Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management
September 2017 saw the release of a comprehensive white paper, “Acupuncture’s Role in Solving the Opioid Epidemic”, credited to dozens of authors and a half-dozen different organizations of acupuncturists and TCM professionals. In this series, we’ll be looking at the different reasons why and the ways in which acupuncture can help alleviate the opioid abuse epidemic wreaking havoc in America.
Over the past 20 years, pain management has become nearly synonymous with opioids. Recent data has shown that opioid prescriptions vary widely and that most surgical patients are over-prescribed, with 70% of pills going unused, leaving opioids lying around in many households.(26) About 6% of all Americans prescribed opioids after surgery become dependent upon those opioids; in head and neck cancer patients, however, it’s as high as 40%.(28) Although they do manage pain, even for those who don’t become dependent, opioids lengthen patients’ recovery times through side effects like sedation, pneumonia, and delirium.
Acupuncture, on the other hand, is a safe, affordable, and readily available non-pharmacologic approach to decreasing opioid dependence that our healthcare systems badly need. It can be used in hospital settings from the emergency room to delivery room, and it’s already in use by the Veterans Administration and the US military.
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Part 1: Acupuncture is an effective and safe treatment for both acute and chronic pain.
A growing body of research supports the effectiveness of acupuncture for the relief of pain, especially chronic pain, with the strongest evidence emerging for back, neck, and shoulder pain; chronic headaches; and osteoarthritis.
The Acupuncture Evidence Project(1), which we’ve previously covered, searched the literature with a focus on the highest form of evidence available to identify the conditions for which acupuncture has been found to be most effective. They also looked for evidence of acupuncture’s safety and cost-effectiveness and reported how the evidence for acupuncture’s effectiveness has changed over an eleven-year time-frame. Overall, the study found evidence for the effectiveness of acupuncture for 117 conditions, with stronger evidence for some conditions than others. Strong or moderate evidence supported the effectiveness of acupuncture for almost fifty conditions, including IBS, many varieties of musculoskeletal pain, post-operative nausea and vomiting, some types of headaches, PTSD, obesity, and stroke, as well as the aftereffects of stroke. It was found to be particularly safe and cost-effective compared to other potential treatments for allergic rhinitis and migraine.
In another study, the largest study of its kind to date, nearly half a million patients were treated with acupuncture for headache, low back pain, and/or osteoarthritis in an open pragmatic trial; treating physicians rated it as effective in 76% of all cases. Minor side effects were seen in 8% of patients, and major side effects in only 13 patients total.(3) Other studies found acupuncture, particularly electroacupuncture, equal or superior to standard care for sciatica, joint pain, post-surgical discomfort, and the infamously difficult-to-treat fibromyalgia.
Next time: acupuncture is affordable and reduces opioid use.
26: Hill MV, McMahon ML, Stucke RS, Barth RJ. Wide Variation and Excessive Dosage of Opioid Prescriptions for Common General Surgical Procedures. Annals of Surgery. 2017: 265(4), 709-714. doi:10.1097/sla.0000000000001993.
28: Pang J, Tringale KR, Tapia VJ, Moss WJ, et al (2017). Chronic Opioid Use Following Surgery for Oral Cavity Cancer. JAMA Otolaryngol Head Neck Surgery. 2017: doi:10.1001/jamaoto.2017.0582.
1: McDonald J, Janz S. The Acupuncture Evidence Project: A Comprehensive Literature Review. Australian Acupuncture & Chinese Medicine Association Limited, Dec 19, 2016.
3: Weidenhammer W, Streng A, Linde K, Hoppe A, Melchart D. Acupuncture for Chronic Pain within the Research Program of 10 German Health Insurance Funds–Basic Results from an Observational Study. Complementary Therapies in Medicine. 2007;15(4):238-46.