense, there is reduced circulation to peripheral tissues, and suppressed digestion, immune response, and bodily repair psychotherapy, especially with rapid trauma release techniques like energy psychology and EMDR, biofeedback, neurofeedback and relaxation training are among the most helpful mind/body therapies for pain relief.

Massage. Ten weekly deep tissue massage sessions or myofascial release have been shown to provide extended pain relief for musculoskeletal pain.

Acupuncture. In 2020, Medicare announced they would pay for acupuncture treatment of low back pain, stating that it was based on evidence that acupuncture is an effective treatment for that condition. Acupuncture has also been shown to be helpful for many other kinds of pain, including acute pain, headaches, neuropathy, and fibromyalgia.

Light therapy. Thousands of studies have shown Red and infrared light therapy with low-level lasers or LEDs to reduce pain and inflammation and promote tissue healing. It does this by increasing the production of ATP, the fuel our cells use for energy, as well as increasing the permeability of cell membranes, which allows waste products to be removed and nutrition and oxygen to be absorbed into the cells more efficiently. It also increases the production of endorphins, the body’s own painkillers. Green light therapy has also been shown to be helpful for migraines and fibromyalgia. Inexpensive devices for home use are now available, as well as more powerful clinical devices.

This is not an exhaustive list. There is much more. A lot of innovation is now occurring in the arena of electrical stimulation therapies, electromagnetic therapies, sound therapies, and more.

Yes, I know that these therapies are not affordable for many patients because they are not covered by insurance. That is why it is time for a massive provider and patient education campaign and spirited advocacy efforts to ensure that these safe and effective treatments are accessible to any patient who can benefit from them. Then we can finally end the dual epidemics of opioid addiction and chronic pain.

Cindy Perlin is a licensed clinical social worker, chronic pain survivor, and author of The Truth About Chronic Pain Treatments: The Best and Worst Strategies for Becoming Pain Free. She is founder and CEO, Alternative Pain Treatment Directory and can be reached on Facebook.

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