More than 12 million patients have become dependent on prescription opioids to manage chronic pain. If we are to effectively address the opioid epidemic, we need to improve patient access to alternative therapies that relieve chronic pain, such as acupuncture, massage, yoga, and other mind-body techniques that can often reduce the need for opioids or eliminate it entirely.
Merely denying them medication is not the answer. According to the Centers for Disease Control and Prevention, many chronic pain patients will eventually switch to even more dangerous alternatives, such as heroin, unless they receive treatment and help with controlling pain.
Many national health organizations such as the CDC, the Food and Drug Administration, and the American College of Physicians recommend using alternative, non-drug approaches first and foremost, and that narcotics should be prescribed only after other treatments fail.
But many patients face barriers to receiving these treatments – for example, while insurance isn’t likely to cover yoga classes, it is likely to cover opioids, which are inexpensive. And thus, primary care physicians, who treat the most patients with chronic pain, are unable to offer non-drug alternatives.
The reality is this: doctors are bound by ever-increasing healthcare coverage restrictions, and yet, they are also under pressure to cut back on opioid prescribing. Meanwhile, the patient, who is still in pain, is left with few options.
The system is essentially broken. We can’t treat an epidemic by merely restricting access to the drugs that these patients have come dependent upon for relief. Greater accessibility to addiction treatment is a must, but so is greater access to safer means to manage chronic pain.
There are several potentially effective, pain-relieving drugs currently undergoing clinical testing, including those based on the numbing effects of both spider and sea snail venom, but nothing likely to be on the market in the foreseeable future.
Effective Alternative Therapies
A recent survey by Consumer Reports found that the following alternative therapies performed well when back-pain patients were asked about their effectiveness and how much they cost:
Yoga and Tai Chi
Total Spent out of Pocket: Less than $100 (55% of respondents) to $1,000 or more (7% of respondents)
Total Spent out of Pocket: Less than $100 (35% of respondents) to $1,000 or more (9% of respondents)
Total Spent out of Pocket: Less than $100 (38% of respondents) to $1,000 or more (11% of respondents)
Total Spent out of Pocket: Less than $100 (56% of respondents) to $1,000 or more (6% of respondents)
Total Spent out of Pocket: Less than $100 (35% of respondents) to $1,000 or more (8% of respondents).
Also, the American College of Physicians also says that some evidence supports the effectiveness of biofeedback and low-level laser therapy.
Unfortunately, as noted above, the alternative therapies listed by survey respondents as being helpful for chronic pain relief are less likely to be covered by insurance than traditional medication.
According to the results from the Consumer Report’s survey, respondents spent over $200 out-of-pocket for the duration of their full treatment for massage, acupuncture, or chiropractic care. And nearly one-fourth spent more than $500. By comparison, patients spent $80 out-of-pocket for treatment from a doctor.
Moreover, insurance often covers multiple visits to a chiropractor or physical therapist, but typically, only the most expensive plans offer coverage for other treatments
such as massage, acupuncture, and yoga.
And yet, there’s evidence that suggests that non-drug treatments for pain are also cost-effective. In 2016, a review of 33 studies revealed that exercise in conjunction with counseling, acupuncture, spinal manipulation, and yoga fared well economically.
Covering The Cost of Alternative Treatment
But truthfully, if you want access to alternative therapies and to not remain reliant on opioids, you will likely have to pay more. Here are some tips that may help:
- Comb through your insurance policy. While many companies and policies do not cover all of the treatments as mentioned above, some do. The Consumer Reports survey found that more than 1 in 10 people had coverage that paid for 75% of massage therapy services.
- Ask for a referral. Your physician may need to refer you or contact your insurance carrier and explain why an alternative treatment to drugs is necessary.
- Ask treatment providers if they offer discounts for multiple treatment sessions.
- Consider switching between therapies. That is, if coverage for one therapy runs out, opt for another.
- Think about the total cost. For example, how much are you paying for alternative treatments out-of-pocket versus high deductibles for conventional medical care?
- Use tax-free dollars. These may include funds in a health savings account or flexible spending account.
- Fall back on your right to appeal if your insurance company refuses to cover a service that you believe should be covered.
- Worst case scenario, consult the Internet. YouTube has hundreds of videos of yoga sessions, stretches, meditation practices, deep breathing techniques, and other do-it-yourself ways to relieve many types of pain without drugs.
~ G. Nathalee Serrels, M.A., Psychology