Why doctors don’t use alternatives to opioids
April 16, 2018
As Congress deliberates how to respond to the surging opioid epidemic, a number of bills have been introduced to support the development and Food and Drug Administration approval of a non-opioid pain medication. But the problem in American medicine is not a lack of alternatives to opioids, but the minimal utilization of the many non-opioid treatments for pain that already exist.
More than 200 medications other than opioids have evidence of benefit in at least some pain conditions. These range from the familiar (ibuprofen) to the surprising (gabapentin, an anti-seizure medication, that is FDA-approved for certain types of nerve-related pain). Yet most physicians are not aware how many medications other than opioids have strong evidence of relieving pain.
Beyond medications, many psychological and behavioral interventions have a substantial ability to reduce pain and improve function. Yet treatments such as physical therapy, cognitive-behavioral psychotherapy and yoga are prescribed far less commonly than opioids.