Pain relief without opioids

To provide a comprehensive range of treatment options to patients with chronic pain, Christiana Care Health System is launching the Comprehensive Pain Center – the first of its kind in Delaware.

Patients must be referred to the new outpatient center, which will offer effective non-opioid pain treatment strategies for patients with acute and chronic pain.

Valerie E. Dechant, M.D.

“Christiana Care is taking a leadership role to help patients combat pain while limiting the use of opioid drugs, which have created an enormous health crisis in our community and across the nation,” said Valerie E. Dechant, M.D., physician lead for the Neurosciences Service Line.

The Comprehensive Pain Center brings together “the skills of multiple disciplines to help patients discover a safer path” toward pain relief, she said.

“The new outpatient Comprehensive Pain Center fills a niche that currently does not exist in the community,” said Rajivan Maniam, M.D., the center’s medical director. “By addressing pain at the right time with the right combination of therapies, we can help our patients find relief without the worry of opioid overuse and addiction.”

Dr. Maniam continued: “Increasing evidence has shown that patients with chronic non-malignant pain who are maintained on chronic opioid therapy have limited functional benefit despite increasing narcotic doses. This has led to serious concerns regarding patient safety, particularly the risk of tolerance, dependence and abuse.

“We have long since known that chronic pain is a complex and particularly challenging condition to treat. The most effective pain treatment strategies involve a multi-faceted approach with multiple providers working together. This multidisciplinary team approach has not only been shown to improve functional outcomes but enhance patient well-being as well.”

Christiana Care’s Comprehensive Pain Center focuses on opioid-sparing treatments. Dr. Maniam and his colleagues consult with patients and multiple providers to coordinate pain management.

Services at the Comprehensive Pain Center include:

  • Consultations for opioid-tapering strategies to help patients on high-dose opioid therapy. These strategies will be implemented in coordination with the patient’s prescribing physicians; the center will not be prescribing or taking over prescribing opioid medications at this time.
  • Referrals to six-week outpatient group clinical psychology sessions that can enable patients to overcome or find relief from pain through mind/body strategies, including changing their perception of pain or learning breathing and relaxation techniques.
  • Referrals to a new chronic pain focused physical therapy program, available at multiple Christiana Care sites.
  • Integrative therapies, including osteopathic manipulation, myofascial release, acupuncture and the use of anti-inflammatory supplements.
  • Interventional therapies, including epidural steroid injections, joint injections, trigger-point injections and radiofrequency ablation.

Minimally invasive outpatient procedures will be performed in both the office and at the Christiana Surgicenter.

Because Christiana Care’s Comprehensive Pain Center focuses on opioid-sparing treatments, it complements Christiana Care’s overall strategy to reduce opioid use by educating providers about responsible prescribing practices, promoting non-opioid alternatives to control pain and spreading evidence-based guidelines around opioid prescribing.

Delaware has the highest rate of opioid prescriptions in the U.S. — nine per every 100 people in the state — and the second-highest rate of extended-release opioid prescriptions, according to the Centers for Disease Control and Prevention. In 2018 in Delaware, 345 people died from opioid overdoses, a 12% increase from the previous year.

Among the evidence of Christiana Care’s progress in reducing opioid prescriptions since January 2018 includes a 50% decrease in opioid prescriptions for discharged emergency department patients and a 23% drop among primary care practices.

“The Comprehensive Pain Center creates a new way for our health care providers to refer patients to a trusted source for pain relief,” Dr. Dechant said.