In recent years, we have seen the level of opioid abuse in this country increase significantly. In 2014, about 28,000 people died from opioid overdose in the US. For comparison, the total killed in all car accidents in 2013 was about 30,000. And while car accident deaths continue to decline, especially in relation to the number of miles Americans drive, opioid deaths have nearly quadrupled since 1999, and account for more than 60% of all drug overdose deaths in the US.
We know that prescription opioids are a major factor. In fact, they account for about half of all opioid overdose deaths, and–probably not coincidentally–opioid prescriptions have nearly quadrupled since 1999. So we need to find ways to reduce prescriptions of opioids and encourage other treatments for chronic pain conditions like TMJ.
The New HHS Strategy
As part of the campaign to control the epidemic of opioid deaths, the US Department of Health & Human Services (HHS) has issued a new plan for managing chronic pain with fewer opioids.
The efforts to develop the National Pain Strategy began in 2011 in response to the opioid overdose crisis. The HHS convened the Interagency Pain Research Coordinating Committee (IPRCC), which included representatives from the Department of Defence, Veterans Affairs, Agency for Healthcare Research and Quality, the Centers for Disease Control, the Food and Drug Administration, the National Institutes of Health, as well as patient advocates and other private sector representatives. The IPRCC was charged with developing the new strategy, which was released in March.
The new approach to chronic pain recommends:
- Developing approaches that help us prevent and manage pain
- Encourage the use of integrated pain management practices that recognize the factors behind basic pain include biological factors, psychological factors, and social factors
- Ensure patients have access to the full spectrum of pain management options, including home care
- Improve access to better pain care for people who have encountered barriers in the past
- Increasing public awareness–including doctors–about chronic pain conditions and the full range of treatments available for chronic pain
With millions of Americans suffering from chronic pain, it seems imperative that we discover better approaches to chronic pain care that lead to quality results without opioids. In part because opioids have always yielded dubious results with respect to pain, which has contributed to the epidemic of overdoses. Although opioids may at first yield good results, their effectiveness diminishes over time, requiring larger doses for pain control and increasing the risk of overdose.
The Role of TMJ Treatment in the New Pain Plan
As the National Pain Strategy encourages us to move away from drug-related treatments and more toward forms of alternative care, it’s likely that drug-free TMJ treatment under the care of a neuromuscular dentist will come to play a more important role in the future.
There is evidence that TMJ treatment is a cornerstone condition, and through its involvement with the trigeminal nerve may contribute to the development of other chronic pain conditions, such as migraine, fibromyalgia, and irritable bowel syndrome (IBS).