September 2022 is Drug-Free Pain Management Awareness Month

Opioid pain medications work in the nervous system or in specific receptors in the brain to reduce the intensity of pain. More than 191 million opioid prescriptions were dispensed to American patients in 2017, and the most common drugs involved in prescription opioid overdose deaths include Methadone, Oxycodone, and Hydrocodone[1].

Up to 25% of patients receiving long-term opioid therapy struggle with opioid addiction[2]. In 2016, more than 11.5 million Americans reported misusing prescription opioids in the previous year[3].

Prescription opioid use and abuse leading to addiction and catastrophic outcomes remains a national crisis. The leading cause of injury death in the United States is drug overdose[4], and most of the deaths from drug overdose deaths involved an opioid. From 1999 to 2020, more than 263,000 Americans have lost their lives to overdoses involving prescription opioids[5].

Because many die prematurely, surviving family members and communities lose out on benefits from an individual’s lifetime earnings. Opioid use disorder also results in costs associated with added health care expenses, criminal justice, lost productivity, and reduced quality of life. In 2017, these costs totaled an estimated $1.02 trillion—54% was attributed to overdose deaths and 46% to opioid use disorder[6].

Overdose deaths involving prescription opioids nearly increased by five times from 1999 to 2020[7]. We are losing 187 people a day from opioid overdoses and 68,630[8] people died from opioid overdoses in the U.S. in 2020 (74.8% of all drug overdose deaths).

Prescription opioids are often recommended for low back, neck, and musculoskeletal pain management, as well as for patients suffering from peripheral neuropathy. More than 100 million suffer with chronic pain and an estimated 80 percent of all Americans will experience some form of back pain during their lifetime.

On October 24, 2018, President Donald Trump signed the Opioid Crisis Response Act (OCRA) into law. OCRA received overwhelming bi-partisan support in both Chambers. HR6, which is now Public Law 115-271, broke new ground in being the first legislation to mandate aggressive development and adoption of alternative pain treatments that include “innovative medical technologies for pain management”. On October 11, Congress held its first ever briefing on ending opioid use through “innovative medical technologies for pain management”. Photobiomodulation (PBM) was the featured technology^[9].

Summus Medical Laser devices are class 4 therapeutic lasers, FDA-cleared as adjunctive devices for the temporary relief of pain^[10]. Photobiomodulation (PBM) utilizes non-ionizing red and infrared laser light and is a non-thermal process involving endogenous chromophores eliciting photochemical events at various biological scales.

PBM treatments are shown to resolve inflammation, improve peripheral circulation, modulate pain, and enhance tissue healing.^[11]

PBM treatments delivered with a class 4 therapeutic laser are shown to significantly reduce symptoms in patients with chemotherapy-induced peripheral neuropathy^[12] and significantly reduce pain and improve the quality of life of older patients with painful diabetic peripheral neuropathy^[13].

Summus Medical Laser treatments are non-invasive, pain-free, have no side effects yet are proven to be effective for both superficial wounds and deep neurological conditions.

SUMMARY

Photobiomodulation treatments delivered with a Summus Medical Laser class 4 therapeutic laser are a proven non-invasive opioid-free solution for pain management, with concomitant societal improvement and health care savings.

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[1] https://www.cdc.gov/opioids/basics/prescribed.html

[2] Banta-Green CJ, Merrill JO, Doyle SR, Boudreau DM, Calsyn DA. Opioid use behaviors, mental health and pain—development of a typology of chronic pain patients. Drug Alcohol Depend 2009;104:34–42

[3] Centers for Disease Control and Prevention. 2018 Annual Surveillance Report of Drug-Related Risks and Outcomes — United States. Surveillance Special Report 2pdf icon. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.

[4] https://health.gov/healthypeople/objectives-and-data/browse-objectives/injury-prevention

[5] https://www.cdc.gov/drugoverdose/deaths/prescription/overview.html

[6] Curtis Florence, Feijun Luo, Ketra Rice. The economic burden of opioid use disorder and fatal opioid overdose in the United States, 2017. Drug and Alcohol Dependence, 2021-01-01, Volume 218, Article 108350.

[7] https://www.cdc.gov/drugoverdose/deaths/prescription/overview.html

[8] https://www.cdc.gov/drugoverdose/deaths/index.html

[9] https://citizenoversight.blogspot.com/2018/11/ending-opioid-use.html

[10] https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfPCD/classification.cfm?ID=ILY

[11] https://journals.sagepub.com/doi/abs/10.1258/ebm.2012.012180

[12] https://pubmed.ncbi.nlm.nih.gov/27887804/

[13] https://pubmed.ncbi.nlm.nih.gov/31405365/

How Photobiomodulation is changing healthcare

The use of lasers in healthcare has a very interesting history. Albert Einstein first theorized the possibility of building a laser device in the early 1900s. In the 1960s Theodore Maimon invented the first laser and soon afterwards nearly all of the laser types used in healthcare were invented.

In 1967 physician Andre Mester was trying to repeat experiments showing that lasers could be used to treat malignant tumors. Mester’s laser device was very low in power and did not have an effect on the tumors; however, it did cause more rapid hair growth in the test animals. This accidental discovery was the landmark moment in the history of laser therapy.

In 2015 a worldwide panel of experts convened to agree upon a term that would be acceptable to everyone involved, that would describe the effect of therapeutic lasers, and would take the place of the dozens of terms being used to that time (i.e., cold laser, low-level laser, low-reactive laser, etc). The term they agreed upon was “photobiomodulation”: using light to modulate biological processes.

The official definition is, “A form of light therapy that utilizes non-ionizing forms of light sources, including LASERS, LEDs, and broad-band light, in the visible and infrared spectrum. It is a non-thermal process involving endogenous chromophores eliciting photophysical (i.e., linear and non-linear) and photochemical events at various biological scales. This process results in beneficial therapeutic outcomes including but not limited to the alleviation of pain or inflammation, immunomodulation, and promotion of wound healing and tissue regeneration.”

From the 1970s through the 2000s therapeutic lasers used in healthcare were very low in power, being class three laser devices. Like a light bulb, low power with a therapy laser means that the light is not very bright. A 40-Watt light bulb would not be sufficient to fully illuminate a large room. In similar way the earliest therapeutic laser devices were not powerful enough to deliver light deep into the body.

The first therapeutic laser to gain FDA clearance used 100 milliwatts of power and an 830-nanometer wavelength. It was used to treat carpal tunnel syndrome in automobile factory workers. The nerves in the wrist are not very deep, so photons from that device could reach the nerves and have a beneficial effect. However, these devices would not be very effective at treating low back pain, hip pain or at reaching any other tissue deep inside the body.

In 2003 the FDA gave clearance to the first class 4 therapy laser device. In the 18 years since then class 4 therapy lasers have virtually become standard of care in health care clinics treating both human and animal patients. Veterinarians use class 4 therapeutic lasers to treat conditions ranging from post-surgical incision healing to canine ear infections to osteoarthritis and hip dysplasia.

Today in human medicine, therapeutic lasers are used in chiropractic offices for musculoskeletal pain and ailments. They are used in physical therapy clinics, pain management clinics, and concierge medical clinics. Class 4 therapeutic lasers are used widely in sports athletic training rooms. Athletic trainers have realized the benefit of using laser therapy over ice for acute injuries.

Regenerative medicine is the use of various injections to stimulate healing in the body. These would include prolotherapy, platelet rich plasma therapy, and stem cell injections. Whenever these injections are performed the patient will have significant post injection pain. Class 4 therapeutic lasers can be used immediately after these injections to help with that pain.

New studies are showing that therapeutic lasers help with the effectiveness of regenerative medicine injections. We are on the brink of an exciting field in health care. New techniques, materials and methods are showing great promise to help patients recover from traumatic injuries, peripheral neuropathy, neuro degenerative diseases and more.

Photobiomodulation is here to stay. Class 4 therapeutic lasers are here to stay. In the 18 years since gaining FDA clearance the numbers of units used in healthcare has grown exponentially. The future is bright - these devices will become standard of care in all healthcare disciplines.