The pendulum of opioid prescribing for pain has swung sharply in the last decade, as the epidemic of opioid overuse, addiction and overdose has led policy makers and health care providers to ratchet back on the prescriptions patients receive.

But for about 5 million Americans who have taken prescription opioids for years to address their chronic pain, that pendulum swing has led to trouble getting refills, finding new providers when their former ones retire or relocate, or getting access to multi-modal pain care that goes beyond pills.

In a new paper in the Journal of Pain Research, researchers from the University of Michigan describe the consensus of a wide range of experts about how to help patients with chronic pain get adequate pain care, and coverage for the cost of that care.

Specifically, the experts call for restructuring the insurance models under which health care providers get reimbursed for caring for people with chronic pain, enhancing education of health care providers in chronic pain care as well as identifying and treating opioid use disorder, and addressing racial inequities in care which are often rooted in stigma around pain and opioid use.

The experts involved in the newly published paper emphasize the importance of helping patients who have taken opioids for long periods of time get access to the gold standard for chronic pain care.

Called multi-modal pain care, it involves not just oral pain medications but physical therapy, cognitive behavioral therapy, injected pain therapies and integrative medicine techniques including acupuncture and chiropractic care.

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