Non-Opioid Alternatives to Managing Chronic Pain

Abstract

While public health practitioners generally focus on the primary prevention of illness and disease by developing programs and policies that promote health and well-being, an understanding of chronic pain and its treatment is important for public health professionals working to address the opioid crisis. There are unintended consequences of well-intentioned policies that may restrict prescribing behavior or otherwise interrupt or change access to opioids. For example, one consequence of expanding state prescription drug monitoring programs has been concern by providers that “legitimate” pain patients may be subjected to increased suspicion and stigma and not able to obtain needed medications. State and federal efforts to shut down “pill mills” are vital to addressing diversion and criminal behavior, but pain patients who are also seen in these clinics may have an interruption in their treatment or access to medication. Understanding chronic pain treatment and non-opioid alternatives to pain management is an important part of developing sound public health policies to prevent opioid use disorder and its sequelae. This chapter presents these alternatives and the evidence base for each.