Opioids Aren't the Answer: Innovations for Chronic Pain Relief
Chronic pain is one of the most pressing public health challenges in the United States today. Affecting more than 50 million adults, or approximately 20% of the population, chronic pain has become a leading cause of long-term disability and a key driver of healthcare costs1. For municipal governments, this issue is not only a public health concern but also a management priority that intersects with economic planning, workforce stability, public safety, and social services. If local leaders and municipal employees are to tackle this issue effectively, pain management must be approached through a coordinated, multidisciplinary strategy that addresses physical, mental, and social dimensions of health.
The complexity of chronic pain stems from how many conditions can lead to it, including arthritis, fibromyalgia, neuropathy, and injury-related trauma. Importantly, pain is not always proportional to physical damage. For many patients, pain continues long after the initial injury has healed, driven by changes in the nervous system, emotional distress, and other biopsychosocial factors2. This complexity demands a comprehensive treatment approach that most American healthcare systems are currently unequipped to offer. Fragmented care—where different specialists work in silos, primary care doctors are overwhelmed, and mental health services are separated from physical health—leads to poor outcomes and higher costs for municipalities that shoulder part of the healthcare burden through public health departments, Medicaid programs, and employee healthcare plans.
Municipal leaders and managers are uniquely positioned to champion innovative care models that better support residents suffering from chronic pain. One of the first steps is recognizing that the traditional reliance on opioids has failed to provide sustainable relief. In fact, the overprescription of opioids has contributed to a national addiction crisis, with over 80,000 overdose deaths in 2021 alone, many of them linked to synthetic opioids3. While opioids may be appropriate for some acute or palliative care scenarios, they are poor long-term solutions for chronic pain, often leading to dependency while failing to address underlying causes.
Municipal healthcare strategies should instead prioritize non-opioid, interdisciplinary approaches. Multidisciplinary pain management programs, which integrate physical therapy, mental health counseling, dietary guidance, and patient education, have shown superior outcomes compared to conventional, siloed care. These programs are based on the biopsychosocial model of pain, which acknowledges that a person’s experience of pain is influenced not just by physical injury, but also by emotional, psychological, and environmental factors4.
Unfortunately, access to such comprehensive care is limited, particularly in underserved communities. Municipalities can step in to fill these gaps by investing in community health centers that offer integrated services. For instance, some local governments have partnered with academic medical centers to develop chronic pain clinics within public health systems. These clinics often employ nurse practitioners, social workers, dietitians, and physical therapists in addition to physicians, ensuring continuity of care and helping patients avoid unnecessary emergency room visits and surgeries5.
A critical area where municipalities can drive change is by promoting training for primary care providers. Most general practitioners receive minimal instruction in chronic pain management during medical school—often less than 10 hours over four years6. This educational gap increases the likelihood of mismanagement and overprescribing. Municipal health departments can collaborate with local universities and public health organizations to offer continuing education courses focused on evidence-based, non-opioid pain management strategies. These could include cognitive behavioral therapy (CBT), structured exercise programs, mindfulness training, and nutrition counseling.
Exercise and diet are particularly promising areas for municipal intervention. Physical activity has been shown to not only reduce chronic pain symptoms but also improve functional mobility and mental health7. Municipal parks and recreation departments can contribute by providing free or low-cost fitness classes tailored for individuals with chronic pain, such as yoga, tai chi, or aquatic therapy. Likewise, initiatives like urban gardens and healthy food subsidies can improve dietary habits, which in turn influence inflammation and pain perception.
From a research standpoint, municipalities should consider allocating funds and forming partnerships to study lifestyle interventions in chronic pain prevention. Community-based participatory research (CBPR) models are especially effective in municipal settings. These models involve residents in the design and implementation of studies, ensuring that interventions are culturally appropriate and responsive to local needs8. Data gathered through such efforts can inform policy decisions, help secure grants, and guide the expansion of successful pilot programs.
Another often overlooked aspect is workplace accommodations for municipal employees who suffer from chronic pain. Cities and towns are major employers, and chronic pain significantly impacts employee performance and attendance. Implementing flexible schedules, ergonomic workstations, and telecommuting options can help retain valuable staff and reduce disability claims9. Human resources departments should be trained to recognize chronic pain as a legitimate health issue deserving of accommodations under the Americans with Disabilities Act (ADA).
Finally, municipal governments should advocate for state and federal policies that support comprehensive pain management. This could include lobbying for Medicaid reimbursement for non-pharmacological treatments, expanding funding for pain research, and supporting legislation that incentivizes integrated care models. When cities and counties align their local strategies with broader policy frameworks, they can amplify their impact and ensure more equitable access to effective care.
Chronic pain is not only a medical issue—it is a public management challenge that affects workforce productivity, public health spending, and community well-being. By shifting away from fragmented and opioid-centered care toward integrated, lifestyle-focused strategies, municipal governments can play a critical role in changing the trajectory of this crisis. With thoughtful planning, interdepartmental collaboration, and evidence-based interventions, local leaders can help residents and employees alike find relief and restore quality of life.
Centers for Disease Control and Prevention. “Chronic Pain and High-Impact Chronic Pain Among U.S. Adults, 2019.” Morbidity and Mortality Weekly Report 70, no. 3 (2021): 100–105. https://doi.org/10.15585/mmwr.mm7003a2.
Gatchel, Robert J., and Dennis C. Turk. Psychosocial Factors in Pain: Critical Perspectives. New York: Guilford Press, 1999.
Hedegaard, Holly, Arialdi M. Miniño, and Margaret Warner. “Drug Overdose Deaths in the United States, 1999–2021.” National Center for Health Statistics Data Brief No. 457. Hyattsville, MD: National Center for Health Statistics, 2023.
Institute of Medicine. Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Washington, DC: National Academies Press, 2011. https://doi.org/10.17226/13172.
Krebs, Erin E., et al. “Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients with Chronic Back Pain or Hip or Knee Osteoarthritis Pain.” JAMA 319, no. 9 (2018): 872–882. https://doi.org/10.1001/jama.2018.0899.
Mezei, Lena, and Anna Murinson. “Pain Education in North American Medical Schools.” Journal of Pain 12, no. 12 (2011): 1199–1208. https://doi.org/10.1016/j.jpain.2011.06.006.
Nahin, Richard L. “Estimates of Pain Prevalence and Severity in Adults: United States, 2012.” Journal of Pain 16, no. 8 (2015): 769–780. https://doi.org/10.1016/j.jpain.2015.05.002.
Viswanathan, Meera, et al. “Interventions to Improve Care for Chronic Noncancer Pain: A Systematic Review.” Agency for Healthcare Research and Quality, 2020. https://effectivehealthcare.ahrq.gov/products/chronic-pain/research.
Weiner, Scott S., and Lisa R. Levi. “Managing Chronic Pain in the Workplace: Occupational Health Strategies.” Occupational Medicine 65, no. 5 (2015): 403–409. https://doi.org/10.1093/occmed/kqv071.
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ABOUT THE ROLE The Department of Public Defense (DPD) is recruiting for Public Defense Attorney Supervisor positions within The Defenders Association Division. The role involves supervising attorneys, ensuring high-quality legal representation, mentoring staff, and fostering an inclusive environment committed to equity and social justice. Supervisors may carry a partial caseload and must demonstrate a passion for public defense and client representation. KEY RESPONSIBILITIES - Supervise, develop, evaluate, train, mentor, and coach unit employees and interns - Ensure work conforms to professional standards, statutes, rules, and policies - Conduct disciplinary investigations, impose discipline, and implement corrective action plans - Conduct annual performance evaluations and assign or balance attorney workloads - Carry a partial caseload requiring excellent legal representation, trial, research, and negotiation skills - Maintain and update computerized case-management systems to track caseloads - Identify ethical conflicts of interest - Serve on-call at least twice a year and supervise on-call attorneys - Participate in the Division Management Team and assist with office-wide initiatives MINIMUM QUALIFICATIONS - Juris Doctor degree from an accredited law school or completed the WSBA's Rule 6 Law Clerk Program - Member of the Washington State Bar Association in good standing with at least three years of experience as a lawyer - Murder/Sex/Felony High qualified to be considered for Felony placements - Washington State Driver's License or ability to travel to required destinations SPECIAL REQUIREMENTS - Must reside in Washington state and within a reasonable distance to the King County worksite - Subject to DPD Ethical Walls Policies and Outside Work Policy for Attorneys - Represented by Teamsters 117 bargaining unit - Must maintain a home workspace with a reliable internet connection SELECTION PROCESS - Evaluation of application materials and supplemental questions - Interviewing - References - Personnel file review going back three years - Background check if applicable HOW TO APPLY - Submit a completed King County application - Attach a current or chronological resume - Attach a cover letter detailing your background and what you bring to the DPD - Current TDAD supervising attorneys wishing to transfer should email Managing Attorney Ben Goldsmith at benjamin.goldsmith@kingcounty.gov by the closing date - Applications submitted by 11:59 p.m. on August 10, 2026, receive priority consideration EMPLOYMENT DETAILS - Job Type: Career Service Executive, Full Time, Exempt from FLSA overtime provisions - Location: Hybrid model with an onsite minimum of four days per week and five days during the probationary period - Work Locations: Various locations including Seattle, Kent, and Redmond District Court - Travel: Required to various locations throughout King County, including courts, jails, hospitals, and treatment centers - Benefits: Pension plan, holidays, transit pass, training, and education opportunities
ABOUT THE ROLE The Seattle City Attorney's Office seeks an attorney with experience in employment law and litigation to join the Employment Section. The role involves advising on and litigating legal issues for Seattle's diverse workforce of over 10,000 employees. Attorneys act as generalists in labor and employment, handling all aspects of litigation in state and federal courts and administrative forums, while implementing the City's Race and Social Justice Initiative. KEY RESPONSIBILITIES - Act as legal counsel to City policy makers, departmental leadership, human resources professionals, and labor negotiators on complex labor and employment matters. - Advise City departments on ADA accommodations, leaves of absence, employee and labor relations, FLSA, EEO investigations, and discrimination claims. - Represent the City in litigation before federal and state courts, administrative agencies, and labor arbitrations. - Manage ediscovery, draft and respond to interrogatories, and handle electronically stored information. - Take and prepare witness testimony for depositions, trials, and arbitrations. - Draft motions for summary judgment, conduct motion practice, mediate cases, and negotiate settlement agreements. - Collaborate with colleagues and clients to align with the City's mission of ending institutionalized racism. MINIMUM QUALIFICATIONS - Membership in good standing with the Washington State Bar Association, or licensure in another state with the ability to complete WA membership within four months of an offer. - Expertise in state and federal employment law. - Experience litigating labor and employment matters, including the ability to first-chair complex litigation and appeals. - Experience advising HR professionals, managers, executives, and elected officials on complex employment and labor issues. - Ability to independently manage a portfolio, meet deadlines, and navigate a fast-paced environment. - Ability to develop positive relationships and work efficiently under tight deadlines. SPECIAL REQUIREMENTS - Expertise in traditional labor law is desired. - Experience advising public employers, including public safety clients, is desired. - Experience in applying policies and practices related to equity. SELECTION PROCESS - The position is open to all candidates who meet the minimum qualifications. - The City values diverse perspectives and life experiences, considering applicants regardless of race, color, creed, national origin, ancestry, sex, gender identity, disability, age, sexual orientation, or other protected characteristics. HOW TO APPLY 1. Complete the online City of Seattle Application at governmentjobs.com/careers/seattle. 2. Attach required documents in PDF, DOC, or DOCX format prior to the closing date. 3. Include a cover letter describing your interest in the position. 4. Include a resume detailing relevant experience. 5. Include a legal writing sample that is less than 10 pages. - Note: Inquiries via email or third-party sites will not be considered unless applied via the Government Jobs site. Contact Law_HR@Seattle.gov for application assistance. EMPLOYMENT DETAILS - Job Type: Civil Service Exempt, Regular, Full-time. - Department: Law Department. - Location: Columbia Center, 701 5th Avenue, Suite 2050 Seattle, WA. - Work Schedule: Flexible/Hybrid (currently 3 days in the office, 2 days remote, subject to change). - Closing Date: Continuous. - Benefits: Comprehensive package including vacation, 12 official holidays, 2 floating holidays, sick and paid parental leave, medical, dental, vision, life, and long-term disability insurance. Also includes executive leave, merit leave eligibility, and a defined benefits retirement program.
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ABOUT THE ROLE The Office of Economic Development seeks a community-centered advisor to lead, guide, and support Seattle neighborhoods through the complex processes of forming and expanding Business Improvement Areas. This role blends technical expertise, policy fluency, data analysis, strategic advising, and community relationship-building to serve as the subject-matter expert on formation, assessment structures, and governance models. KEY RESPONSIBILITIES - Lead and facilitate formation across multiple neighborhoods simultaneously through the full lifecycle. - Provide expert technical assistance on assessment structures, sustainable funding models, and governance. - Analyze complex datasets including parcel characteristics, land use, and taxation data, utilizing GIS tools to map boundaries and run scenarios. - Develop tools, resources, toolkits, and policies that strengthen city support for early-stage operations. - Support newly formed areas in establishing governing boards, operational systems, and service delivery plans. - Facilitate high-stakes community engagement, building trust and navigating political dynamics among diverse stakeholders. - Oversee projects, consultant contracts, neighborhood grants, and program implementation while coordinating with city departments. MINIMUM QUALIFICATIONS - Experience in community engagement, coalition building, and stakeholder facilitation with diverse groups. - Background in place-based economic development, special assessment districts, or similar community-driven initiatives. - Ability to analyze complex property, land use, zoning, or taxation data and interpret assessment models. - Proficiency in using or directing GIS tools to map boundaries and evaluate district conditions. - Experience in policy development, program design, and project management for multistakeholder efforts. - Strong communication skills to synthesize data and legal requirements into actionable recommendations for decision-makers. SPECIAL REQUIREMENTS - Passion for advancing the Race and Social Justice Initiative and committing to equitable, community-centered outcomes. - Dedication to reducing barriers faced by communities of color, immigrant-owned businesses, and historically underserved neighborhoods. - Eligibility for Language Premium Pay ($200 monthly stipend) if evaluated and assigned to provide direct in-language communication services. SELECTION PROCESS Applications are reviewed by a human hiring team without the use of artificial intelligence or automated screening tools to ensure an equitable process. Applications received by 4:00 p.m. Pacific Time on Tuesday, July 21, 2026, receive first consideration. The hiring team evaluates transferable skills, growth mindset, and commitment to racial equity. HOW TO APPLY Submit your application online at https://www.governmentjobs.com/careers/seattle using Job Number 2026-00849. You must include a resume and a cover letter with your application. For accommodation requests or questions, contact Nicolette.Hornbeck@seattle.gov. EMPLOYMENT DETAILS - Employer: City of Seattle - Location: Seattle Municipal Tower, 700 5th Ave., Seattle, WA (Flexible/Hybrid) - Department: Office of Economic Development - Job Type: Classified Civil Service, Regular, Full-Time - Classification: Strategic Advisor 1, General Government -L17 - Job Number: 2026-00849 - Opening Date: 06/25/2026 - Closing Date: Continuous - Reports to: Business Districts Manager
About the Role This position is for a Psychologist at Eastern State Hospital, a fully accredited psychiatric inpatient state-owned hospital in Medical Lake, WA. The role focuses on providing exceptional evidence-based care without production-driven pressures, offering clinical autonomy, a person-centered approach, and a quality work-life balance. The standard schedule is Monday through Friday with no on-call requirements, and hybrid or alternative work schedules may be available after a 6-month probationary period. Key Responsibilities - Provide individual and group psychotherapy to support patient treatment goals, empower patients, and support self-discovery - Provide consultation to multidisciplinary treatment teams - Complete psychological assessments along with supporting clinical documentation - Provide court-required documentation and expert testimony as needed - Civil and Forensic Hybrid Ward: Provide a full range of psychological services, assist in assessing risk for community integration, and consult courts on suitability for increased community access - Discharge Consultation and ITA Evaluator: Conduct structured risk assessments for discharge readiness and evaluate patients for continued involuntary treatment pursuant to Washington's Involuntary Treatment Act Minimum Qualifications - Doctor of Psychology (Ph.D./Psy.D.) in clinical or forensic psychology from an accredited university - Licensed or eligible to obtain a license in Washington to practice psychology by the hire date (applicants with a completed degree pursuing licensure will be considered) - Experience with inpatient civil and forensic populations and/or people with severe behavioral health issues - Eligible for a 12-month In-Training position, allowing up to 12 months to become fully licensed and achieve in-training objectives Special Requirements - Valid driver's license if driving on state business - Liability insurance on privately owned vehicles if used for state business - Must disclose any relative, household member, close friend, or romantic partner within the potential supervisory chain of command in compliance with the DSHS Relationships and Reporting Structure policy Selection Process - A background check, including criminal record history, will be conducted prior to hiring - Background check information will be considered in determining the applicant's suitability and competence to perform the job - This announcement may be used to fill multiple vacancies How to Apply - Submit an application via the official State of Washington job portal before the closing date - For questions, contact sean.brauner@dshs.wa.gov and reference job number 2026-01979 Employment Details - Employer: State of Washington, Department of Social and Health Services (DSHS) - Division: BHHA - Location: Spokane County - Medical Lake, WA (Eastern State Hospital) - Job Type: Full Time - Permanent - Job Number: 2026-01979 - Opening Date: 08/05/2026 - Closing Date: 8/19/2026 at 11:59 PM Pacific Time (US & Canada); Tijuana - Equal Opportunity Employer
ABOUT THE ROLE This position provides financial leadership, management, and oversight within the Administrative Services Division of Public Health at King County. Reporting to the division finance and administrative services manager, the role involves business planning, accounting, contracting, biennial budget development, financial analysis, and sustainability planning. The administrator acts as a key adviser and coordinator for multiple projects and programs. This recruitment will also create an eligibility pool for future career service, term-limited temporary, or special duty assignment vacancies. KEY RESPONSIBILITIES - Act as a key financial and budget adviser to the division - Oversee financial and business management, including accounting, biennial budgets, and contracts/grants management - Develop quantitative analyses and financial modeling for potential funding changes - Perform regular and ad-hoc financial data research, compilation, and interpretation - Ensure compliance with grants management, including applications and billings - Ensure the accuracy of financial accounting systems and financial information - Review and approve contracts for the division - Administer policies and procedures for personnel, purchasing, contracting, and regulatory issues - Supervise assigned staff and perform quality checks on technical work - Interpret and participate in the development of administrative policies and procedures - Represent the division at department-wide finance meetings - Analyze internal systems and recommend performance improvements MINIMUM QUALIFICATIONS - At least 3 years of experience in financial management, including accounting, contracts management, federal grants management and reporting, budget development, and complex financial analyses - Demonstrated ability to manage technical budget development, including preparation, justification, and financial modeling - Ability to gather, interpret, and communicate financial data to both technical and non-technical audiences - Experience reviewing and approving contracts - Demonstrated multi-tasking and project management skills in a dynamic environment - Strong oral and written communication skills - Demonstrated problem-solving and conflict resolution abilities SPECIAL REQUIREMENTS - Must pass a thorough background investigation - Must reside in Washington state within a reasonable distance to the King County worksite - Must protect the privacy and security of protected health information per State and Federal Law - Must be proficient with Microsoft Office and web-based tools - Must adhere to OSHA/WISHA guidelines, including completing mandatory trainings on time and obtaining required immunizations - Must maintain regular and reliable attendance - Must be available for emergency response duties, which may include nights, weekends, and deployment to other locations SELECTION PROCESS The selection process may include the evaluation of application materials and supplemental questions, interviewing, and testing. HOW TO APPLY Applications must be submitted online via NEOGOV by 8/21/2026 at 11:59 PM Pacific Time. The following items are strictly required: 1. NEOGOV Job Application (must be thorough and complete) 2. Supplemental Questions 3. Resume 4. Cover Letter explaining your interest and qualifications Do not substitute the application with a resume or cover letter. Incomplete applications stating "see resume" will be rejected. Contact Salyse Duckworth at sduckworth@kingcounty.gov for accommodations or alternate formats. EMPLOYMENT DETAILS - Employer: King County (Department of Public Health) - Location: Chinook Building, 401 5th Avenue, Seattle, WA (Hybrid work model) - Job Type: Career Service (Exec), Full-Time, Exempt - Schedule: Monday through Friday, 8:00 AM to 5:00 PM - Bargaining Unit: Not represented by a labor union (Z3 : KC Personnel Guidelines)
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