The only way to battle opioids is to find holistic approaches to pain management

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More than 60,000 Americans died from opioids in 2017, lowering life expectancy in the United States, and prompting President Trump to declare opioid addiction a public health emergency. He was right. But, since then, other than saying the government will do plenty to solve this, he has done virtually nothing to halt this crisis and his most recent actions will make it worse.

As a former administrator of the Centers for Medicare and Medicaid and as a practicing physician dedicated to the health and well-being of America’s military members and their families, we urge our leaders to include the availability of non-drug approaches for pain management among the immediate steps.

{mosads}Over 12 million patients have become dependent on opioids to control their chronic pain. They need help. Simply restricting opioids without managing their pain and addiction will increase suffering and kill more people.


We have effective non-drug treatments for pain management, including acupuncture, mind-body methods, therapeutic yoga, and massages. All of these can ease patients’ suffering without making them addicted to opioids. These kinds of approaches can also help patients who have already become dependent on opioids.

Take, for example, Liz. She is a veteran who had an opioid prescription to manage her chronic back pain. Over time, her physician grew concerned about Liz’s prolonged use of opioids and began cutting down on prescribing them.

While her doctor was on vacation, Liz came in and requested a refill. A short visit was all it took to realize that Liz not only needed to get off opioids but that she also needed another way to manage her pain.

After an explanation of the dangers of long-term opioid use and a description of non-drug approaches for pain, Liz said she wanted to try therapeutic yoga — an effective treatment for back pain.

National organizations like the Veterans Health Administration, the American College of Physicians, the Centers for Disease Control and Prevention and the Food and Drug Administration, recommend using such non-drug and integrative approaches for pain first and continuously.

But we could not make that happen for Liz. Insurance coverage for therapeutic yoga was not available, and her doctor did not have the time to find and integrate such non-covered approaches into her usual care. She ended up getting more drugs.

Liz and her doctor are not alone. Primary care doctors who treat most chronic pain in this country are not able to provide non-drug approaches for pain.

As coverage for even basic services is scaled back, including the recent Administration order removing the requirement that insurance plans provide addiction coverage, doctors are in a double bind. They are both under increasing pressure to provide a quick fix, like more drugs, while their ability to use opioids appropriately is also restricted. The new tax law will restrict healthcare coverage further and make this bind worse. It is a no-win situation. The result is that patients like Liz will not get what they need. And more will suffer and die.

If the Trump administration is serious about defeating America’s opioid addiction, it must commit to expanding the availability of non-drug, holistic approaches to pain management.

Leaving patients like Liz to deal with chronic pain on their own is not an answer. It’s too often just a route to an early grave.

Donald M. Berwick, M.D., is president emeritus and senior fellow at the Institute for Healthcare Improvement and former administrator of the Centers for Medicare & Medicaid Services.

Wayne Jonas, M.D., is executive director of Samueli Integrative Health Programs, and former Director of the National Institutes of Health Office of Alternative Medicine. He is the author of, “How Healing Works.”

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