15 - DEPRESSION, ANXIETY, CANNABIS AND OPIOID USE AND COMPLEMENTARY INTEGRATIVE HEALTH PRACTICES IN WOMEN WITH CHRONIC PAIN

Formal pain management clinics have now existed for more than 30 years and from the beginning have incorporated integrative approaches to assist patients suffering from chronic pain conditions. This article will describe the development of these programs and the role that biofeedback and other psychosocial interventions have played in this development. Case vignettes and interviews are used to demonstrate the value of integrating biofeedback and other integrative health practices into a formal pain management practice.

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Synthesizing the Strength of the Evidence of Complementary and Integrative Health Therapies for Pain

Pain Medicine ◽

10.1093/pm/pnz068 ◽

2019 ◽

Vol 20 (9) ◽

pp. 1831-1840 ◽

Cited By ~ 8

Author(s):

Karleen F Giannitrapani ◽

Jesse R Holliday ◽

Isomi M Miake-Lye ◽

Susanne Hempel ◽

Stephanie L Taylor

Keyword(s):

Chronic Pain ◽

Systematic Reviews ◽

English Language ◽

Tai Chi ◽

Large Body ◽

Visual Display ◽

Opioid Use ◽

Evidence Map ◽

Integrative Health ◽

Positive Effects

Abstract Objective Pain and opioid use are highly prevalent, leading for calls to include nonpharmacological options in pain management, including complementary and integrative health (CIH) therapies. More than 2,000 randomized controlled trials (RCTs) and many systematic reviews have been conducted on CIH therapies, making it difficult to easily understand what type of CIH therapy might be effective for what type of pain. Here we synthesize the strength of the evidence for four types of CIH therapies on pain: acupuncture, therapeutic massage, mindfulness techniques, and tai chi. Design We conducted searches of English-language systematic reviews and RCTs in 11 electronic databases and previously published reviews for each type of CIH. To synthesize that large body of literature, we then created an “evidence map,” or a visual display, of the literature size and broad estimates of effectiveness for pain. Results Many systematic reviews met our inclusion criteria: acupuncture (86), massage (38), mindfulness techniques (11), and tai chi (21). The evidence for acupuncture was strongest, and largest for headache and chronic pain. Mindfulness, massage, and tai chi have statistically significant positive effects on some types of pain. However, firm conclusions cannot be drawn for many types of pain due to methodological limitations or lack of RCTs. Conclusions There is sufficient strength of evidence for acupuncture for various types of pain. Individual studies indicate that tai chi, mindfulness, and massage may be promising for multiple types of chronic pain. Additional sufficiently powered RCTs are warranted to indicate tai chi, mindfulness, and massage for other types of pain.

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A new OPIATE (Optimizing Positive Ibuprofen and Acetaminophen Treatment Expectations) model: A brief comment on “Concurrent and lagged associations of prescription opioid use with pain and negative affect in the daily lives of chronic pain patients” (Carpenter, Lane, Bruehl, & Trull, 2019).

Journal of Consulting and Clinical Psychology ◽

10.1037/ccp0000436 ◽

2019 ◽

Vol 87 (10) ◽

pp. 887-892

Author(s):

Jack Stevens ◽

Tarun Bhalla

Keyword(s):

Chronic Pain ◽

Negative Affect ◽

Prescription Opioid ◽

Opioid Use ◽

Treatment Expectations ◽

Daily Lives ◽

Chronic Pain Patients ◽

Prescription Opioid Use ◽

Pain Patients

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Supplemental Material for Complementary and Integrative Health Approaches to Manage Chronic Pain in U.S. Military Populations: Results From a Systematic Review and Meta-Analysis, 1985–2019

Psychological Services ◽

10.1037/ser0000417.supp ◽

2020 ◽

Keyword(s):

Systematic Review ◽

Chronic Pain ◽

Meta Analysis ◽

Integrative Health ◽

Military Populations

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Faculty Opinions recommendation of Oral opioid use alters DNIC but not cold pain perception in patients with chronic pain - new perspective of opioid-induced hyperalgesia.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1119101.575248 ◽

2008 ◽

Author(s):

Robert Edwards ◽

Claudia Campbell

Keyword(s):

Chronic Pain ◽

Pain Perception ◽

Opioid Use ◽

Cold Pain ◽

Opioid Induced Hyperalgesia ◽

New Perspective

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Retrospective analysis on the effect of spinal cord stimulation on opioid consumption

Pain Management ◽

10.2217/pmt-2020-0016 ◽

2020 ◽

Author(s):

Awinita Barpujari ◽

Michael A Erdek

Keyword(s):

Spinal Cord ◽

Chronic Pain ◽

Retrospective Analysis ◽

Spinal Cord Stimulation ◽

Alternative Therapy ◽

Opioid Consumption ◽

Opioid Use ◽

Number Of Patients ◽

Chronic Pain Conditions ◽

Post Trial

Aim: Spinal cord stimulation (SCS) is used to clinically manage and/or treat several chronic pain etiologies. A limited amount is known about the influence on patients' use of opioid pain medication. This retrospective analysis evaluated SCS effect on opioid consumption in patients presenting with chronic pain conditions. Materials & methods: Sixty-seven patients underwent a temporary trial device, permanent implant or both. Patients were divided for assessment based on the nature of their procedure(s). Primary outcome was change in morphine equivalent dose (MED), ascertained from preoperative and postoperative medication reports. Results: Postoperative MED was significantly lower in patients who received some form of neuromodulation therapy. Pretrial patients reported an average MED of 41.01 ± 10.23 mg per day while post-trial patients reported an average of 13.30 ± 5.34 mg per day (p < 0.001). Pre-implant patients reported an average MED of 39.14 ± 13.52 mg per day while post-implant patients reported an average MED of 20.23 ± 9.01 mg per day (p < 0.001). There were no significant differences between pre-trial and pre-implant MED, nor between post-trial and post-implant MED. Of the 42 study subjects who reported some amount of pre-intervention opioid use, 78.57% indicated a lower MED (n = 33; p < 0.001), 16.67% indicated no change (n = 7) and 4.76% (n = 2) indicated a higher MED, following intervention. Moreover, SCS therapy resulted in a 26.83% reduction (p < 0.001) in the number of patients with MED >50 mg per day. Conclusion: Spinal cord stimulation may reduce opioid use when implemented appropriately. Neuromodulation may represent alternative therapy for alleviating chronic pain which may avoid a number of deleterious side effects commonly associated with opioid consumption.

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