The Opioid Crisis

 Death from prescription painkillers (specifically opioids such as Methadone, Oxycontin, and Vicodin) have quadrupled since 1999 and is the leading cause of accidental death. (1) The CDC came out with these alarming statistics that estimated 165,000 people (with a majority ages 24-54) have died between 1999 and 2014 from opioids; that comes out to be about 1,000 people a month dying from these prescriptions. Opioids can come both in prescription and illegal/illicit form. Heroin, being the illicit street drug, and Vicodin and Oxycontin being the legal, prescription version. Not only has the death toll increased by 4 fold in the last 15 years, but so has the prescription rate. The CDC also claims that physicians have written four times the amount of opioid scripts in that same time period (99-14), however, the number of patients in pain has not changed. 1 out of 5 patients are being given prescriptions for opioids in doctors offices, routinely. Primary care physicians make up half of these doctors prescribing the drugs, while chronic pain specialists, surgeons, and physical rehab physicians make up the remaining population.

These opioids are prescribed to reduce the sensation of pain. Opioids effect the same part of the brain that is responsible for breathing, so patients who succumb to opioid overdose often suffer "respiratory depression". Often the use of alcohol and these prescriptions can add to the death toll. University of Colorado recently published a study claiming that long term opioid usage can lead to an increase of chronic pain! (2)

In Acupuncture, we are trained to treat a wide variety of diseases and especially pain syndromes. We explore, investigate, and diagnose the type of pain someone might be experiencing. However, the down-side to Acupuncture, is the true cause is not always evaluated. Since I completed my Doctoral degree in Integrative Medicine and began practicing Functional Medicine, I have become proficient in pinpointing the cause of many people's struggles. This is most frequently achieved by blood test and lab analysis (much more in depth diagnosis than a traditional MD gives you), palpation and physical exam, and most importantly, a very deep understanding of the patient's whole health (verbal comprehensive evaluation). With these tools in Functional Medicine, the cause can more likely than not be determined, and treatment can be applied. Pain syndromes can come from the most unlikely of places. I have seen pain originate solely from emotional trauma, to high creatinine levels in the blood, from cardiovascular distress, or pain from insulin resistance and high sugar intake, food allergies, post concussion/trauma, viruses, parasites, autoimmune diseases such as Sjogren's or Ankylosing Spondylitis, or even liver disease. Not one case is the same, and not one patient expresses their pain the same. Sometimes the pain is quick to go away, while other cases can take time and diligence.

Most importantly to me though, beyond finding the cause of the pain, is treating the pain. What good is it to sit around and talk about a problem if we have no solution? Well the CDC finally released a statement (actually a manual) about better alternatives to opioids. The manual continually cites both exercise and physical therapy and acupuncture isn't directly mentioned on the CDC manual, and for good reason; it is not well researched. The mechanisms of acupuncture are so complex, that an isolated study does not work. But this is what we do know for certain about acupuncture:

1. By sticking a needle near nerve bundles we can affect both the sensory cortex of the brain and the prefrontal cortex which stimulates natural endogenous endorphins and opioid peptides, and serotonin (5 HT) (3)
2. Acupuncture reduces both neuropathic pain, nociceptive pain, and psychological pain (4)
3. Acupuncture can regulate neurotransmitters/peptides (both upregulate and downregulate) that can be involved in pain and addiction (dopamine, serotonin, norepinephrine, ACTH, and GnRH)
4. Acupuncture can decrease inflammation both locally and systemically
5. Acupuncture can regulate organ function which can often be a cause of pain

Not only does acupuncture make an affect in the lab, acupuncture has outstanding clinical results. I have helped patients in one treatment with decades long back pain, I have treated patients with undiagnosed chronic pain successfully day in and day out, I have seen over 100 patients per day (in China) come into our Orthopedics floor in the common hospital with a wide variety of pain syndrome be treated with absolutely zero prescriptions of opioids and zero harmful effects. I have treated post-surgery, chronic pain, acute pain, pain from disease, pain from unknown origin. When dealing with pain, it seems common sense to try something such as acupuncture, exercise, or physical therapy which has no chance of causing death, over taking a pill that could cause a moderate to high probability of complications, long term repercussions, and even death! You have absolutely nothing to lose, and so much to learn about what is happening to your body how to prevent it again.

(1)(Bowman S, Eiserman J, Beletsky L, Stancliff S, Bruce RD (2013). "Reducing the health consequences of opioid addiction in primary care". Am J Med 126 (7): 565–71.doi:10.1016/j.amjmed.2012.11.031)

(3) (http://www.denverpost.com/2016/05/30/cu-boulder-study-narcotic-painkillers-cause-chronic-pain/)

(4) (Filshie J, White A. Medical Acupuncture: A Western Scientific Approach. London, UK: Churchill Livingstone; 2006:76)

(5) (White A., Cummings M., Filshie J. An Introduction to Western Medical Acupuncture. London, UK: Churchill Livingstone; 2008:48-53)