About Chronic Pain

Millions of Americans suffer from chronic pain, a major health concern in the U.S. While there is no single cure for chronic pain, there are many ways to manage and treat it, depending on the type of pain, the underlying cause, and a patient’s physical and mental health.

Prescription opioids are one of many strategies to manage and treat pain, and they are appropriate for some patients in some cases. However, they have many negative side effects and bring with them a serious risk of dependence, addiction, overdose and death. While opioids are sometimes prescribed in limited amounts to address acute pain following trauma or surgery, opioids are reserved for cases of chronic pain when other strategies to manage and treat are not effective and when the risks and side effects of the opioids are manageable.

Over-reliance on opioids as a single strategy to address both acute and chronic pain has contributed to an epidemic of opioid addiction and overdose death. The impact of the opioid epidemic has been so pervasive and severe that life expectancy has declined for three years in a row for the first time since the influenza pandemic of 1918.  

While North Carolina has addressed the opioid epidemic through three recent laws – the Strengthen Opioid Misuse Prevention (STOP) Act, the Synthetic Opioid Control Act, and the Heroin and Opioid Prevention and Enforcement (HOPE) Act – nothing in these three laws do not tells health care providers how to treat chronic pain. Although the STOP act sets a five-day limit for an initial prescription for acute pain (seven days for pain following surgery), these limits do not apply to the treatment of chronic pain or to pain being treated as part of cancer care, hospice care, or palliative care.

The Centers for Disease Control and Prevention (CDC) developed the Guideline for Prescribing Opioids for Chronic Pain to help primary care providers make informed prescribing decisions and improve patient care for those who suffer from chronic pain in outpatient settings. Under the CDC Guideline, non-opioid therapy is preferred for chronic pain outside of active cancer, palliative, and end-of-life care. The North Carolina Medical Board and the North Carolina Board of Nursing have adopted and endorsed the CDC Guideline.

By providing insurance coverage for evidence-based alternatives to opioids, private insurance companies and government payers like Medicaid and Medicare have an important role to play in addressing both the opioid epidemic and the needs of chronic pain patients.

Learn how our lead healthcare partner Atrium Health is guiding appropriate opioid use through quality and safety efforts, decreasing opioid use for cancer pain, reducing opioid dependency in patients with sickle cell disease, and addressing the opioid epidemic.                                                                                         

Blue Cross and Blue Shield of North Carolina is working to foster a conversation with consumers about the opioid epidemic, including the appropriate use of opioids to treat chronic pain. Their website collects a range of opioid-related resources to carry the conversation further.

The More Powerful NC opioid awareness campaign is designed to raise awareness around the impact of the opioid crisis in North Carolina. The campaign is anchored in the message that together, we are more powerful than the opioid epidemic, and we can all play a part in ending the epidemic. The campaign does not tell health care providers or patients how they should treat chronic pain.