Saturday, February 24, 2018

Response to the Surgeon General’s Opioid Pledge: It Misses the Point

turntidebonakdar_twitterLast week, the Academy of Integrative Pain Management (formerly the American Academy of Pain Management) held its 27th Annual Meeting, educating attendees on a broad range of non-pharmaceutical treatments they could use to effectively, safely, and sanely treat patients in pain. Given the national furor over opioid prescribing, the meeting provided timely alternatives for nearly a thousand participants.

In his keynote session, AIPM’s immediate past president, Robert A. Bonakdar, MD FAAFP, Director of Pain Management at Scripps Center for Integrative Medicine and Assistant Clinical Professor at UCSD School of Medicine, addressed the evolution of alternative pain treatments used around the world and showed how they may inform and improve access to and quality of US pain care.

In his talk, Dr Bonakdar shared that on the same day he received the Surgeon General’s unprecedented letter to all physicians urging restraint in opioid prescribing, he also received two denials from insurance companies for patients to be treated with biofeedback and acupuncture – two proven-effective therapies.

In an op-ed just published in USA TODAY, Dr Bonakdar expounded further on his keynote remarks stating that, while over-prescribing of opioids and lack of insurance coverage for non-pharmacological treatments are problems, what the Surgeon General really needs to address is more fundamental – in the US, we have difficulty dealing with chronic pain. Period. Dr Bonakdar writes,

“Chronic pain is a complex scenario that not only affects the back or shoulder, but one that over time can shrink the brain while creating or worsening fatigue, insomnia, depression, anxiety, obesity and risk of suicide.  The pain transformation called for by the IOM and most recently the National Pain Strategy requires not just a campaign, but an integrative, patient-centered approach to support someone whose entire existence is affected.”

The Academy of Integrative Pain Management has been a leader in advocating this approach to pain care since 1988 by training and educating clinicians. In addition, it is the only organization with three staff working full time on policy and advocacy at the federal, state, and local level to assure patients have access to integrative care that is paid for by insurance companies.

Read the op-ed on USA TODAY here.

For more information, contact Robert Twillman, PhD, Executive Director of the Academy of Integrative Pain Management, at

3 responses

  1. Janice Reynolds
    September 30, 2016 at 9:34 pm

    Just to throw out there, there are multiple problems entirely overlooked by people such as the Surgeon General. Not all medications or all non-pharmaceutical interventions work for everyone or every pain syndrome. Non-opioid medications may not be paid for by insurance either. One thing overlooked by everyone almost is the person’s ability to comply with a non-pharmaceutical intervention (most are not in the home). After my brain surgery, I was doing physical therapy. If my husband couldn’t take me, a taxi was $11. Some it isn’t just the money, they are physically incapable of the journey. Over all it is the person with pain who is held to blame. Prejudice and bias seem to be winning out.

  2. Ida Heath, NP
    October 11, 2016 at 9:41 pm

    We must not adopt a “one size fits all” approach to pain management. There are patients who are not controlled with 100mg of ME or 200mg of ME. What is the government doing to the ability of a provider to prescribe based on the patient’s needs? How can arbitrary amounts be subscribed to rules when the rule makers are not the same people examining and prescribing accordingly. Yes, there are many opioid deaths. The relationship between these deaths and other substances with the opioid need to be clearly addressed. “Oxycodone killed my friend” does not include the friend was using heroin, methamphetamine, ETOH, and/or cocaine. Guidelines are recommendations NOT ultimatums.

    • Michelle Wagner Talley
      January 13, 2017 at 6:39 pm

      You are absolutely correct! There is a difference some physicians are not aware of. The difference between psychological addiction and physiological dependence. Studies have proven true chronic pain patients rarely become addicted, they are dependent not addicted. The war in drugs, has made CP patients the biggest casualties.The system is totally skewed when one has to be fighting for their life to get pain control. CP patients do fight for a quality of life. You nailed it when you wrote opioid fatalities don’t include they were al dc o on illegal drugs or obtained them illegally. We HAVE to advocate for individualized treatment for chronic pain patients

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The American Academy of Pain Management improves the lives of people with Pain by advancing a person-centered, integrative model of pain care through evidence-guided education, credentialing, and advocacy.