Exploring the World of Opioid Alternatives

Opioids are associated with many physical, psychological and socially adverse consequences and have reached epidemic proportions in the United States. Despite the danger they pose and lack of literature to support their efficacy in chronic pain, opioids continue to be prescribed frequently to injured workers. This session at WCI’s 2018 Workers’ Compensation Educational Conference explored alternative treatments for chronic pain management.

The panel included:

• Eric Patten, Senior Director of Clinical Services, One Call
• Marcos A. Iglesias, MD, MMM, FAAFP, FACOEM, Senior Vice President/Chief Medical Officer, Broadspire
• Mark Pew, Senior Vice President, Product Development & Marketing, Preferred Medical

Contrary to most thoughts, opioids are not the best solution for pain because they are not actually addressing the pain. Opioids are addressing our mood related to the pain. The health community needs to educate the general population on this concept because there is still an overwhelming demand. The demand exists because most think opioids are the only answer to pain management.

Pain is multifactorial, so we need a lot of tools in the toolbox. Prescribing pills is a passive treatment. Active treatments include methods like ways help someone to sleep better, eat better and deal with depression. These are all items that accompany pain. Careful coaching and skill building with tips and techniques to increase mood and activity, ultimately, help cope with pain.

It is not just about training your mind, you also have to train your body with activity. Things like acupuncture, yoga or massage will only help if they are built into a regular and repetitive schedule. Someone needs to coach to this activity.

At the end of the day, workers’ compensation professionals are supposed to try to return that injured worker to as close to what they were prior to the injury. To do this, we have to treat the whole person. That includes treating attitudes towards the situation. It is not effective to try to reduce pain by attacking it directly, putting the patient’s attention on it. We attack it by diverting attention away from it. Words matter. Do not ask about pain. Ask about function.