By Mark Pew, Senior VP, Preferred Medical
This week I want to share two interesting articles about two different topics. The first article is about how alternative treatments can be just as effective as prescription opioid use. The second article is about our brain’s cognitive biases. As is becoming increasingly known and accepted, the human brain is the most important tool in finding the most successful approach to managing pain.
Although opioids are often the first thing people think of when wanting to manage chronic pain, there are many other alternative methods that could work just as well. This article shares the story of one woman who turned to meditation for reducing her pain which has in turn led her opioid intake to decrease by 75 percent. While removing opioids entirely from a treatment plan may not be the best option for everyone, there is great value in using #BioPsychoSocialSpiritual treatments as part of a pain management regimen.
A powerful story—of a meta-analysis published in JAMA and the highly personal story of Pamela Bobb—about the value of a BioPsychoSocialSpiritual treatment model which includes meditation, acupuncture and biofeedback for Pamela. I found this quote of interest: “Yet, a paper published last year finds that most insurers have not adopted policies that are consistent with these guidelines, and many don’t pay for coverage of these services. An accompanying editorial argues that it’s time for that to change.” Fortunately, Work Comp is becoming increasingly more comfortable with “alternative” (or, should we say, the new mainstream) treatments. Not enough…Yet…But progress. Geralyn Datz posted some very helpful context from her personal/professional experience with this treatment approach:
“A 60 study meta-analysis, including over 6000 patients, evaluated “mind-body” treatments for chronic pain helped reduce the need for pain medications – treatments included Cognitive Behavioral Therapy (CBT) and meditation. CBT is not new but is enjoying renewed attention in the context of the opioid epidemic. Pain treatment needs to be individualized and address the whole person. This includes treating mood, sleep problems, anxiety, and adapting to physical limitations. Note that this patient remained on some medication, but was able to significantly reduce her dosing when a multidisciplinary approach was taken. Pain is a health problem that overwhelms the whole body, and mind, and therefore a brain-based approach is often helpful for bringing relief. The main challenges to the delivery of these valuable treatments are knowledge of them, insurance coverage and access to providers. There have been improvements in these areas, but not enough to address the 50 million Americans suffering from chronic pain related challenges, and the 20 million suffering from high impact chronic pain. Looking forward to doing better and proud to be part of that solution.”
Our brains are very complex and have a lot to process in our everyday lives. Before we make a decision or have a reaction to anything, our brains filter through our many internal biases that are built into us since birth. That’s a good thing because without filters our brain would be overwhelmed with input. However, that can be a bad thing as well if it’s filtering via biases out inputs that could lead to poor decisions. This article uncovers four main cognitive biases and different approaches we can use to learn from them.
Your brain is not objective. Everything—including Chronic Pain—is processed thru a set of filters that have been built up since before you were born. Another way to think about it is there are biases built into your brain that affect your brain’s conclusions about inputs. According to Buster Benson there are 175 known cognitive biases from “We fill in characteristics from stereotypes, generalities, and prior histories” to “We favor simple-looking options and complete information over complex, ambiguous options” (reference the full codex). There are also 20 Cognitive Biases That Screw Up Your Decisions from “bandwagon effect” to “ostrich effect” (reference the full list). In other words, every decision you make is affected by every decision you’ve ever made, and the longer you live the more filters/biases will be involved. Which is why the concept of Neuroplasticity is SO important and how YOU can consciously influence those filters/biases. Who you are now isn’t who you have to be.
To read everything on my mind this past week, please visit me on LinkedIn.
Disclaimer: The views and opinions expressed above are those of Mark Pew, and do not necessarily reflect the views of Preferred Medical.
About Mark Pew
Mark Pew, Senior Vice President of Product Development and Marketing for Preferred Medical, is a passionate educator and agitator. Known as the RxProfessor, Mark is focused on the intersection of chronic pain and appropriate treatment, particularly as it relates to the clinical and financial implications of prescription painkillers, non-pharma treatment modalities and the evolution of medical marijuana. He is a strong champion for the workers’ compensation industry to #PreventTheMess and #CleanUpTheMess, movements he created to drive attention to the importance of individualized appropriate treatment for injured workers. Mark is a vocal advocate of the BioPsychoSocialSpiritual treatment model.
Mark serves on the IAIABC’s Medical Issues Committee and SIIA’s Workers’ Compensation Committee. In addition, he serves as technical advisor to regulators and legislators in 20+ jurisdictions on subjects such as drug formularies, treatment guidelines, Opioid Task Force initiatives, encouraging support of non-pharma treatment options and the medicinal use of cannabis. Mark received the WorkCompCentral Magna Comp Laude award in 2016 and the IAIABC’s Samuel Gompers Award in 2017.