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  • Laura Neal, DPT

CDC Recommends Non-Opiate Alternatives for Chronic Pain

In March of 2016 , the Center for Disease Control (CDC) came out with new guidelines for the prescription of opioid medications for patients with chronic pain. Within these guidelines, the CDC recommended specifically that “nonpharmocologic therapy and nonopiod pharmacologic therapy are preferred for chronic pain.” These new guidelines are coming out due to a national epidemic of overuse of opioid medications for the treatment of chronic pain. Within these guidelines, physical therapy is used as a potential alternative for the use of opioids.

While opioid medications can be useful for pain and are recommended by the CDC in cases such as cancer treatment, end of life, and palliative care, there are a handful of significant side effects that accompany their use. Common side effects include constipation, drowsiness, and nausea and vomiting. More significant issues with opioid use however include tolerance, addiction, and when used incorrectly overdose. According to the CDC, in 2014 almost 52 died per day from opioid overdoses. Due to the addictive aspect of opioids, if you use these prescriptions for a long time, you may also go through withdrawal symptoms if you then abruptly stop taking them. It is because of this, as well as an increase in societal abuse of these medications, that opioids are getting more and more media attention lately and physicians are being steered away from their use when not necessary.

Physical therapy offers an alternative to consistent use of opioids in an attempt to treat chronic pain. For chronic pain conditions such as low back pain, knee osteoarthritis, hip arthritis, and fibromyalgia both physical therapy and exercise therapy have been found to be significantly associated with improved function in the long term. There is high level of evidence at this time to support these as alternatives to opioid use for chronic pain.

See below for sources related to opioid use as well as the new guidelines presented by the CDC:

1. Dowell et al. CDC Guideline for Prescribing Opiod Pain For Chronic Pain. Recommendations and Reports / March 18, 2016 / 65(1);1–49. http://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm 2. Opioid Data Analysis: Center for Disease Control. http://www.cdc.gov/drugoverdose/data/analysis.html

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