Study: Early Intervention Is Key to Safely Treating Chronic Pain
Chronic pain is an ongoing issue. Unfortunately, the way we treat chronic pain is largely reactive. But a new study out of Duke Health suggests a different way to approach treatment. Rather than reacting to patient complaints of chronic pain, perhaps it’s better to be proactive in order to facilitate early intervention.
The study in question was published in the New England Journal of Medicine in early 2024. Researchers wanted to know how effectively they could predict and manage chronic pain after asking two simple survey questions:
- Have you ever felt your pain is terrible and will never get any better?
- Have you ever used an illegal drug or prescription med for non-medical purposes?
These two simple yes or no questions allowed researchers to effectively identify patients at high risk of opioid overuse following surgery or injury. Respondents who answered ‘yes’ to both questions were considered high risk.
What the Researchers Discovered
More than 13,500 patients were enrolled in the study. They were divided into high, medium, and low risk groups. All of them were already experiencing some measure of pain. Interventions were tailored to how they were currently handling pain management. Research was also focused on holistic interventions.
Researchers identified 432 high risk patients to participate in holistic intervention. A surprising 224 (51%) reduced their morphine consumption within 30 days. At 60 days, 299 patients had reduced morphine consumption while a total of 349 had done so at 180 days.
The researchers concluded that identifying high risk patients early on and getting them enrolled in holistic intervention programs ultimately led to the need for less pain medication over time. Their data clearly points to the necessity for early intervention rather than responding to chronic pain in a reactionary way.
Alternatives to Prescription Medication
To me, one of the most important takeaways from the study is that there are alternatives to prescription medications. We don’t have to immediately start passing out prescriptions for morphine and oxycodone when a patient complains of chronic pain. And in fact, if we can anticipate someone who is at high risk of developing chronic pain, there are ways to intervene.
For the record, the alternative interventions utilized by the Duke researchers included:
- Working with a pain specialist.
- Behavioral health therapies.
- Physical therapy.
- Nutritional services.
Researchers also referred some patients to social service programs to help meet their needs for housing, transportation, etc. Needless to say, all of the utilized strategies have merit. Yet there is one thing noticeably missing: medical cannabis.
A Different Kind of Medication
It could be argued that medical cannabis was left out of the equation because it is another form of medication similar to prescription painkillers. I would have liked to see it included in the study for the simple fact that it is a different kind of medication.
Medical cannabis is not offered by way of traditional prescription despite the fact that its most common use in medicine is to manage chronic pain. The folks at Utahmarijuana.org explain that chronic pain is the most often cited complaint among medical cannabis users.
Because it is not provided via prescription, patients essentially self-Medicaid under the guidance of pharmacists and medical providers with advanced knowledge. Medical cannabis is often combined with other interventions for a more complete treatment.
Even taking medical cannabis out of the equation, the Duke research clearly shows that prescription medications are not the only way to treat chronic pain. Their research also demonstrates the importance of early intervention as a key to safely treating chronic pain without the use of addictive drugs.