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  • sdadmin
    Keymaster
    September 21, 2018 at 11:26 am #1511
    1. WHEREAS, Osteopathic Manipulative Treatment (OMT) has been found to be as effective as
    2. tandard therapy in treating low back pain1,2,3, while requiring less medication. OMT is also
    3. associated with lower risk4 and lower cost, and “osteopathic treatment was found to be a dominant
    4. and cost-effective strategy compared to standard treatment,”5 and
    1. WHEREAS, patients “generally [give] high ratings for satisfaction and were positive about the
    2. OMT following orthopedic and thoracic surgery,”6 and 63% of patients with back pain treated with
    3. OMT for 8 weeks reported an improvement in pain, while only 46% of the sham treatment group
    4. reported improvement,7 after which the authors concluded “a trial of OMT may be useful before
    5. progressing to other more costly or invasive interventions,” and
    1. WHEREAS, the Federation of State Medical Boards recommends the use of many therapies,
    2. including OMT, before, with, or in place of opioid therapies in order to minimize the inappropriate
    3. use thereof, and8, and the WHO recommends adjuvant therapies such as OMT at all steps of pain
    4. management, in the WHO “Pain Relief Ladder,” as pre-and co-therapy with opioid drugs,9 and
    1. WHEREAS, 66% of all drug overdose deaths involved opioids, and opioid overdose death rates
    2. increased 200% from 2000 to 2014; similarly, the number of deaths was five times higher in 2016
    3. than in 1999,10, 11 and
    1. WHEREAS, opiate prescriptions cost $2.8 billion, while opiate misuse and abuse cost $78 billion in
    2. 2013,12 and dependence on opioids is associated with increased 30-day readmission rates after
    3. surgery, costing $41 billion per year in the US as of 2013, while inpatient stays resulting in opioid
    4. abuse have increased only 5% from 1993-2012,11
    1. WHEREAS, opiate prescription continues to increase, as they have since a 33% increase in
    2. dependence and addiction from 2002 to 2011;11 and one million patients were estimated to be
    3. dependent on prescribed opioids in 2006, with projected increases,14 and in 2013 National survey on
    4. Drug use and Health, 4.5 million individuals surveyed in one month in the US were current
    5. nonmedical users of prescription opioids13; now, therefore, be it
    1. RESOLVED, that the American Osteopathic Association recommend and reaffirm that Osteopathic
    2. manipulative treatment should be used as adjuvant therapy as part of a comprehensive pre-opioid
    3. non-cancer pain management plan.

    Explanatory Statement
    The opioid addiction epidemic is continuing to grow out of control; it costs many lives and vital resources. Osteopathic manipulative treatments are a uniquely safe, affordable, efficient, and effective alternative which may reduce or remove the need for opioid drugs in non-cancer pain management, and should be used to alleviate this suffering.

    References

    1. Andersson et al, (1999). A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain. New England Journal of Medicine, 1999(341), 1426.-1431. doi:10.1056/NEJM199911043411903, Retrieved from https://www.nejm.org/doi/full/10.1056/nejm199911043411903
    2. Prinsen, J., Hensel, K., & Snow, R. (2014). Response: Observational Study Demonstrates That OMT Is Associated With Reduced Analgesic Prescribing and Fewer Missed Work Days. The Journal of the American Osteopathic Association,114(7), 530-531. doi:10.7556/jaoa.2014.104
    3. Task Force on the Low Back Pain Clinical Practice Guidelines (2016). American Osteopathic Association Guidelines for Osteopathic Manipulative Treatment (OMT) for Patients With Low Back Pain. The Journal of the American Osteopathic Association, 2016, 116-536.
    4. Dubey, J. (2018). Osteopathic manipulative treatment for low back pain. Integrative Medicine Alert, 21(5) Retrieved from https://www.reliasmedia.com/articles/142604
    5. Verhaeghe, N., Schepers, J., Dun, P. V., & Annemans, L. (2018). Osteopathic care for low back pain and neck pain: A cost-utility analysis. Complementary Therapies in Medicine, Volume 40 (2018), 207-213. doi:10.1016/j.ctim.2018.06.001
    6. Sposato, et al. (2018). Osteopathic Manipulative Treatment in Surgical Care. Journal of Evidence-Based Integrative Medicine, 2. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5900809/
    7. Licciardone, J.C. (2016). Recovery From Chronic Low Back Pain After Osteopathic Manipulative Treatment: A Randomized Controlled Trial. Journal of the American Osteopathic Association, 116, 144.-155. doi:10.7556/jaoa.2016.031
    8. Gifford, J.D. et al (2017). Guidelines for the Chronic Use of Opioid Analgesics. Retrieved from https://www.fsmb.org/globalassets/advocacy/policies/opioid_guidelines_as_adopted_april-2017_final.pdf
    9. WHO’s Pain Relief Ladder. (2018). Retrieved from http://www.who.int/cancer/palliative/painladder/en/
    10. Dowell, D. (2016). CDC Guideline for Prescribing Opioids for Chronic Pain — United States. Morbidity and Mortality Weekly Report, 65(1), 1.-49. Retrieved from https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
    11. Gupta, A. et al. (2018). Opioid Abuse or Dependence Increases 30-day Readmission Rates after Major Operating Room Procedures: A National Readmissions Database Study. Anesthesiology, 128, 880.-890. doi:10.1097/ALN.0000000000002136
    12. Florence, C.S. et al (2013). The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States. Med Care, 54(10), 901.-906. doi:10.1097/MLR.0000000000000625.
    13. Mateu-Gelabert, P. (2015). Injection and sexual HIV/HCV risk behaviors associated with nonmedical use of prescription opioids among young adults in New York City. Journal of Substance Abuse Treatment, 48), 13.-20. doi:10.1016/j.jsat.2014.07.002
    14. Substance Abuse and Mental Health Services Administration. (2013). Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: Center for Behavioral Health Statistics and Quality

    15. Submitted by:
      Dakota A. Dalton, OMS II – Lincoln Memorial University – DeBusk College of Osteopathic Medicine
      Staci Hunter, OMS I – Lincoln Memorial University – DeBusk College of Osteopathic Medicine
      Skyler Hill-Norby, OMS II – Lincoln Memorial University – DeBusk College of Osteopathic Medicine

      Action Taken:

      Date:

      Effective Time Period: Ongoing

  1. Kate de Klerk
    CCOM
    Posts:
    September 26, 2018 at 6:18 pm #1561

    A question for the authors: this is already one of the AOA’s top legislative priorities, what are you hoping will change as a result of this resolution?

    I think this is an important issue, and SOMA and the AOA do stand in full support of OMT being used for pain to prevent the unnecessary use of opiates, but I don’t know that we need to use political capital to reaffirm something that is already in place and being actively addressed. Also, have the authors had any contact with the AOA legislative affairs team? If the authors do want to pass a resolution on this topic, I encourage them to reach out to the AOA team that works on the issue, to find out what the biggest hurdles are that they encounter in their advocacy efforts, so that we can be more specific in our ask of the AOA.