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 m