Maine’s Mercy Hospital Offers Comprehensive Pain Therapy As Alternative To Opioids
Maine has adopted a strict opioid prescribing law.The purpose of the law is to reduce the overall opioid supply, limit doses and prescription length, and prevent doctor-shopping.
So with less opioids available, what are those in pain to do?
Well, according to Dr. Stephen Hull, who teaches the Living Well Pain Rehabilitation Program at Mercy Hospital in Portland opioids are not proven to be effective at treating chronic pain. In fact. evidence shows that the addictive nature of opioids leads to higher doses, and a greater likelihood of dying from an overdose.
Also, long-term use of opioids can lead to hyperalgesia, or the increased sensitivity to pain. Clearly, this fact flies in the face of any argument for the use of opioids for chronic pain.
So Dr. Hull has decided to use another, multidisciplinary approach. This approach includes other types of pain therapy – that is, meditation, exercise, group support, and other techniques to assist patients to deal with their chronic pain.
“I want to get them all off of opioids. That’s my goal. We are giving them the tools here to live a vital life.”
The new laws have been enacted, in large part, due to the opioid epidemic raging in Maine and in many areas across the country.
Dr. Hull believes that his alternative forms of treatment can help during this crisis:
“If because of the new law physicians are now reluctant to prescribe opioids, they are looking for alternatives.”
Hull hopes his program will be replicated. Mercy Hospital currently has the only program of its kind in Maine, and it is rare elsewhere in the U.S – perhaps fewer than 100 programs. The program, which also includes a psychologist and exercise therapist, costs roughly $700,000 annually to operate.
About the Program
Hull said that the “became disenchanted with the outcomes” of those who were treated with opioids, and therefore began seeking alternative pain therapy. He visited similar programs throughout the east before developing the program for Mercy Hospital over 3 years ago.
So far, the program has graduated over 200 students. Among those, nearly half were talking opioids when they began the program, which runs for 12 weeks. Half of those quit using opioids at the program’s end, and another 25% had decreased their dosages significantly.
Hull’s tough love also includes common sense that used to be pervasive before we became so attached to opioids – pay attention to posture, be social, exercise, eat well, move around as much as possible, get sleep, and enjoy life – in moderation.
Among Hull’s other teachings is ow the immune system surpresses pain. For example, inflammation can be reduced through diet, exercise, and hot/cold therapies, which are all beneficial for pain relief.
The Problem of Pain?
Hundreds of thousands of persons in Maine are currently being given opioids for pain. However, many are prescribed them correctly for acute surgical pain, or are cancer patients experiencing end-of-life pain.
However, around 16,000 persons are taking relatively high doses – including 100 morphine mg equivalents or more. Under the new law, many of them will need be weaned to lower dosages.
And of course, even Dr. Hull is aware that it’s not possible to eliminate pain – whether with drugs or other therapies. Moreover, pain is how your body interprets threats. However, your body does not always accurately reflect the threat’s severity – a small wound, for example, can yield a tremendous amount of pain, whereas a severe threat may yield a relatively low amount of pain.
Have you ever had a second degree burn? They can be extremely painful. However, third degree burns can be so severe, the area affected is literally numb. So the severity of the pain does not necessarily indicate the severity of the wound. This is one reason why opioids should not be prescribed based on the level of pain.
The challenge is to help people distract themselves from pain, and go on with their lives as much as possible, despite its presence. People who are suffering from pain often dwell on it, do less, and therefore get trapped in a negative cycle of pain and disablement.
Be reasonable about your activities, and don’t be afraid to try new things. Overexerting, however, is bad as well. Hull notes
“Don’t overdo it. Every day do a little bit more than you did the day before, and gradually build up to your goal.”
Once, I had a minister ask me what I thought we, as a society, should do about the problem of pain. I answered: Pain is not really a problem. It’s an indicator that something is wrong with your body. That said, there’s nothing wrong with pain therapy or pain management. The problem is when the cure is worse than the condition.
~ G. Nathalee Serrels, M.A., Psychology