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The Joint Acupuncture Opioid Task Force
Posted on January 13, 2016 by Matthew Bauer
The Acupuncture Now Foundation (ANF) has teamed with the American Society of Acupuncturists (ASA) to form the Joint Acupuncture Opioid Task Force. We are calling for an expanded role for acupuncture to combat the North American opioid crisis that is now claiming 44 lives a day surpassing auto accidents as the number one cause of accidental deaths in the U.S. Our task force submitted a packet of information to the Centers for Disease Control (CDC) containing a large review of acupuncture research for chronic pain conditions, cost effectiveness, acupuncture mechanisms, and information on acupuncture for opioid addiction.
The CDC had requested public input as they are in the process of rewriting their opioid prescribing guidelines for primary care providers. While these guidelines are voluntary, they provide authoritative information that sets a standard that tends to be followed by many. In my review of the draft of the CDC guideline I realized that, while they mentioned the possible use of “non-pharmacologic” therapies, they also stated that the guideline was not intended to give the same level of authoritative advice for non-pharmacologic therapies as it does for opioids. The non-pharmacologic section was only intended to give physicians some context regarding the evidence of the effectiveness of these methods.
However, when I dug into the addendums to the draft guideline, I realized the only evidence they were referencing was for exercise therapy and behavior modification. The ANF’s V.P. and Chair of our Research Committee, John McDonald, did a tremendous job of compiling many research studies. Some of those showed acupuncture outperforming other non-pharmacologic therapies as well as opioids. We also added studies showing that acupuncture can cause the production of the body’s own safe and natural “endogenous” opioids. No other therapy can show evidence of that. Together with the ASA’s President, David Miller, we wrote a carefully worded introduction to the research calling on the CDC to work with experts in non-pharmacologic approaches to develop guidelines for their use so physicians can have real, evidence-based information on those therapies.
Our Task Force will be reaching out to other acupuncture groups as well as groups involved in integrative medicine to continue to call for an expanded role for acupuncture in addressing this crisis. The ANF will also look to undertake similar education campaigns highlighting acupuncture’s potential for treating non-pain conditions. The opioid crisis gives us a unique opportunity to both take advantage of the publicity this crisis is generating and to have an impact on easing pain and suffering. But the ANF is just as committed to helping the public, healthcare professionals and health policymakers understand that acupuncture can effectively treat much more than pain.
The introduction to the CDC packet follows below and the full packet with the research studies can be found on the ANF’s website on our North American Opioid Crisis Campaign page. Stay tuned for more information on both the Task Force and the ANF’s other campaigns.
January 12, 2016
FROM: Joint Acupuncture Opioid Task Force, Acupuncture Now Foundation and the American Society of Acupuncturists
TO: Centers for Disease Control
RE: Federal Register Notice: Proposed 2016 Guideline for Prescribing Opioids for Chronic Pain Docket CDC-2015-0112
The Joint Acupuncture Opioid Task Force thanks the CDC for soliciting public input for consideration in the development of the “CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.”
Our task force is comprised of experts in the field of acupuncture including a national membership organization, an international non-profit educational foundation, and concerned authorities. We seek to provide the CDC with research findings to help improve the quality of information currently found in the draft of this guideline, specifically the sections dedicated to “Contextual Evidence Review” of “non-pharmacologic alternatives.”
Research is showing that acupuncture can effectively stimulate the production of the body’s own “endogenous opioids” as well as natural anti-inflammatory compounds [34,35,38]. In other words, acupuncture can facilitate the better usage of the body’s own natural chemistry creating the potential for similar or sometimes better benefits than synthetic drugs, without the risks of addiction or side effects. This being the case, acupuncture has the potential to reduce or even in some cases eliminate the need for opioids and non-opioid drugs while also helping to treat opioid addiction [42,43,44,45].
Before detailing the relevant research, we want to acknowledge three important statements contained within the current guideline draft as they relate to the contextual evidence review. First, that the guideline is not meant to “provide detailed recommendations on the use of non-pharmacologic and non-opioid pharmacologic treatments for chronic pain.” Second, that you recognize that, “reviewing the effectiveness of such strategies as alternatives to opioid therapy provides important contextual information to providers considering opioid therapy and available options for their patients.” And third, that due to time constraints, “a rapid review was required for the contextual evidence review for the current guideline.”
We strongly believe that the CDC is undervaluing the best chance we have as a nation to address this crisis: non-pharmacologic alternatives. Our healthcare system has become overly dependent on the use of drugs as the primary means of addressing health issues including chronic pain. While it is useful to refine guidelines on how these drugs are prescribed, we feel it would be fruitful and to the public benefit for policymakers to consider the significant potential of non-drug alternatives. Of these, acupuncture is a highly promising and increasingly researched tool.
The tendency to rely on pharmacologic rather than non-pharmacologic approaches is in part influenced by the disparity in the financial interests promoting them. In light of this, support from philanthropic and governmental sources is needed to work with experts in non-pharmacologic alternatives to investigate and develop their potential. We ask the CDC to seek the input of such authorities in the development of guidelines for the use of non-pharmacologic therapies, and not leave this important topic to solely a rapid review of contextual evidence within a drug prescribing guideline.
While acupuncture has consistently been found to provide significant improvements in common, chronic pain conditions, a frequent criticism is that “real” (verum) acupuncture often does not statistically outperform the sham control. This criticism has been debunked in a landmark meta-analysis undertaken to reduce some of the common disparities found in acupuncture trial reporting standards [1]. This study found that when key reporting data were standardized, verum acupuncture outperformed sham.
Critics fixated on how much of acupuncture’s clinical benefits may be due to placebo effects are overlooking perhaps the most important point: the risk to benefit ratio of acupuncture for common chronic pain conditions is clearly superior to opioid medications and often better than other non-opioid therapies, regardless of mechanism. A very recent systematic review and network meta-analyses of 21 different interventions for sciatica found that acupuncture produced better outcomes for global effect and pain reduction than all other therapies except a Cytokine-modulating procedure still in experimental stages [5].
Considering the magnitude of the opioid crisis, non-opioid alternative approaches to the management of chronic pain that are shown to be safer, while of equal or superior clinical effectiveness to opioids, should not merely be categorized as a “possible option”. The research presented below demonstrates these positions and we urge policy makers to carefully consider this information and contact us with and questions.
Sincerely,
The Joint Acupuncture Opioid Task Force
Member organizations:
The Acupuncture Now Foundation
http://www.AcupunctureNowFoundation.org
The American Society of Acupuncturists
https://www.facebook.com/AmericanSocietyofAcupuncturists/?fref=ts
Posted on January 13, 2016 by Matthew Bauer
The Acupuncture Now Foundation (ANF) has teamed with the American Society of Acupuncturists (ASA) to form the Joint Acupuncture Opioid Task Force. We are calling for an expanded role for acupuncture to combat the North American opioid crisis that is now claiming 44 lives a day surpassing auto accidents as the number one cause of accidental deaths in the U.S. Our task force submitted a packet of information to the Centers for Disease Control (CDC) containing a large review of acupuncture research for chronic pain conditions, cost effectiveness, acupuncture mechanisms, and information on acupuncture for opioid addiction.
The CDC had requested public input as they are in the process of rewriting their opioid prescribing guidelines for primary care providers. While these guidelines are voluntary, they provide authoritative information that sets a standard that tends to be followed by many. In my review of the draft of the CDC guideline I realized that, while they mentioned the possible use of “non-pharmacologic” therapies, they also stated that the guideline was not intended to give the same level of authoritative advice for non-pharmacologic therapies as it does for opioids. The non-pharmacologic section was only intended to give physicians some context regarding the evidence of the effectiveness of these methods.
However, when I dug into the addendums to the draft guideline, I realized the only evidence they were referencing was for exercise therapy and behavior modification. The ANF’s V.P. and Chair of our Research Committee, John McDonald, did a tremendous job of compiling many research studies. Some of those showed acupuncture outperforming other non-pharmacologic therapies as well as opioids. We also added studies showing that acupuncture can cause the production of the body’s own safe and natural “endogenous” opioids. No other therapy can show evidence of that. Together with the ASA’s President, David Miller, we wrote a carefully worded introduction to the research calling on the CDC to work with experts in non-pharmacologic approaches to develop guidelines for their use so physicians can have real, evidence-based information on those therapies.
Our Task Force will be reaching out to other acupuncture groups as well as groups involved in integrative medicine to continue to call for an expanded role for acupuncture in addressing this crisis. The ANF will also look to undertake similar education campaigns highlighting acupuncture’s potential for treating non-pain conditions. The opioid crisis gives us a unique opportunity to both take advantage of the publicity this crisis is generating and to have an impact on easing pain and suffering. But the ANF is just as committed to helping the public, healthcare professionals and health policymakers understand that acupuncture can effectively treat much more than pain.
The introduction to the CDC packet follows below and the full packet with the research studies can be found on the ANF’s website on our North American Opioid Crisis Campaign page. Stay tuned for more information on both the Task Force and the ANF’s other campaigns.
January 12, 2016
FROM: Joint Acupuncture Opioid Task Force, Acupuncture Now Foundation and the American Society of Acupuncturists
TO: Centers for Disease Control
RE: Federal Register Notice: Proposed 2016 Guideline for Prescribing Opioids for Chronic Pain Docket CDC-2015-0112
The Joint Acupuncture Opioid Task Force thanks the CDC for soliciting public input for consideration in the development of the “CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.”
Our task force is comprised of experts in the field of acupuncture including a national membership organization, an international non-profit educational foundation, and concerned authorities. We seek to provide the CDC with research findings to help improve the quality of information currently found in the draft of this guideline, specifically the sections dedicated to “Contextual Evidence Review” of “non-pharmacologic alternatives.”
Research is showing that acupuncture can effectively stimulate the production of the body’s own “endogenous opioids” as well as natural anti-inflammatory compounds [34,35,38]. In other words, acupuncture can facilitate the better usage of the body’s own natural chemistry creating the potential for similar or sometimes better benefits than synthetic drugs, without the risks of addiction or side effects. This being the case, acupuncture has the potential to reduce or even in some cases eliminate the need for opioids and non-opioid drugs while also helping to treat opioid addiction [42,43,44,45].
Before detailing the relevant research, we want to acknowledge three important statements contained within the current guideline draft as they relate to the contextual evidence review. First, that the guideline is not meant to “provide detailed recommendations on the use of non-pharmacologic and non-opioid pharmacologic treatments for chronic pain.” Second, that you recognize that, “reviewing the effectiveness of such strategies as alternatives to opioid therapy provides important contextual information to providers considering opioid therapy and available options for their patients.” And third, that due to time constraints, “a rapid review was required for the contextual evidence review for the current guideline.”
We strongly believe that the CDC is undervaluing the best chance we have as a nation to address this crisis: non-pharmacologic alternatives. Our healthcare system has become overly dependent on the use of drugs as the primary means of addressing health issues including chronic pain. While it is useful to refine guidelines on how these drugs are prescribed, we feel it would be fruitful and to the public benefit for policymakers to consider the significant potential of non-drug alternatives. Of these, acupuncture is a highly promising and increasingly researched tool.
The tendency to rely on pharmacologic rather than non-pharmacologic approaches is in part influenced by the disparity in the financial interests promoting them. In light of this, support from philanthropic and governmental sources is needed to work with experts in non-pharmacologic alternatives to investigate and develop their potential. We ask the CDC to seek the input of such authorities in the development of guidelines for the use of non-pharmacologic therapies, and not leave this important topic to solely a rapid review of contextual evidence within a drug prescribing guideline.
While acupuncture has consistently been found to provide significant improvements in common, chronic pain conditions, a frequent criticism is that “real” (verum) acupuncture often does not statistically outperform the sham control. This criticism has been debunked in a landmark meta-analysis undertaken to reduce some of the common disparities found in acupuncture trial reporting standards [1]. This study found that when key reporting data were standardized, verum acupuncture outperformed sham.
Critics fixated on how much of acupuncture’s clinical benefits may be due to placebo effects are overlooking perhaps the most important point: the risk to benefit ratio of acupuncture for common chronic pain conditions is clearly superior to opioid medications and often better than other non-opioid therapies, regardless of mechanism. A very recent systematic review and network meta-analyses of 21 different interventions for sciatica found that acupuncture produced better outcomes for global effect and pain reduction than all other therapies except a Cytokine-modulating procedure still in experimental stages [5].
Considering the magnitude of the opioid crisis, non-opioid alternative approaches to the management of chronic pain that are shown to be safer, while of equal or superior clinical effectiveness to opioids, should not merely be categorized as a “possible option”. The research presented below demonstrates these positions and we urge policy makers to carefully consider this information and contact us with and questions.
Sincerely,
The Joint Acupuncture Opioid Task Force
Member organizations:
The Acupuncture Now Foundation
http://www.AcupunctureNowFoundation.org
The American Society of Acupuncturists
https://www.facebook.com/AmericanSocietyofAcupuncturists/?fref=ts
The Joint Acupuncture Opioid Task Force |
Posted from acupuncturenowfoundation.orgPosted in these groups: 
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Acupuncture
Alternative Medicine Acupuncture
Posted 9 y ago
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