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Complementary and Alternative Medicine (CAM) Included In a New Evidence-based Clinical Guideline

Posted by Jocelyn Bonebrake (jbonebrake) on Mar 11 2012
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Complementary and Alternative Medicine (CAM) Included In a New Evidence-based Clinical Guideline
Beaverton, OR – March 12, 2012
Complementary and alternative medicine (CAM) is included in a new evidence-based clinical guideline that was recently released by the Substance Abuse and Mental Health Services Administration (aka SAMHSA, part of the US Department of Health and Human Services). With the bulky title of “Managing Chronic Pain in Adults With or in Recovery from Substance Use Disorders,” (Treatment Improvement Protocol (TIP) Series 54. HHS Publication No. (SMA) 12-4671. Rockville, MD.) the new guideline focuses on a clinically challenging population: people with chronic pain and a history of substance abuse.
SAMSHA Administrator Pamela S. Hyde, JD, noted in the Treatment Improvement Protocol (TIP) foreword that the administration’s mission is, “… to improve prevention and treatment of substance use and mental disorders by providing best practices guidance to clinicians, program administrators, and payers. TIPs are the result of careful consideration of all relevant clinical and health services research findings, demonstration experience, and implementation requirements. A panel of non-Federal clinical researchers, clinicians, program administrators, and patient advocates debates and discusses their particular area of expertise until they reach a consensus on best practices.”
Dr. Charles A. Simpson, DC, Vice President, Medical Director of the CHP Group, was a member of the consensus panel that consisted of national experts in the field of chronic pain treatment. As the only CAM clinician on the panel, he had an opportunity to provide input on the treatment guideline that highlighted non-drug, non-surgical approaches that the scientific evidence shows help people with chronic pain.
Dr. Simpson stated that the panel all agreed that chronic non-cancer pain (CNCP) in patients with substance use disorder (SUD) is an enormous clinical challenge that also has significant psychosocial, ethical, and legal challenges as well. Chronic pain (pain lasting longer than three months) is widespread. National surveys show over 50% of people over 20 years of age report pain lasting more than three months. Thirty-six percent report pain that has led to restriction of activity at work and at home. Among people with opioid addiction, 29-60% report chronic pain. Drug addiction often starts during medical treatment for pain. Patients who recover from addiction are often reluctant to take any more medication for their pain. 
Confronted with SUD and chronic pain, many patients look for non-drug, non-surgical treatments offered by licensed CAM providers. The evidence shows how often these treatments are sought out and used. One study revealed that over 40% of pain patients treated with opioids also used some form of CAM. (Fleming S, Rabago DP, Mundt MP, et al. CAM therapies among primary care patients using opioid therapy. BMC Complement Altern Med 2007;7:15.) Simpson noted that CAM providers are a valuable addition to a chronic pain patient’s care team. “CAM clinicians excel at creating a productive therapeutic relationship and leverage a patient’s own innate power of self-efficacy and avoiding destructive dependency…whether on drugs or passive therapies.”
This TIP is for primary care providers who treat or are likely to treat adult patients with or in recovery from SUDs who present with CNCP. Given the prevalence of CNCP in the population, this audience includes virtually all primary care providers. Addiction specialists, psychiatrists, nurses, and other clinicians may find information here that will help them ensure that their patients with CNCP receive adequate pain treatment. By providing a shared basic understanding of and a common language for these two chronic conditions, this TIP facilitates cooperation and communication between healthcare professionals treating pain and those treating addiction.
Jamie Sewell
Director of Sales & Marketing
800-449-9479 x126
6600 SW 105th Avenue, Suite 115
Beaverton, Oregon
About The CHP Group
Since 1989 The CHP Group has been the complementary and alternative medicine (CAM) authority and partner of choice for health plans, employers, and providers. Based in Beaverton, Oregon, the company designs, implements, and manages flexible, cost-effective CAM solutions with a level of clinical knowledge and business expertise that creates seamless access to high-quality, effective, and affordable care. The CHP Group’s growing network of fully credentialed CAM providers includes chiropractors, acupuncturists, naturopathic physicians, and massage therapists. For more information, visit

Last changed: Mar 12 2012 at 4:49 PM