Comprehensive pain management as a frontline treatment to address the opioid crisis

Background: The opioid crisis continues to devastate individuals and communities in the United States and abroad. While there have been several measures to address the over‐prescription of opioid analgesics, the number of overdose deaths related to prescription opioids has not changed appreciably in the last 10 years. Comprehensive (or multidisciplinary) pain recovery programs consist of providers from multiple backgrounds that treat pain on an individual level through a combination of approaches including physical therapy, emotional and spiritual support, cognitive behavioral therapy, and non‐opioid pharmacotherapies. Because there is a dynamic interplay between a given chronic pain patient and multiple providers, comprehensive pain programs are not as “standardized” as other medical treatments because they are meant to meet the individual needs of each patient and their specific pain diagnoses Methods: Review of the literature. Results: There is evidence that comprehensive pain treatment can reduce pain severity and improve functioning; comprehensive pain treatment can be used to treat those with post‐surgical pain, thus preventing the onset of non‐medical opioid use and opioid use disorder, and in persons with chronic pain who are on long‐term opioid therapy, as a method to reduce or eliminate opioid medication use. Comprehensive pain recovery programs were abundant for a period from the 1960s through the 1980s, but for a variety of reasons, they became financially unsustainable as the national reimbursement environment evolved. Conclusions: In the context of the protracted and deadly opioid crisis, revitalizing and expanding comprehensive pain treatment should be considered as a frontline approach to treat chronic pain. Prescription opioids play a major role in the opioid crisis, yet long‐term opioid therapy is often ineffective in treating chronic pain. Comprehensive pain treatment is a multidisciplinary approach to pain treatment that favors combinations of psychological and physical therapies to treat pain without opioid analgesics. Increasing access to comprehensive pain treatment is a logical step in reducing the availability of prescription opioids and addressing the deadly and protracted opioid crisis in the United States.