CBT offers valuable treatment alternative for millions taking opioids for chronic pain

CBT offers valuable treatment alternative for millions taking opioids for chronic pain

By teaching patients better strategies for coping with chronic pain, cognitive behavioral therapy (CBT) is a valuable treatment alternative for the millions of Americans taking opioids for noncancer pain, according to an article in the Journal of Psychiatric Practice. The journal is published by Wolters Kluwer.

“Cognitive behavioral therapy is a useful and empirically based method of treatment for pain disorders that can decrease reliance on the excessive use of opiates,” write Drs. Muhammad Hassan Majeed of Natchaug Hospital, Mansfield Center, Conn., and Donna M. Sudak of Drexel University College of Medicine, Philadelphia. They discuss evidence supporting the use of CBT to avoid or reduce the use of opioids for chronic pain.

CBT Offers Effective, Safer Alternative to Opioids for Chronic Pain

Rising use of opioid (sometimes called opiate) medications to treat chronic noncancer pain is a major contributor to the US opioid crisis. But despite the aggressive marketing and prescribing of these powerful painkillers, there has been little change in the amount and severity of pain reported by Americans over the past decade. “There is no evidence that supports the use of opioids for the treatment of chronic pain for more than one year, and chronic use increases the serious risks of misuse, abuse, addiction, overdose, and death,” Drs. Majeed and Sudak write.

They believe that CBT is an important alternative to opioids for treatment of chronic pain. The goal of CBT is to help patients change the way they think about and manage their pain. The idea is not that pain (in the absence of tissue damage) “is all in your head”–but rather that all pain is “in the head.” Cognitive behavioral therapy helps patients understand that pain is a stressor and, like other stressors, is something they can adapt to and cope with.

Interventions may include relaxation training, scheduling pleasant activities, cognitive restructuring, and guided exercise–all in the context of an “empathic and validating” relationship with the therapist. These interventions “have the potential to relieve pain intensity, improve the quality of life, and improve physical and emotional function,” according to the authors.

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Source: News Medical

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