'Encouraging' New National Data on Chronic Pain Management

Megan Brooks

February 10, 2022

Most adults in the US who have chronic pain favor a combination of non-drug and non-opioid approaches to control their pain, which is "encouraging," new research shows.

A national survey reveals 55% of adults with chronic pain used pain management techniques that did not involve any opioids at all during the prior 3-month period.

However, few participants took advantage of cognitive-behavioral therapy (CBT), which is effective for easing chronic pain, Cornelius Groenewald, Department of Anesthesiology and Pain Medicine, University of Seattle, Washington, and colleagues write.

The results were published online in a research letter February 7 in JAMA Network Open.

First Time for Pain Questions

An estimated 50.2 million US adults experience chronic pain, according to the 2019 National Health Interview Survey.

The 2019 version of the survey included questions on pain management techniques for the first time. Adults with chronic pain were asked to report on their use of 11 pain management techniques during the previous 3 months.

Among the 31,916 survey respondents, 64% were women; 69% were non-Hispanic White, 13% Hispanic, and 11% non-Hispanic Black; 71% were between 18 and 64 years of age, and 29% were 65 and older.

Among the key findings, an estimated 55% of adults with chronic pain only used non-opioid pain management techniques, 11% used both opioids and non-opioid techniques, and 4% only used opioids for chronic pain management; 30% did not report any pain management techniques during the previous 3 months.

Complementary therapies were the most commonly used non-opioid pain management technique (by 35% of adults with chronic pain), followed by physical, occupational, or rehabilitative therapies (19%).

Only about 4% of adults with chronic pain used CBT.

Other techniques used included self-management programs (5%) and chronic pain peer support groups (2%). In addition, 39% of adults with chronic pain reported using other pain approaches not specifically captured in the data set.

Benchmark Data

Participants using complementary and psychological or psychotherapeutic interventions were more likely to be younger women with more education, the investigators report.

Adults using physical, occupational, or rehabilitative therapy were more likely to be highly educated older women with medical insurance.

Prescription opioid use for chronic pain was more common among older adults aged 45 to 64 years vs those aged 18 to 44 years (19% vs 8%).

It was also more common in women than men (17% vs 13%), in adults with vs without health insurance (16% vs 6%), and in those with a high school education or lower compared with those had more than a high school education (17% vs 14%).

Prescription opioid use was less common among adults making $100,000 or more annually vs those making less than $35,000 a year (9% vs 20%).

"While effective for some, opioids prescribed for chronic pain management remain an important determinant of the national opioid crisis," the investigators write.

The study "provides baseline information on opioid and non-opioid pain management techniques used for chronic pain and serves as a benchmark for evaluating the outcome of health care policies aimed at reducing prescription opioid use," they add.

The study had no specific funding. The investigators have disclosed no relevant financial relationships.

JAMA Netw Open. Published online February 7, 2022. Full text

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