Pharmacy Times interviewed Rita Roy, MD, CEO of the National Spine Health Foundation (NSHF) regarding alternative treatments for chronic back pain , to aid in tackling the opioid crisis.
Alana Hippensteele Hello, my name is Alana Hippensteele from Pharmacy Times. I’m joined by Rita Roy, MD, CEO of the National Spine Health Foundation, also known as NSHF and she is here to talk about alternatives to treating back pain chronically in order to address the growing opioid crisis.
So you, Dr. Roy, how many opioid prescriptions are prescribed to back pain?
Rita Roy: Thank you for inviting me to participate. I have to tell you that the statistics are staggering. We know that 1 out of five patients suffering from back pain is prescribed opioids as a long-term therapy that could result in an increase likelihood of becoming addicted in the future. In addition to cancer patients, opioids are the commonly prescribed to those suffering from back or neck pain.
We also recognize the fact that over the lives of 100 million Americans suffer from chronic pain each year. If you put the figures together, it’s a shocking amount. The CDC estimates that in the year 2020, more than 140 million prescriptions for opioids were issued across the United States.
Alana Hippensteele These numbers are amazing. How do opioids work in helping people manage the backache that is chronic?
Rita Roy: Yes, opioids can be beneficial for patients trying to treat acute pain, that lasts longer than two weeks or in the post-operative phase , recuperating from surgical procedures. However, they shouldn’t be part of a long-term treatment program for those suffering from chronic pain. This is because the chance of addiction is very high. As we all know, they are extremely addictive medications. Therefore, there are a variety of alternatives and pain management solutions for those who suffer from constant pain.
Alana Hippensteele What are some alternatives to treatment plans that can reduce the symptoms of patients suffering from debilitation beyond the treatment of opioids?
Rita Roy: It’s crucial to be aware of what these alternative therapies are. Non-drug-related treatments for spinal patients may include physical therapy, diet changes or lifestyle adjustments, and most importantly, smoking cessation. A majority of people are unaware of the link between smoking and back pain. Smoking is a significant factor in the damage to the discs that line your back. These are just a few of the other non-drug related activities that you can try.
We then consider alternatives to pain management which, are, if you believe in them, could include meditation, acupuncture, is extremely beneficial to many people such as the use of massage, myofascial release and electrical nerve stimulation. We are also aware that exercises that strengthen the core not only aid in preventing discomfort, but also alleviate pain and ease the pain.
I’d like to share an personal story about this. I was injured in a skiing accident in my back. I developed the condition known as spondylolisthesis. This is the most basic form of fractured vertebrae. I was able to manage back pain for the past 10 years by an extremely regular practice of yoga. Yoga was not something I’d before. I believed it was only for other people which I didn’t believe I was, since I wasmore in traditional medical practices. But I actually learned about yoga and discovered its value and the benefits yoga can provide for strengthening the core and managing spinal discomfort.
Alana Hippensteele What’s NSHF doing to raise awareness of alternative pain management techniques for patients and doctors?
Rita Roy: This is why the National Spine Health Foundation focuses on three areas that are patient education, research and advocacy for patients. As the nation’s only dedicated spine health foundation offering a wide range of ways to inform.
We have an exclusive Facebook support group, and we also have a platform known as Spine Talks. There are 50 of the country’s top specialists in the field of spine on our medical board and they are part of Spine Talks, answering frequently requested questions in simple terms.
We then offer an audio podcast in which we invite those we call Spinal Champions, people who have overcome their back or neck problem to tell their story and, through this offer the hope that others will be able to find the path towards healing.
We are currently leading research in the industry on an crucial project known as Enhanced Surgical Recovery. These are protocols currently at the hospital that will change the way that spinal post-operative recovery is handled. This includes better control of pain as well as removing the requirement for IV medications as well as decreasing the dependence and demand for opioids following surgery. We’ve seen that lots of people develop addiction following surgery. If we can help get people off opioids following surgery is there less of for an addiction developing.
Alana Hippensteele Right. What do pharmacists need to know about the effects of opioids on back pain?
Rita Roy: I’m so happy to meet with pharmacists. Today we have we are the National Spine Health Foundation works in an eminent level of patient-centered education and assists those suffering from back and neck pain get back to living their lives. Pharmacists are able to have the unique chance to change how we inform patients about the dangers of using opioids and help set patients on a effective path to pain-free recovery.
We’ve all heard about the FDA prescription that pharmacies distribute instructions, warnings and recommendations for medications. These are stapled on the white bag that you receive when you purchase your prescription. However, we believe that patient education shouldn’t end there. I’d love to see pharmacies give the most practical and digestible information related to opioids and encouraging patients to understand how to gradually wean themselves from these addictive drugs following surgery. If there are signs the patient is dependent on too many of these medications, we can consider intervening. It could be that are as easy as adhering the QR code or a pamphlet that has an QR code on the prescriptions at the point of sale , when customers are buying their prescriptions to make sure they get these tools in their possession, once they’re back at home, and possibly surrounded by a family members who could discuss methods for living a pain-free lifestyle without opioids.
Alana Hippensteele What are alternatives to help to alleviate concerns over the increase in prescriptions for opioids in patients who suffer from chronic back pain?
Rita Roy: As I stated earlier that opioids can be extremely beneficial in an emergency. But , the prescription for opioids they should be the last option for those who are suffering from back or neck pain. The doctor and patient should look at alternatives to treatment, like non-prescription medications.
We’re aware that a lot of people don’t use their [non-steroidal anti-inflammatory medications (NSAIDs)appropriately. Therefore, there’s a chance to inform. There’s no need to just take one Motrin is it? It’s not how anti-inflammatory medicines perform and physical therapy is extremely beneficial for lots of people.
Additionally, there are innovative treatments available in the field of regenerative medicine. Stem cell therapy has shown amazing results for the appropriate patient. Acupuncture has been proven to help many patients. Therefore, there are many treatment options available that patients should explore and consider before committing to opioids. Therefore, opiate is somewhat at the very bottom of the spectrum of options to try before making the leap to.
Alana Hippensteele Right. What are the reasons why issues related to the opioid crisis be crucial to deal with in the present?
Rita Roy: There is a crisis in the nation. There’s an opioid epidemic across the United States. I don’t think it comes as a shock to anyone one of us today.
CDC said that in the year 2000 140,000 people were killed due to opioid abuse. That’s 140,000 people whohave died. This is a staggering amount.
Between 2019 and 2020, deaths due to drug overdoses have increased by 30 percent. I’m not sure if this is related to COVID, but that’s certainly a extremely interesting figure. This raises the possibility that we’re heading in the wrong direction.
We’ve been discussing this opioid epidemic for some years and we’re at a point where we can finally act. Yet, we’re seeing an increase in deaths due to opioids across the United States, and we’ve to take action. It is imperative to immediately take action. As the spine foundation, we’re contributing by providing patients and doctors with information on alternative methods for managing pain. The advancements are occurring so fast that it’s difficult to keep track of them. It’s difficult to keep up with and, in turn, it’s complicated information.
Therefore, at the National Spine Health Foundation, we strive to bring information in simple to understand ways. We build community, there are people who you can chat with, and we can provide the information that you need to try to combat this disease which is currently afflicting our country.
Alana Hippensteele Absolutely. What do you hope regarding the direction of your nation’s relationship with opioids in the treatment of back pain?
Rita Roy: First that I’d like those suffering from chronic neck and lower back discomfort to understand that that there is hope. Hope is available. Knowledge can bring hope, doesn’t it? This is where the power lies–to be educated about treatment options and knowing that you are able to get rid of pain and back into your normal life. It doesn’t have to mean surgery or narcotics to help with the treatment of pain. But there is possibility, and there are alternatives, and you’ll have to be educated. You have to become your own advocate for yourself to gain control of your life.
In addition, I’d like to suggest that doctors and pharmacists make contact and join forces to fight the opioid crisis by providing education to patients and ongoing research using the evidence-based approach to look at what is working by looking at the numbers. Let’s make that research a reality.
If there’s something you or any viewers are interested in I would encourage them to get involved with the work we’re working on with the National Spine Health Foundation. This will require everyone of us. It will need be a multidisciplinary approach to combat this issue. We’re all required to come together to tackle the issue.