that have managed pain for over half a century.
In other words, you’ve got physical therapists
and chiropractors; you’ve got acupuncturists
and naturopaths; you’ve got pain psychologists.”
Among physician specialty pain management
practices, McAnally says that traditionally
they fall into one of two categories known
colloquially as “pill mills” or “block shops.”
Pill mills have ended up in the limelight due
to their tendency to lean on opioid prescriptions
in an attempt to manage chronic pain. Block
shops, on the other hand, are practices that
essentially minimize the use of prescribed medi-
cation. These practices rely more on injections
and other medical procedures to manage pain.
McAnally denounces the pill mill approach,
pointing out that some 90 million Americans
received an opioid prescription last year; 10
million to 15 million are misusing opioids;
and at least 5 million are addicted. However,
he also suggests that the block shop approach
hasn’t done much to mitigate the problem
either, with the federal government reporting one out of three Americans suffering with
“This isn’t working. First of all, just from
a disease standpoint, but secondly, from an
economic standpoint,” he says.
Health economists from Johns Hopkins
University have reported that the annual cost
of chronic pain is as high as $635 billion a year.
That number, however, includes economic
costs, such as lost productivity.
“Our leaders are recognizing that we’re
going to bankrupt the healthcare system, if
not the nation, if we don’t change how we
manage pain,” McAnally says.
However, attempting to limit opioid
prescription to minimize the risk of abuse,
addiction, and overdosing does not mean that
general practitioners and pain management
clinics are unable to help patients suffering
from acute or chronic pain. Opioids are simply one tool in their ever-growing toolbox.
In fact, the Alaska Native Medical Center
Pain Management Clinic doesn’t prescribe
opioids at all.
“So in general, pain medications for chronic
pain should be handled through a primary
care provider that has a relationship with the
patient and understands their full health
picture, not via our pain management clinic,”
says Fiona Brosnan, the director of marketing and communications at the Alaska Native
Tribal Health Consortium.
Others practices, such as AA Spine & Pain
Clinic, which serves Fairbanks and Anchorage,
consider opioid prescriptions as just one option
in its pain management arsenal.
“We always consider all treatment options for
each patient’s needs. Prescription medications
are only one possible option in our toolbox,”
says Aaron Wollrich, the marketing director
for AA Spine & Pain Clinic. “Pain specialists
have the ability to utilize a multitude of treat-
ments, such as regenerative therapies, epidural
injections, facet injections, nerve root blocks,
cryo- or radio frequency nerve ablation, neuro
stimulators, and pain pumps. Our providers
always weigh the risk and benefits of all appli-
cable treatment options.”
The introduction of HB159 has had a
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