A registered nurse helps a nursing home resident with his medications

Most American adults use alternatives to opioid drugs to manage chronic pain, but psychological therapies could be used more frequently, a new study has found.

Approximately 50 million U.S. adults experience chronic pain, according to the Centers for Disease Control and Prevention. Opioid drugs remain an effective treatment for some, but deaths due to dependency and misuse have grown steadily among adults aged 55 years and older over the past two decades, most often tied to prescription opioid pain medication, according to a recent report from the AARP.

To determine the prevalence of opioid drug use associated with chronic pain in adults overall, researchers examined data from the 2019 National Health Interview Survey. Nearly 30% of survey participants were at least 65 years of age.

More than half (55%) of the respondents reported using non-opioid pain medications to control their pain, the researchers found. Approximately 11% of respondents reported using both opioid and non-opioid techniques; 4.4% used opioids alone and 30% did not report using any pain management techniques during the past three months.

Complementary therapies such as massage, yoga, tai chi, mediation, or seeing a chiropractor were the most common non-opioid therapies used. These were followed by physical, occupational or physical rehabilitative therapies. Other pain approaches that weren’t captured in the data set were used by 39% of respondents, the authors added.

Patient choices varied by sociodemographic characteristics, they noted. Adults who used PT, OT or physical rehabilitation were more likely to be older, female and have medical insurance than those who did not participate in these therapies, for example.

“It is encouraging to note that most adults with chronic pain use a combination of various non-opioid modalities for treatment,” the authors wrote. Yet only about 4% of adults said they managed their pain with psychological or psychotherapeutic interventions. These therapies could represent an unexplored modality for pain management, they said.

“Psychological therapy, including cognitive behavioral therapy, is effective for improving chronic pain, and our study indicates that it is underused,” the authors concluded. 

Full findings were published in JAMA Network Open.