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Mind-body therapies alleviate pain in people prescribed opioids
A new study published Nov. 4, 2019, in the journal JAMA Internal Medicine details the first comprehensive look across the scientific literature at the role of mind-body therapies in addressing opioid-treated pain. The researchers found that certain mind-body therapies can reduce pain, as well as reduce opioid use, among patients treated with prescription opioids.
"These findings are critical for medical and behavioral health professionals as they work with patients to determine the best and most effective treatments for pain," said Eric Garland, lead author on the study, associate dean for research at the University of Utah College of Social Work and the director of the University of Utah's Center on Mindfulness and Integrative Health Intervention Development.
Garland explained that mind-body therapies focus on changing behavior and the function of the brain with the goal of improving quality of life and health. Mind-body therapies include clinical use of meditation/mindfulness, hypnosis, relaxation, guided imagery, therapeutic suggestion and cognitive-behavioral therapy.
[...] They found that meditation/mindfulness, hypnosis, therapeutic suggestion and cognitive-behavioral therapy all demonstrated significant improvements in pain severity. They also found that the majority of the meditation/mindfulness, therapeutic suggestion and cognitive-behavioral therapy studies showed improvements in opioid use or misuse. In contrast, two studies utilizing relaxation found significantly worsened results in opioid dosing.
[...] "A study published earlier this year projected that by 2025, some 82,000 Americans will die each year from opioid overdose," said Garland. "Our research suggests that mind-body therapies might help alleviate this crisis by reducing the amount of opioids patients need to take to cope with pain. If all of us -- doctors, nurses, social workers, policymakers, insurance companies and patients -- use this evidence as we make decisions, we can help stem the tide of the opioid epidemic."
Eric L. Garland, Carrie E. Brintz, Adam W. Hanley, Eric J. Roseen, Rachel M. Atchley, Susan A. Gaylord, Keturah R. Faurot, Joanne Yaffe, Michelle Fiander, Francis J. Keefe. Mind-Body Therapies for Opioid-Treated Pain[$]. JAMA Internal Medicine, 2019; DOI: 10.1001/jamainternmed.2019.4917
(Score: 2) by DannyB on Thursday November 07 2019, @07:17PM (18 children)
Wow. That almost sounds like taking opioids is contagious.
Even if someone has used modest amounts of opioids for over a decade doesn't mean there is a problem to be fixed.
I understand there are people who have trouble with opioids. And alcohol. Nicotine. Other drugs.
I get triggered by the new focus to stop everyone from using any opioids. Opioids, used judiciously, can improve one's quality of life. I've used opioids for almost eleven years. (arthritis) When I don't need them, I don't take them. When I do need them, I have no trouble quitting when I no longer need them. I sometimes go weeks without taking any. They are just a tool. Nothing more.
I'll skip the new age hocus pocus.
I'll stick with the old reading my bible and praying. Unrelated, when I need to, I'll take modern drugs, Advil, stronger prescription NSAIDS, or . . . opioids. Drugs that we are blessed with that generations long gone could only have dreamed of.
Finally, if you live a life filled with pain, learn to laugh at things. Even yourself. Try to discover the answer to the question: what makes this certain joke funny?
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 2, Interesting) by Anonymous Coward on Thursday November 07 2019, @07:42PM (6 children)
I have come to the conclusion (as long as you're not an addict or dependent and can stay that way) you'd probably be better off getting your opioids from an independent reseller that you can trust not to have fentanyl-laced opioids. Going to a pain clinic for years of lousy treatment plans and expensive bills has shown me the futility of pain management actually helping chronic pain sufferers. Grow your own THC containing plants if that works for you. Hell of a lot cheaper than the state approved medical cannabis $$$$ dispensaries and pain clinic racket.
Mindfulness exercises and other thought-calming exercises can and do work to an extent on pain, even praying to a non-existent entity if that's your poison.
I thought I knew pain when I had a nail driven through my hand, or when I slammed into a car windshield in a head-on collision, or when I had my first cluster headache culminating in a migraine with aura where I would crawl into a closet and lie in the darkness wishing for death. Neuropathic pain puts all that into perspective and moves them down the scale of pain assessment. Try sleeping when every night is filled with background pain that hovers around 7/10 and random spikes of sharp pain in the 9/10 or even 10/10 range. It's hard to laugh when the only sleep you get is when your body finally collapses from exhaustion for that sweet 2 hours of non-restorative sleep. Laughter does not help.
(Score: 0) by Anonymous Coward on Thursday November 07 2019, @07:53PM
Weed worked better for me than 10 years on fentanyl. As far as mind-body therapy... Yes, it worked but in my case it was a severe PTSD trigger that pushed emotional pain in front of the physical pain. The only way I knew my physical pain was too high was the tachycardia (180 bpm) accompanying it.
(Score: 4, Interesting) by DannyB on Thursday November 07 2019, @08:13PM (2 children)
My primary care doctor writes a prescription. My Arthritis specialist could do it, but I only want one Dr. writing these. Walgreens seems to have very pure high quality opioids. Way cheaper than "medical marijuana" at $5 for bottle of 30 tablets. And works a lot better for pain based on trying medical marijuana in summer 2017.
It is. I'm convinced he exists.
You truly have my sympathy.
Pain is subjective. But my particular arthritis is quite severe. I do know severe pain. When I had kidney stones (several times) a few years back, they were bad, but not as bad as I thought they would be. I totally relate to the thing that most ordinary pain goes way down the subjective pain scale. I also relate to the nights with background pain and anytime sharp intense spikes of pain -- anywhere, at random, in any joint -- but always in a joint. Finger. Ankle. Knee. Shoulder. Just out of the blue a super intense, but brief spike of pain somewhere. I only go for the narcotic pain killers when the pain approaches that higher intensity, and is fairly persistent. Or when a background pain increases beyond some threshold.
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 1, Interesting) by Anonymous Coward on Thursday November 07 2019, @08:38PM (1 child)
Trying weed one time is not the way to use it for pain control. It takes weeks or perhaps a month for your body to get used to it (the intense high mellows out) and you have to get a variety of both strains or you'll get bad side effects like paranoia. The medical only weed places have better stuff than the recreational weed suppliers. And... It's about 1/4 the cost of RX drugstore pain meds.
(Score: 2) by DannyB on Thursday November 07 2019, @10:49PM
If my state gets medical marijuana, I might give it a try. What I tried before was chocolates.
But opioids work. I've used them for a long time. I'd be surprised if something actually worked better. But I could be convinced.
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 0) by Anonymous Coward on Friday November 08 2019, @06:28PM
I agree with your characterization of neuropathy. Been there, done that! And, yes, opioids are a definite help, nor do they seem quite as problematically addictive when used to treat authentic pain. And, yes, meditation/mindfulness/hypnosis can help (it did for me).
The only item I would add is that learning to fast a couple times each week had a very positive effect. Something in fasting triggers the body to (slowly) begin to repair damaged nerve cells, and over months and years, the stabbing pains have almost completely subsided.
Although I no longer partake of opioids for neuropathy, they were, at one point, the only thing that kept me from suicide, and it would be tragic if they were withdrawn from those patients that truly need them.
My redneck brother-in-law used to opine that instead of wasting public funds fighting addictions, the government should simply hand out opioids and such for free, thereby letting those susceptible to those addictions kill themselves quicker, and allowing the rest of us to get on with the business of living. Oh the irony,... an evangelical advocating a darwinian solution.
(Score: 0) by Anonymous Coward on Sunday November 10 2019, @10:01AM
+1 for grow your own make your own
(Score: 2) by ilPapa on Thursday November 07 2019, @07:43PM (1 child)
So, you prefer old hocus pocus to new hocus pocus. Noted.
You are still welcome on my lawn.
(Score: 2) by DannyB on Thursday November 07 2019, @08:01PM
I think I said that.
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 2) by krishnoid on Thursday November 07 2019, @08:12PM (1 child)
How do you feel about acupuncture for pain relief? That's sort of old-timey hocus pocus, but it's new age in the new world ... more like sideways hocus-pocus. Worth a shot, right?
(Score: 2) by DannyB on Thursday November 07 2019, @08:16PM
I'm not afraid of it in a physical sense. I just don't think it's for me. Can't quite articulate why. My pain management predates starting on opioids. And I'm pretty comfortable with what I'm doing.
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 2) by Magic Oddball on Thursday November 07 2019, @10:47PM (1 child)
I wish that journalists and scientists would stop lumping together patients who take prescribed opioids, people who commit suicide using opioids, highly frail/terminal patients on opioids, people chronically abusing illegal street drugs, and people using street drugs recreationally. Opioid deaths are extremely rare among the regular chronic pain patients who aren't already frail or dying, so aggressively trying to get them off of opiates in favor of therapies that are less effective, less convenient, or more toxic (e.g. NSAIDs) for their alleged safety is a waste of time and resources.
(Score: 2) by DannyB on Thursday November 07 2019, @10:52PM
Yep.
But I also take very potent NSAIDs in addition to opioids as needed.
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 2) by All Your Lawn Are Belong To Us on Friday November 08 2019, @03:57PM (4 children)
Hard to tell if you're being ironic here or not, but if you've found methodologies which help to address your pain with resorting to medication or allow you to take less medication overall, could we not say that you have found a complementary or alternative method than relying exclusively on pharmacology?
If the answer is yes.... Well, CAM is the same category that meditation/mindfulness, hypnosis, relaxation, guided imagery, therapeutic suggestion, and CBT belongs to. :) Also biofeedback and acupuncture. Biofeedback used with CBT has been clinically shown to achieve beneficial effects, and acupuncture has had some clinical data supporting its use. Oh, and before and after Patch Adams the use of humor therapy [nih.gov] has also been well-known. If you can make someone laugh then maybe you can stop them from crying.... that's some powerful healthcare there when used well.
This sig for rent.
(Score: 2) by All Your Lawn Are Belong To Us on Friday November 08 2019, @03:58PM
Meh, "without resorting to medication" is what I meant but hopefully you finaguled that out.
This sig for rent.
(Score: 2) by DannyB on Friday November 08 2019, @07:01PM (2 children)
Not being ironic or sarcastic about that part. I actually do read and pray. I think I have encyclopedic knowledge of the Revelation -- but haven't put it to the test in closed book format. I think it amusing if people compare that negatively to new age hocus pocus.
And I've made myself the butt of a joke here sometimes. Recent example was on the topic of a treatment for people in vegetative state or unconscious. I joked that my fellow java programmers and I might be interested in this. Or "in my experience with tin foil hats . . .". And a few others. This all started on Usenet's moderated rec.humor.funny with the original moderator. I found it hilarious. I was much younger. I wanted to understand what made those jokes so funny. After almost three decades, I think there are several common patterns for humor. I try to look for things that fit one of the patterns.
Yes. I would say that is true. But naturally my alternative method is obviously objectively better than the new age hocus pocus. /s And still there are days where I'll reach for the narcotic pain killers.
Another thing is to learn to breathe slowly. Calm down. Relax. I've figured that out without looking at any type of learning or studying. Just figured it out through practice. I've observed how women in labor breathe a certain way, and mimic that sometimes.
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.
(Score: 2) by All Your Lawn Are Belong To Us on Friday November 08 2019, @10:54PM (1 child)
Sorry it was hard for me to distinguish. I read more than one place that Groucho Marx would sometimes get upset because if he got genuinely mad and insulting at someone the other person would laugh it off as a funny "joke" from Groucho. Your posts are often entertaining as well as making one think.
Anyway.... The good part is that what works for you is what works. New age stuff might work better for someone else. So long as it actually works, more power to them, and you. It's taken medicine a long while to recognize that there are things which complement existing medical therapies, and that people will indeed use other therapies as alternatives to medicine. And there are plenty of clinical people who don't believe in CAM, either, or try to minimize it. We still don't have good methods to objectify pain (not ones that keep someone conscious, anyway), so we still rely on subjective reporting more than anything else to judge efficacy. But if it's working for you, awesome!
Focused breathing techniques are great methods. There are forms of meditation, by the way, which outright claim for themselves that all they are teaching is focused breathing - no additional new-age belief required. (The same is true for many "mindfulness" techniques - try to control your focus and your experience changes whether one is concentrating on "the living force" or just trying to get how a joint feels into context with your whole body which may be feeling OK). But your carbon dioxide level (and bicarbonate, but CO2 is regulated by breathing), have a lot to do with how your blood regulates it's pH level which must always be not too acidic or alkalinic (7.35 to 7.45 pH is normal for your blood). A lot of your nervous system's control and the hormones which regulate exocrine systems take big cues from your blood pH, and vice-versa. Breathing well and using your breathing to stay in control has a lot to do with your pain perception. Not everything, as you point out. But a lot.
And then... you've got the pharmacology to help out as well, too. If pharmacology wasn't beneficial sometimes nobody would use it, either....
This sig for rent.
(Score: 2) by DannyB on Monday November 11 2019, @03:33PM
There seems to be a growing view that opioids are never good and nobody should take them. I think that used judiciously, one can use them for a long time (as I have, almost 11 years), and with careful use they most certainly do improve one's quality of life. Other ways of dealing with pain are good and hopefully help to avoid or reduce taking narcotic pain killers. I get triggered at the idea that nobody should take them for long term use. I am still on the weak dose. And I hope I never start looking to get tablets with a higher dosage.
As for my beliefs, reading the bible and praying, I don't think that changes my circumstances so much as that it changes me.
People in my life over the last decade or more have remarked about the change. I think when you're in pain a lot, it can get easier to want to help other people, be less selfish, not be so picky about lots of small things. The more I let go of the things of this world, the easier it is to help others, let others have their way, etc. I (and my spouse also) find that we're at a point where it is far more enjoyable to give gifts than to get them. At Christmas for example. What could anyone possibly get me that would make my life much better? After a lifetime to get things I wanted, the only things that I might possibly want but don't have are probably too expensive. But there is a joy in getting things for other people, for example.
When trying to solve a problem don't ask who suffers from the problem, ask who profits from the problem.