As we ease into 2018 and the ever-changing healthcare landscape, one thing to be excited about is that the Joint Commission (JACO) of the United States has directed major hospitals to offer non-opioid options for pain starting on January 1st! Based on the success of hundreds of studies, acupuncture is one of the leading options hospitals have agreed would provide pain relief when opioids would not be appropriate for the patient.
According to Paul F. Lachiewicz, MD, of the Department of Orthopedic Surgery at Duke University Medical Center in Durham, N.C., among the risks of opioid use for certain patients are abuse, confusion, nausea, vomiting, itching, constipation and respiratory depression. While adapting to non-opioid options could prove to be challenging to implement because of the lack of infrastructure, many hospitals like St. Joseph’s Regional Center in Paterson, NJ of have begun the process of creating programs as directed. They’ve been using alternative protocols for pain management since January of 2016 with their ALTO (Alternates to Opioids) program - and if the busiest Emergency Room in NJ can find a way, there’s hope for the rest of the country.
Outside the hospital, acupuncture has received rave reviews by the World Health Organization (WHO), such that WHO has now directed MD’s to consider acupuncture therapies BEFORE corticosteroids or other pain medicine. Even the American College of Physicians (ACP) recommended acupuncture in 2016 as a preferred option for Low Back Pain versus pain meds!
In terms of acceptance into the mainstream healthcare market, 2018 marks the first year acupuncture is listed in the Bureau of Labor Statistics Occupational Handbook as an independent healthcare profession, and by popular demand more insurance companies appear to be including acupuncture in their benefits package.
This is not a surprise to the Traditional Chinese Medicine (TCM) community, as acupuncture has been proven to work for thousands of years in Asian countries, and now around the world. At least 50 years of research is finally coming to the fore, including Brattberg 1983, who compared corticosteroid injection use to acupuncture for treatment resistant tennis elbow in a study that included over 50 subjects. 61.8% of the acupuncture group (21 subjects, out of 34) showed a significant improvement, while just 30.8% of the steroid group (8 subjects, out of 26) reported improvement.
A more recent study in York, England (March 2017), declared acupuncture as the most cost- effective method to treat osteoarthritis of the knee. A quote from the conclusion of the study reads as follows: “If only higher quality trials are considered, acupuncture is cost-effective at the NICE (National Institute for Clinical Excellence) threshold, at any higher thresholds, and at thresholds down to about £14,000 per QALY (Quality Adjusted Life Years).”
This and hundreds of other studies should be forwarded to former NJ governor Chris Christie so that he may reconsider and amend his 138-page report entitled, “The President’s Commission on Combating Drug Addiction and the Opioid Crisis”, where he neglected to offer acupuncture as an option amongst the 56 recommendations he did make.
1. The Joint Commission Introduces Revised Pain Assessment and Management Standards, for Accredited Hospitals, to Include Use of Non-Pharmacologic Treatments and Strategies* http://www.nccaom.org/blog/2017/07/12/joint-commission-assessment/
2. “Surgeons explore non-opioid options for pain management”. Orthopedics Today (2014) https://www.healio.com/orthopedics/total-joint-reconstruction/news/print/orthopedics-today/%7B9da4e094-2f3d-451d-acbc-5a5f7d4d3e46%7D/surgeons-explore-non-opioid-options-for-pain-management
3. ALTO – Alternative to Opiates Program - https://stjosephshealth.org/alto
4. Glatter, Robert, MD, “If You Have Low Back Pain, Don’t Reach for a Pill”, Forbes, (2016) https://www.forbes.com/sites/robertglatter/2017/02/15/new-guidelines-recommend-a-change-in-treatment-of-low-back-pain/#5b62954529ef
5. Acupuncturists Earn Unique Occupational Code From U.S. Bureau of Labor Statistics https://finance.yahoo.com/news/acupuncturists-earn-unique-occupational-code-120000322.html
6. Brattberg, G., “Acupuncture for tennis elbow”, Pub Med (1983) https://www.ncbi.nlm.nih.gov/pubmed/6888954
7. Woods, Beth et al, “Cost Effectiveness of adjunct non-pharmacological interventions for osteroarthriis of the knee”, PLOS One, (03/2017)