After watching a dramatic rise in the numbers of opioid-related poisonings in the US, which has reached epidemic proportions in some places, the Centers for Disease Control (CDC) have finally come out with a sweeping statement that doctors should not rely on opioids to relieve chronic pain conditions like TMJ. Although these guidelines are voluntary, there is hope that it will encourage doctors to seek other, possibly drug-free, approaches to relieve chronic pain.
The CDC acknowledged that the management of chronic pain is both “an art and a science.” It said that there has to be some flexibility for doctors to work with their patients to find the optimal solution for pain control. However, in its statement the CDC said the science gave a very clear picture of opioids: “for the vast majority of patients, the known, serious, and too-often fatal risks far outweigh the unproven and transient benefits,” wrote two CDC doctors in an editorial in the New England Journal of Medicine. Those consequences are serious: every day 40 Americans die of opioid overdose, and about 2 million Americans abuse or misuse the drugs every year. Not to mention the fact that people may experience worse pain, such as those whose migraines transition from episodic to chronic.
The CDC’s guidelines are aimed at primary care doctors, who actually write the majority of prescriptions for opioids. It said treatment with opioids is best for short-term relief, not relief from chronic pain conditions. Opioids should only be tried after other approaches have failed, and then doctors should start with the lowest possible doses and only increase them incrementally as necessary.
These guidelines have been carefully crafted over more than a year, but it’s hard to know how many physicians will pay attention to the voluntary recommendations. It is also unclear how drug manufacturers, who have played a significant role in this developing crisis, will respond.
Drug Free Pain Relief
One important aspect of overcoming this crisis is finding alternatives to opioids for chronic pain management. If people aren’t getting relief from other options, they will continue to return to their doctors asking for more pain relief, until doctors, who run out of options, just prescribe them opioids after all. We need to find more ways to treat chronic pain without drugs.
TMJ treatment is a drug-free approach to chronic pain, and it may be able to help with more than just jaw pain. Some researchers believe that TMJ could set off a major release of calcitonin gene-related peptide (CGRP), which triggers other chronic pain conditions, ranging from migraines to chronic back pain to IBS.
Not everyone with chronic pain will respond to TMJ treatment, but for those who do, the benefits could extend throughout the body.