Treating Pain Without Drugs
Other pain relief
in defeating drug
By Autumn Heisler
Non-drug treatments such as cognitive behaviorial therapy, physical therapy and yoga can help patients avoid opiods.
From high praise to a spiraling crash, opioid-based pain medications are out of favor. Once thought to be the solution to chronic pain, opioids opened the door to an even bigger and scarier addiction epidemic — one that menaces the workers’ comp industry and the population in general.
According to the Centers for Disease Control and Prevention, since 1999,
more than 183,000 people have died from narcotic painkiller addiction. An
estimated 91 people die each day from opioid abuse.
“Opioids are dangerous drugs. The side effects are dangerous and severe.
Their efficacy is not always what people expect,” said Marcos Iglesias, senior vice
president, chief medical officer, Broadspire.
“If opioids aren’t the answer, what do we turn to?”
The time to answer that question is now. Workers’ comp professionals,
physicians, insurers and employers alike are looking for that next solution to pain,
one that will help curb addiction and more quickly get workers on their feet.
Medical cannabis is one candidate.
“Marijuana is unique in that everyone comes into the conversation with a bias,”
said Mark Pew, senior vice president, PRIUM, a division of Genex Services.
With opioids, he said, no one knew of the dangers at first. Marijuana, on the
other hand, always provoked two very polarized views: It does a great deal of good
or it’s a strong drug with bad consequences.
A 2014 study published by the Journal of the American Medical Association
(JAMA) found a link between legalized medical marijuana and a decrease in
opioid-related deaths. States that legalized medical marijuana saw a 25 percent
decrease in deaths from opioid overdoses.
Yet, “when people make the claim that medical marijuana is the solution to the
opioid epidemic, it resonates with some people because of that bias,” said Pew.
Because of ongoing controversy, not to mention its classification as a Schedule
1 narcotic by the federal government, medical marijuana isn’t lined up to be the
pain-relief answer anytime soon.
So how about this: Let’s treat pain with no drugs. Radical as it may sound, non-
drug pain therapies hold merit.
Meta-analyses collected for a U.S. National Library of Medicine study found
that cognitive behavior therapy (CBT) had a positive effect on chronic pain and
fatigue. Specifically, CBT was found to be a superior method to other treatments
for decreasing pain intensity in fibromyalgia patients.
Iglesias, who has worked as a physician for more than 25 years, said CBT, a psycho-
social therapy used to teach patients about the emotional and psychological factors
influencing their pain, leaves a lasting impression on the injured.
“The methods I’ve seen work well are behavioral approaches — giving people
Assessing these additional forces
tools and methods so they can manage their own life.”
In workers’ comp, physicians using a CBT approach look at an injured worker’s
life outside the office walls. Their
home life, their health, their financial
responsibilities and their mental ability
to cope with an injury all factor into the
healing process and could potentially
lead to a lengthened claim if untreated.
enables a physician to recommend
therapies beyond the typical pill
Sometimes that means sending a
patient to physical or occupational
therapy. Sometimes yoga or acupuncture
will do the trick, with both philosophies
“Marijuana is unique in that
everyone comes into the
conversation with a bias.”
— Mark Pew, senior vice president, PRIUM
• Medical marijuana acceptance
is still split, making it an unlikely
solution to the opioid epidemic.
• Treating chronic pain with non-drug therapies, like CBT, is a safer
alternative to opioids.
• However, treating injuries without
any medication may not be the
wisest choice. Balance is needed.