Federal pain management task force emphasizes opioid alternatives

A federal task force issued a report Thursday outlining best practices for managing acute and chronic pain with an emphasis on treatment approaches beyond opioid use.

The 108-page report lays out a multidisciplinary approach to pain management that includes opioids but also behavioral and physical therapy as well as other treatments like massages and minimally invasive procedures. According to the report, “mitigating unnecessary opioid exposure” is vital.

“It’s important to exploit the benefits of multimodal, non-opioid approaches in acute pain management in conjunction with possible opioid therapy,” the report said.

The report was put together by the Pain Management Best Practices Inter-Agency Task Force, which was mandated to form by the Comprehensive Addiction and Recovery Act of 2016 and includes stakeholders from the HHS, the U.S. Department of Defense, the Veterans Affairs Department and the Office of National Drug Control Policy.

The 29-member task force considered literature and information provided by experts in pain management, addiction and mental health. About 9,000 comments were also reviewed.

The report correlates with a growing trend nationally in which providers are looking at alternatives to opioids to manage pain. There are limitations, however, to some of the non-opioid related treatment options, according to the report. For example, more research is needed to understand which physical and occupational therapies are best for specific pain syndromes. And some minimally invasive procedures aren’t covered by insurance even when clinically appropriate.

The report also offers best practices for clinicians weighing whether or not to prescribe a patient opioids. A thorough assessment of the patient should be conducted that includes their history, physical exam and risk for opioid dependency.

“Identifying patients at risk of substance abuse disorder will help minimize potential adverse consequences,” the report said.

The task force also took a look at specific populations that have unique issues that affect pain management including children, older adults, women and veterans.

For veterans, the task force recommends clinicians treating these patients assess and treat pain conditions with coordination between medical and mental health providers.

“There is a no one-size-fits-all approach when treating and managing patients with painful conditions,” said Dr. Vanila Singh, chair of the task force chair and chief medical officer of the HHS Office of the Assistant Secretary for Health. “Individuals who live with pain are suffering and need compassionate, individualized and effective approaches to improving pain and clinical outcomes.”