The Impact of Nonpharmacological Interventions on Opioid Use for Chronic Noncancer Pain: A Scoping Review

Zhanette Coffee (), Kevin Cheng, Maribeth Slebodnik, Kimberly Mulligan, Chong Ho Yu, Todd W. Vanderah and Judith S. Gordon
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Zhanette Coffee: College of Nursing, University of Arizona, Tucson, AZ 85721, USA
Kevin Cheng: College of Medicine, University of Arizona, Tucson, AZ 85721, USA
Maribeth Slebodnik: Health Sciences Library, University of Arizona, Tucson, AZ 85721, USA
Kimberly Mulligan: Veterans Health Administration, Central California, Fresno, CA 93706, USA
Chong Ho Yu: Department of Mathematics, Hawaii Pacific University, Honolulu, HI 96813, USA
Todd W. Vanderah: Department of Pharmacology, Comprehensive Center for Pain and Addiction, University of Arizona, Tucson, AZ 85721, USA
Judith S. Gordon: College of Nursing, University of Arizona, Tucson, AZ 85721, USA

IJERPH, 2024, vol. 21, issue 6, 1-33

Abstract: Despite the lack of evidence, opioids are still routinely used as a solution to long-term management for chronic noncancer pain (CNCP). Given the significant risks associated with long-term opioid use, including the increased number of unregulated opioid pills at large in the opioid ecosystem, opioid cessation or reduction may be the desired goal of the patient and clinician. Viable nonpharmacological interventions (NPIs) to complement and/or replace opioids for CNCP are needed. Comprehensive reviews that address the impact of NPIs to help adults with CNCP reduce opioid use safely are lacking. We conducted a literature search in PubMed, CINAHL, Embase, PsycINFO, and Scopus for studies published in English. The initial search was conducted in April 2021, and updated in January 2024. The literature search yielded 19,190 relevant articles. Thirty-nine studies met the eligibility criteria and underwent data extraction. Of these, nineteen (49%) were randomized controlled trials, eighteen (46%) were observational studies, and two (5%) were secondary analyses. Among adults with CNCP who use opioids for pain management, studies on mindfulness, yoga, educational programs, certain devices or digital technology, chiropractic, and combination NPIs suggest that they might be an effective approach for reducing both pain intensity and opioid use, but other NPIs did not show a significant effect (e.g., hypnosis, virtual reality). This review revealed there is a small to moderate body of literature demonstrating that some NPIs might be an effective and safe approach for reducing pain and opioid use, concurrently.

Keywords: chronic noncancer pain; opioid use; nonpharmacological interventions; review (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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