The opioid crisis continues to be a significant public health challenge, and more than 10 million people in the United States misused prescription opioids in 2021. This crisis has led to higher levels of addiction, more overwhelming healthcare needs, and rising deaths associated with opioids. It is now more important than ever to seek safer and more effective options for pain management. 

Multimodal pain management, including non-opioid medications, physical therapy, cognitive behavioral therapy (CBT), and regional anesthesia, is a promising potential solution. In this blog, we outline how nurses can adopt and promote these novel pain management approaches to help decrease opioid dependence and improve patient results.  

Opioid Dependence Overview 

Since 1999, the rate of death related to opioids has increased significantly. The side effects of opioid abuse include dependency, increased tolerance, slow breathing, and overdose. For example, patients who have undergone surgery and have been prescribed opioids may become dependent on them and continue to use them. 

Patients with chronic pain may not get the desired relief from the medication and gradually require higher doses of the drug, thus exposing themselves to the risk of overdose. This situation calls for better, safer, and equally effective alternatives to opioids.

Multimodal pain management is defined as the use of different therapies to achieve better pain control without using opioids. Healthcare providers can use these methods to help address this issue and improve patient outcomes.

What is Multimodal Pain Therapy?

A multimodal approach to pain therapy involves the application of various therapies to help manage pain while reducing the use of opioids. This approach also includes non-pharmacological treatments such as physical therapy, acupuncture, nerve blocks, and mindfulness, in addition to pharmacological options like non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and gabapentinoids.

Moreover, psychosocial methods, such as CBT, patient education, and support groups, are also incorporated to help cope with the emotional aspect of pain control.

The advantages of multimodal pain therapy include better pain management, fewer side effects, and a lower risk of opioid dependence. Research shows that patients who receive multimodal treatments can increase their pain control and decrease opioid use by 30-50%.

Thus, considering that pain is a complex entity, multimodal therapy is a holistic way to tackle the issue and help people get the most out of the treatment without having to rely solely on opioids.

New Approaches in Multimodal Pain Management

Several methods of multimodal pain management are changing patient care. The goal of regional anesthesia—nerve blocks and epidurals—is to block pain in certain parts of the body, thus reducing the need for systemic opioids. It has been proven that mindfulness and meditation can lessen pain by 40%.

Virtual reality (VR) is a significant step forward, especially in treating acute and chronic pain. Studies show that VR therapy can relieve pain by 20-40%. Also, exercise therapy is beneficial in the management of chronic pain and in improving function. Individualized exercise plans have been found to mitigate pain and enhance the quality of life. 

For example, St. Joseph’s Hospital in New Jersey has a full-scale protocol incorporating regional anesthesia, VR, and exercise therapy for post-surgical patients. This initiative led to a 35% decrease in opioid use. 

These new methods allow nurses and other healthcare professionals to provide safer and more optimal pain control, resulting in improved patient results and helping to address the problems of the opioid epidemic.

The Role of Nurses in the Transition to Multimodal Therapies

Nurses are key in the proper execution of multimodal pain therapies. They are crucial in educating patients regarding opioid alternatives, the benefits and risks of non-opioid medications, and non-pharmacological techniques. Multimodal care protocols are implemented by nurses at all levels of care. 

Furthermore, they help assess patient outcomes and compliance with the multimodal plan by evaluating pain, medications, and patient feedback. Some successful nursing interventions collaborate with physical therapists, psychologists, and pharmacists to create individualized treatment plans. Nurses also champion patient autonomy so patients can make informed decisions about their pain management preferences.

Advantages and Disadvantages of Multimodal Pain Therapies

Despite the challenges, several barriers limit the adoption of such therapies. These include a lack of adequate nursing education, patient refusal, and slow change within institutions. 

The workable solutions are to provide in-service education to nurses, to fight for the needed policy changes, and to ensure that patients are informed on the available pain control options to make sound decisions in the various forms available.

Conclusion

It is, therefore, important to ensure that patients are treated with multimodal pain therapies to avoid opioid dependence and improve patient care. This initiative offers nurses a unique opportunity to lead this charge by educating patients, implementing multimodal protocols, and promoting safer pain management practices.

Nurses can make significant progress through continuing education on multimodal approaches and advocacy for policy changes in their healthcare settings. These evidence-based strategies must and should be embraced to achieve better results and a healthier future for our patients.