HHS Pain Management Report offers unprecedented potential to support advancement of integrative pain management protocols

The recent release of Pain Management Best Practices Inter-Agency Task Force Report from the U.S. Department of Health and Human Services (HHS) is an unprecedented opportunity to shed light on the potential of integrative and non-pharmacological approaches to pain management, according to the Integrative Health Policy Consortium (IHPC).

Although the nation has been justifiably focused on the action of the pharmaceutical industry that has helped to perpetuate the opioid crisis by promoting drugs for pain that have known potential to cause addiction and harm, this report has received far too little attention, the Washington. D.C.-based non-profit organization said. “This document paints a path forward to effectively address pain with a multidisciplinary strategy utilizing non-pharmacologic approaches,” said IHPC Policy Committee co-chair Sharad Kohli, MD. “Many of the therapies recommended are not only safer, but more effective than opioids, will prevent unnecessary deaths, and will improve the quality of life for the millions of Americans currently suffering with pain.”

The report identifies gaps and inconsistencies in pain management and offers recommendations for improving pain management best practices. The task force emphasizes key non-pharmaceutical centered approaches to improve the lives of patients living with acute and chronic pain. They include individualized patient-centered care fostering a therapeutic alliance between patients and clinicians and multidisciplinary approaches using one or more treatment modalities and the biopsychosocial model for pain care. The report also considers special patient populations and comorbid conditions that accompany complex pain. The Task Force also recommended that the Centers for Medicare & Medicaid Services (CMS) and other insurers align their reimbursement guidelines with these findings.

The Inter-Agency Task Force Report is a welcome addition to the pile of reports generated by government agencies in the context of the opioid overdose syndemic, noted Robert Twillman, Ph.D., an IHPC at-large member and pain management psychologist at St. Luke’s Health System in Kansas City, MO. It is notable, he added, that the work resulting in the document was done by a select group of individuals directly involved with pain management in one way or another, and that it included a broad spectrum of such individuals, as mandated by the SUPPORT Act for Patients and Communities. “Asking those ‘in the trenches’ as people with pain, health care providers, and policymakers to survey the landscape and make recommendations for where we go from here is exactly the way such exercises should be carried out,” Twillman said. “Couple that with robust opportunities for public comment, both online and at the Task Force’s meetings, and you have a document that stands out as an example of the way things should be done.”

The Task Force’s recommendations span five broad treatment approaches to pain management: Medication, Restorative Therapies, Interventional Procedures, Behavioral Health Approaches, and Complementary and Integrative Health. They are reinforced by four cross-cutting themes critical to all treatment approaches: Risk Assessment, Stigma, Access to Care and Education. It represents a philosophical and cultural shift to addressing chronic and acute pain by using Complementary and Integrative Health Protocols, IHPC said.

It is gratifying, Twillman added, to see the task force recognize these ideas because previous guidelines and policies have given little more than lip service to these notions. “Many times non-pharmacological treatments for pain are recognized as preferred first-line therapy, but recognition of the tremendous access barriers to that kind of care is rare,” he said. “Those of us in the field know all too well how difficult it is for most people with pain to access non-pharmaceutical care, and for the Task Force to fully recognize this and recommend changes to coverage policies to promote access is very important.”

Twillman sees this report as a tremendous opportunity for the field of integrative health and medicine. “It is a foot in the door that is enabled by the country’s tremendous problems related to the opioid misuse, abuse, overdose, and overdose death syndemics,” he said. The tremendous opportunity here for integrative providers to demonstrate the value of these interventions can’t be ignored, and the integrative health community needs to do everything in its power to leverage this report to improve access, Twillman added. “Any time a good report is issued, we talk about not letting it just gather dust on a shelf, and far too often, that is exactly what happens. I’m not sure we’ve ever had an opportunity like this, and we can’t allow it to go unrecognized.”

You can read the full report and visit HHS’s accompanying toolkit here