3 ways to cut the path from MSK pain to opioid addiction

In honor of Pain Awareness Month and Opioid Awareness Day, Vori Health and Ophelia are teaming up to spread awareness of the connection between chronic pain and opioid addiction. Opioid-related overdose deaths have more than doubled in the last six years (NCHS, 2023). The trend is expected to continue, especially as many patients with opioid addiction have struggled to access FDA-approved medications for treatment such as buprenorphine.

It’s easy to see how musculoskeletal pain throws gasoline on this fire every day. Back, neck, joint pain...these common complaints are the primary reasons why full agonist* opioids (e.g. morphine, OxyContin) are prescribed, most often inappropriately. From the number of narcotics wrongly given to people on their first doctor’s visit for pain, to rampant opioids prescribed after orthopedic and spine surgeries (many of which were unnecessary in the first place), to the number of resulting addictions and deaths, the slope from pain to addiction is harrowing and heartbreaking.

This is a problem with clear solutions. We can cut the path from MSK pain to opioid addiction, and we can help bring low-cost, evidence-based treatment for addiction into people’s homes. We can stop healthcare costs from spiraling out of control and patients from suffering unnecessarily. Here are three key ways.

1. Build Awareness

Change starts with knowledge. A white paper Vori Health is  releasing this week dives into the many alarming statistics that show why this conversation matters. Here are a few of the most heavy-hitting numbers.

• Despite well-published guidelines encouraging non-opioid treatments, 21.5% of patients are currently prescribed opioids at their initial visit for MSK pain (Feldman, 2020). 
• Every single opioid prescription—even a one-day prescription—carries a risk of addiction (Shah, 2017).
• 50% of surgeries for low back pain and more than 1/3 of knee replacements are unnecessary (HBR, 2017; Riddle, 2014)—with 98% of patients prescribed opioids after spine and orthopedic surgeries (Berardino, 2021).
• 75% of employers face opioid use in their workforce with a 38% loss in productivity (NSC, 2019).
• 15-18% of people who get back surgery will become addicted to opioids (Cook, 2019)
• Among 7.6M+ people with opioid use disorder, fewer than 1-2M receive evidence based treatment in a given year
• Only 35% of care episodes for opioid use disorder include FDA-approved life saving medications such as buprenorphine
• The number one barrier to receiving treatment reported by individuals with opioid use disorder is affordable access

2. Unblock Access with Virtual Care

When pain strikes, many people do not have access to the right care. Patients often turn to their primary care physicians (PCPs), many of whom are not adequately trained in appropriate, evidence-based care for spine, joint, and muscle conditions. With this lack of training and a desire to provide relief quickly, it’s not surprising that PCPs are amongst the highest prescribers of opioids (Kiang, 2020).

In the 21^st century, we can do better. With virtual care solutions, we can provide patients—regardless of where they live—with access to evidence-based specialty care for MSK pain that sharply cuts opioids out of the equation. And in cases where people are already dependent on opioids, telehealth treatment of opioid addiction is also critical for removing barriers to care — such as lack of geographic access, privacy concerns, and stigma associated with in-person care.  

3. Deliver Patient-Centered Care

If we can all agree on the wrong care to give, then what is the right care? Study after study shows: To treat pain and prevent addiction, and likewise to treat addiction and promote recovery, we must address the whole person with patient-centered care.

Pain is a complex phenomenon. The world’s greatest minds are just beginning to understand it. What we do know is that pain is rarely just a physical problem. It often goes hand-in-hand with mental health issues. Not only do up to 85 percent of MSK patients also suffer from depression, studies show that one condition usually worsens the outcomes of the other (Melkevic, 2018). 

To properly treat pain at its root, we must take a whole-person approach. At Vori Health, integrated care teams look at every aspect of a patient’s pain, including the connections between mental and physical health. The same goes for treatment for opioid addiction. Ophelia provides clinical care that is focused on an individual patient’s goals. Treatment is judgment-free, caring, and comprehensive- including for co-occurring conditions like depression, anxiety, PTSD, and insomnia. 

At Vori and Ophelia, we’re proud of the role we’re playing to help to combat the pain and opioid crises—but we’re not in this alone. To cut off the path from pain to addiction, we all need to become a part of the solution. Follow along this month as we publish more information and resources to tackle this problem at its core.

*An agonist is a drug that activates certain receptors in the brain. Full agonist opioids activate the opioid receptors in the brain fully resulting in the full opioid effect. Partial agonist opioids activate the opioid receptors in the brain, but to a much lesser degree than a full agonist. Learn more here.