A new study published in the Journal of Psychiatric Practice, suggest that chronic pain could be managed by teaching patients better approach called cognitive behavioural therapy (CBT), which is a beneficial alternative treatment for the millions of patients who are on opioid therapy for non-cancerous pain.
The escalating use of opioid medications to treat chronic noncancerous pain increases the severe risks of abuse, misuse, drug dependence, overdose and death. CBT is an effective alternative to opioids for treating chronic pain. CBT aimed to help patients to change their thought and manage the pain. It helps patients understand that pain is a stressor and, like other stressors, is something they can adapt to and handle with.
CBT includes relaxation training, cognitive restructuring, scheduling social activities, and guided exercise, which is efficient enough to relieve pain intensity, improve the quality of life, and improve physical and emotional functions. Several studies and articles that support the different alternatives for pain control, summarize that CBT has a "top-down" effect on pain management and perception of painful stimuli. It could also normalize reductions in the brain's gray matter volume, which are thought to result from the effects of chronic stress.
CBT is moderately effective in reducing pain scores, and even it decreases the opioid risks of overuse, addiction, overdose, and death. It can be used as a standalone therapy; in combination with other treatments, including effective non-opioid drugs; or as part of the intervention to reduce the opioid doses necessary to manage chronic pain.
Due to unfamiliarity, patient demands, time pressure, ease of prescribing medications, and low reimbursement rates, CBT and other alternative nondrug treatments become underused. The significant investment of resources would be required to train health care providers and for global implementation of CBT to treat chronic pain. The President's Commission on the opioid crisis should fund such training programs as a preventive decision to control opiate abuse, the researchers noted.
For an efficient pain management and prevention of opioid crisis, there is a need for a paradigm shift from a biomedical to a bio-psychosocial model. The widespread use of CBT as an alternative to opioids might help to reduce the clinical, financial, and social burden of pain disorders in society, the authors noted.