Cutbacks to opioid prescriptions leave chronic pain patients without help

Opioid addiction is getting more attention nationally, but a Washington State University researcher says not enough is being done to help patients transition to non-opioid pain management.

Marian Wilson, an associate professor at WSU’s College of Nursing, has spent much of her career looking at pain management and chronic pain, including alternatives to opioids that can help some people manage pain more effectively.

President Donald Trump spoke about his administration’s plan to fight opioid addiction Monday that called for punitive measures, like the death penalty for some drug dealers, as well as expanded access to treatment and a reduction in opioid prescriptions.

Wilson said most efforts to fight opioid addiction have involved cutting back on prescription drugs, which has reduced access for many pain patients.

“What I’m hearing from people in need of opioids that it’s harder and harder to get somebody to prescribe for them what they’ve had for years,” she said.

Research has shown that tools like yoga, tai chi and mindfulness can help patients manage chronic pain, she said, but those approaches are often inaccessible and not covered by insurance, she said.

“I’m really concerned with all of the attention going towards tightening up access to opioids,” she said. “All of these people were taught to manage their pain with opioids and now they’re being told no … but they’re not necessarily being given alternatives.”

Her latest research focused on people with chronic pain who are already in treatment for opioid addiction or misuse.

There’s existing research showing online coaching programs can help people with chronic pain, and Wilson wanted to test whether the same program could be used successfully with people already being treated for addiction.

People who develop opioid addiction through chronic pain treatment make up a small percentage of addicts, but treatment programs aren’t often well-suited to their needs around managing pain, she said.

The program, made by a company called Goalistics, is a four-month course that includes trackers allowing people to log their moods, pain levels and physical activity, as well as relaxation practice and coaching on goal-setting. Her research team looked at 60 patients who signed up for the study, of whom about 65 percent actually used the tool regularly.

Her results have yet to be published, but she said overall patients who stuck with the program reported better moods, high satisfaction and more control over their pain.

As part of the study, participants were given access to computers. Normally, the program costs $120 for four months, according to the Goalistics website, and requires Internet access, making it a challenge.

Wilson said she’d like to see more funding directed towards non-pharmacological tools to help with pain, and a bigger push for insurance companies to cover them.

“When you’re talking about non-pharmacological interventions, no one wants to pay for that,” she said.

Yoga classes, for instance, can be helpful, but few insurers will pay for a studio membership. Classes typically aren’t targeted for people with chronic pain, who may need different poses or extra support.

“It doesn’t get the attention. It doesn’t get the funding dollars,” she said.