Acupuncture as an alternative to opioids for pain management

Every day 130 people die of an overdose of opioids in the USA alone. Over the past 15 years opioid overdose and dependence has become an increasing health problem. It is not only limited to the USA, but a medical emergency worldwide, also in Switzerland being the 7th largest consumer in the world. Therefore there is a need of non-pharmacologic and non-addictive strategies for pain management and decrease of opioid dependence. And acupuncture is a safe and effective alternative.

Opioids are painkillers and codeine, morphine, oxycodone and fentanyl are the best known. Before the present epidemic opioids were prescribed for short-term, for certain conditions (acute severe pain, cancer pain and other terminal conditions) and under the direct supervision of a healthcare provider (2). Under these conditions it can be considered as “wonder drugs” and helps many people worldwide. But there is a huge downside as well. If it is used for longer periods, most people will experience tolerance. This can require the dose to be increased and leads to dependence. Opioid misuse and addiction is therefore becoming an ongoing and rapidly evolving public health crisis. According to the National Survey on Drug Use and Health an estimated 1.7 million Americans had a opioid dependence in 2017. In the wake of the opioid crisis in the United States, some medical professionals in Switzerland are warning about over-prescription of drugs containing oxycodone and are urging Swiss authorities to take measures. Between 1985 and 2015, the Swiss opioid consumption raised from 18 to 421 mg/person/year, making Switzerland the 7th largest opioid consumer per capita in the world. (3-5)

It is about time to find safe, effective, non-addictive interventions to manage chronic pain.(6) Acupuncture can be an answer. Recent evidence has shown that acupuncture is effective in treating multiple chronic pain conditions, has no advert effects and the effect persists over time. Acupuncture has been demonstrated to activate a number of the body’s own opioids and can be explained with a neurobiological model. Acupuncture should therefore no longer be viewed as some mystic practice.(7-11) Nowadays several guidelines and organizations have already endorsed acupuncture as an important part of the multidisciplinary approach to manage chronic pain and can play an important role in dealing with the opioid epidemic. (12) Acupuncture researchers and practitioners are making meaningful contributions against the opioid crisis and help patients with chronic pain and opioid addiction with a non-addictive, non-pharmacological and harmless strategy. (8-9)

Dr. Med. Raymond Landgraaf (author) & Dr. Med Massimo Fumagalli (co-author)
05.02.2020