What the Opioid Epidemic Really Means

America is in the midst of an epidemic.  Americans are hurting and turning to painkillers to ease their pain.  Unfortunately, opiates pave a road to addiction and death.  In 1999, 4,000 people died from overdoses.  The total number of deaths attributable to opiates skyrocketed to 62,000 in 2015, making the opioid epidemic a greater cause of death in our country than car accidents.  Put another way, prescription drugs end 78 American lives each day.

The feds have responded by declaring a war on prescription drugs and sending their agents out to investigate, prosecute, and penalize.  Cracking down on healthcare providers, government efforts have had the unintended effect of pushing sufferers to turn to heroin to ease their chronic pain.  Of course, the switch from legal to illegal pain management does nothing to reduce the chance of falling victim to an overdose, and many hooked on heroin have ended up on the slab.

Our government is missing the point.  The opioid epidemic is not a drug epidemic but a failure of our current system of healthcare to effectively treat our chronic pain.  With the number of annual prescriptions for pain meds climbing to a staggering pinnacle of 289 million prescriptions in 2016, one thing is clear:  too many patients are left with no better option than to numb their bodies and sedate their minds in order to be able to function.  Revoking the licenses of pharmacists and doctors who demonstrate injudicious or criminal behavior may be a critical stopgap measure, but we ultimately need more innovation and flexibility in our management of chronic pain to get to the root of this problem.

Others have pointed out the absurdity of government policy that is punitive without offering any solutions to the complex dilemma of pain management.  We must always use opiates responsibly to control our aches and pains but we also need to be able to perform simple daily tasks without paralyzing discomfort.  One wonders if, between massive cuts in the healthcare budget and the war on prescription drugs, American patients dealing with chronic pain will be left with no good options beyond biting the bullet and getting through life as best they can despite the agony.

To be clear, this is not a partisan issue or, even, a political issue.  The pain epidemic and the opioid epidemic that follows in its wake is an American healthcare crisis.  Although we need our government to recognize that the American people need its support, not just law enforcement, it is even more important for our healthcare providers to respond to the crisis with new ideas and therapies.

Some good options for pain management do not need discovery but only await formal recognition.  Few alternatives to palliative care with risky opioids are as promising as traditional acupuncture.  As a treatment option, Chinese acupuncture care is methodical, well researched, low cost, and safe.  It can often be used by those who are not be good candidates for surgery and have exhausted other conventional treatments, patients who desperately require relief from chronic pain syndromes, offering them quality of life without the risk of addiction.

Those of us who use acupuncture have been successfully treating chronic pain for decades, but we need a shift on the part of lawmakers who develop policies to incorporate acupuncture care more completely into the mainstream.  Other CAM methods must be explored as well.  Only by first recognizing that Western medicine is failing these patients and then seeking out practical answers for chronic pain conditions will we be able to stem the rising tide of dependence on prescription opiates.  This is the only public health strategy that promises a permanent fix and sets American patients on a course that is safer, healthier, and happier.

New Acupuncture Research

Conventional medical sources regularly publish promising research on acupuncture.  In this blog, we will review some studies that have appeared in the last two months.

According to an article from March 14th, research done at Taipei Medical University in Taiwan demonstrated the effectiveness of acupuncture in treating tumor and cancer surgery related pain.  The sizable meta-analysis reviewed 36 randomized, controlled trials that involved a total of 2,213 patients.  Researchers found that acupuncture was effective in managing the pain due to cancer surgeries and cancerous neoplasms.  Although the meta-analysis failed to show that acupuncture improved pain due to chemotherapy, hormone therapy, or radiation treatment, the Medscape article included reports from several acupuncturists at large U.S. cancer care centers where most patients report pain reduction when acupuncture is used to treat the side effects of cancer treatments.  In fact, acupuncture has proven so effective in providing better quality of life to cancer patients that a subspecialty called oncology acupuncture is being created.

The big news in acupuncture last month was a much publicized article on acupuncture care for migraine sufferers.  Featured on Medscape on February 24th, research conducted at Chengdu University of TCM demonstrated a statistically significant reduction in migraine frequency and severity with true acupuncture compared to sham acupuncture.  Treatment consisted of daily acupuncture treatments for 5 days with a 2-day hiatus each week.  The complete course of care lasted 4 weeks for a total of 20 acupuncture sessions.   There were no serious adverse effects reported, and patients enjoyed benefits for twenty weeks after treatment.  Compare this to the use of regular Botox injections which can cost hundreds or, even, thousands of dollars and may result in a variety of minor to severe side effects.

According to a February 13th article, even the American College of Physicians has joined the growing body of acupuncture proponents.  Their new guidelines, published online in the Annals of Internal Medicine, recommend acupuncture for nonradicular lower back pain.  The authors selected therapies that were low risk and low cost, criteria that very much describe the nature of acupuncture care.  Other therapies featured in the guidelines include mindfulness-based stress reduction and tai ji (t'ai ch'i).  

Stay tuned for more mainstream research validating the effectiveness of Chinese medical care.  For those of us who are familiar with Chinese medical care, generations of empirical experience has more than confirmed the tremendous value of traditional Chinese medicine.  New research, however, adds to our understanding and opens doors for new ways to incorporate these ancient therapies into modern practice.