At any given time, about ten percent of Oregonians suffer from back pain. Many end up being prescribed opioid painkillers such as Vicodin. And as JPR reported in our series on opioid addiction earlier this month, some become addicted. The state has taken notice. Starting in January, the Oregon Health Plan is changing the way it deals with back pain. And sufferers are likely to get fewer pain pills.
Doris Keene brought up four kids, walking everywhere and staying active. But the Portland native said when she turned 59 everything fell apart.
鈥淢y leg started bothering me,鈥� she said. 鈥淔irst it was my knees and then all along I think it was my sciatica but I just ignored it. I just tried to deal with it.鈥�
Eventually, she went to a doctor who prescribed Vicodin and muscle relaxers. Keene says the drugs worked, but only to a degree. 鈥淢y body was saying, 鈥榃ell, if I take another one, maybe it鈥檒l work.鈥� So I mean that鈥檚 just human nature. Especially when you鈥檙e in the kind of pain I was in,鈥� she said.
In the end, she said she became addicted.
At any given time, about 10 percent of Oregonians suffer from back pain. Many receive prescriptions for opioids, and some become addicted. In 2012, more than 900,000 Oregonians received an opioid prescription.
The state has taken notice. Starting in January, the Oregon Health Plan is changing the way it deals with back pain.
Oregon currently leads the nation in 鈥榥on-medical use鈥� of opioids. That means the use of prescription drugs, whether obtained by prescription or otherwise, in a manner that was not prescribed.
About one third of hospitalizations related to drug abuse here are due to opioids.
Keene says her doctor cut her off.
鈥淚 got very upset with them when they told me I couldn鈥檛 have them no more. I said, 鈥榃hat do you mean? You gave them to me. Why鈥檇 you give them to me and then tell me that I couldn鈥檛 have them?鈥� 鈥� she said.
Eventually, Keene was referred to The Quest Center for Integrative Health in Portland. It offers pain management in Portland, which is where OPB caught up with her.
Lying on a fold-out chair in a darkened room with about half a dozen other people, she was speckled with acupuncture needles. 鈥淚 mean, I come in here wearing back braces, knee braces and a crutch. And Dr. Dave told me, 鈥楪et rid of them. They鈥檙e just weakening your muscles.鈥� And when I could walk out of here after the first acupuncture 鈥� I was in shock. I wanted to grab him and kiss him,鈥� she said.
Dr. Dave Eisen is the executive director of The Quest Center. He says doctors need to stop thinking of opioids as a first line of defense against pain. 鈥淭here should be an array of things for people to choose from. Whether it be chiropractic care, naturopathic care, acupuncture, nutrition, massage, to try those things and if they don鈥檛 work you use opioids 鈥� as a last resort,鈥� he said.
Eisen鈥檚 practice offers all those options plus mental health counseling, alcohol and drug treatment, Chinese medicines and psychiatric care.
The state wants patients to try this approach.
Denise Taray with the Oregon Pain Management Commission said traditionally, the Oregon Health Plan鈥檚 main way of dealing with back pain involved bed rest and pain killers. 鈥淭he only thing that might have been covered in the past was narcotics 鈥� because those don鈥檛 require a diagnosis code to define coverage,鈥� she said.
鈥淏ut treatments such as acupuncture, chiropractor, massage therapy, physical therapy and rehab, those additional services would never have been covered, or still aren鈥檛 until 2016,鈥� she said.
Starting January 2016, the state will fund many of those back pain treatments. The hope is to catch things early, stop the pain from becoming chronic, and reduce opioid addiction. 鈥淩esearch is out there that suggests that with back conditions we鈥檙e spending a lot of money on health care treatment and services that aren鈥檛 improving outcomes,鈥� Taray said.
The Oregon Health Authority is working to calculate the cost of treating back pain within the Medicaid population. While some treatments may cost more than a course of pain pills, the hope is money could be saved by reducing the number of people who become addicted.
Copyright 2015 Oregon Public Broadcasting