Tuesday, November 14, 2017

The White Paper, Acupuncture's Role in Solving the Opioid Epidemic

key words:  research literacy, acupuncture for pain relief, acupuncture for pain management, non-pharm pain management options, opioid epidemic, cost-effectiveness of acupuncture, the acupuncture analgesic mechanism, acupuncture and neuroplasticity

"The United States is facing a national opioid epidemic, and medical systems are in need of non-pharmacological strategies that can be employed to decrease the public’s opioid dependence." 

"Acupuncture is an effective, safe, and cost-effective treatment for numerous types of acute and chronic pain. Acupuncture should be recommended as a first line treatment for pain before opiates are prescribed, and may reduce opioid use."

In September 2017, the white paper, Acupuncture's Role in Solving the Opioid Epidemic:  Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management, was published by The Joint Acupuncture Opioid Task Force, chaired by Bonnie Bolash, MAc.

This white paper is just 15 pages long and incredibly well-referenced (21 pages long when including references section).  You can look at a copy on Evidenced-based Acupuncture's website.

This work was a collaboration of the following national and international organizations:  The American Society of Acupuncturists (ASA), The American Alliance for Professional Acupuncture Safety (AAPAS), The Acupuncture Now Foundation (ANF), The American TCM Association (ATCMA), The American TCM Society (ATCMS), and the National Federation of TCM Organizations (NFTCMO).

All the topics in the paper are supported by research in the end notes/reference section.
I highlighted some topics with a related quote below.  Check out the full paper here.


For anyone asking, how does acupuncture work?  The paper states,
 "mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives." 

Is acupuncture cost-effective?
"...acupuncture’s cost-effectiveness could dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding the development of opioid addiction that requires costly care, destroys quality of life, and can lead to fatal overdose."

Who recommends it?
"Acupuncture has been recommended as a first line non-pharmacologic therapy by the FDA, as well as the National Academies of Sciences, Engineering, and Medicine in coping with the opioid crisis. The Joint Commission has also mandated that hospitals provide non-pharmacologic pain treatment modalities." [section 4]
"Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacological treatment options, and acupuncture stands as the most evidence-based, immediately available choice to fulfill these calls.  Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of pain seen commonly in hospitals." 

Acupuncture and neuroplasticity

"Acupuncture is effective for the treatment of chronic pain involving maladaptive neuroplasticity" and "acupuncture has the capacity to reverse adverse neuroplastic changes" [section 3]

Source:  The September 2017 white paper, Acupuncture's Role in Solving the Opioid Epidemic:  Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management
scientific journal citation:
Fan AY, Miller DW, Bolash B, Bauer M, Faggert S, He H, Li YM, Matecki A, Camardell L, Koppelman MH, Stone J, McDonald J, Meade L, Pang J.  Acupuncture's Role in Solving the Opioid Epidemic:  Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management --White Paper 2017. J Integr Med. 2017; 15(6): 411-425.  http://dx.doi.org/10.1016/S2095-4964(17)60378-9

Simultaneously published in Meridians:  Journal of Acupuncture and Oriental Medicine, winter 2018.  www.meridiansjaom.com

Related blogposts
Calculating Morphine Equivalent Dose
Medication Review:  Discerning Side Effects of Opioid Medications
37 Attorney Generals Push Incentive Programs for Non-Pharm Pain Management Therapies
Sept 2017 update on Joint Commission's Pain Management Standard
The Field of Acupuncture Research in 10 Minutes
FDA Pain Management Guideline Recommends Acupuncture
Lunchtime Listen:  the Opioid Epidemic
Metrics and Pain Management, using a Validated Pain Scale

Useful Infographic on Non-Pharm Pain Relief Options for a PCM
Moving Beyond Medications:  Non-Pharm Approaches to Pain Management and Well-Being, a one-page infographic for PCMs.  This is a collaborative work by several national integrative medicine groups.



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