Interventional radiology’s pivotal role in addressing the ‘vicious cycle’ of pain and opioid abuse

Interventional radiology will play a pivotal part in stemming America’s epidemic of pain and opioid overuse, experts advised in a new analysis.

Pain is becoming a pressing problem for physicians as the U.S. grapples with an aging population and growing prevalence of chronic disease. Addressing this concern is complex, but oftentimes providers turn to pain pills, which has led to a rise in opioid use disorder, research noted in the American Journal of Roentgenology.

Deaths from drugs such as OxyContin tripled over the dozen years ending in 2011, and overdose is now the leading cause of unintentional injury in the U.S. But radiologists can help to reverse these trends by providing safe alternatives for pain management, noted physicians with the University of Missouri.

“Treatment of chronic pain with prescription opioids alone is not always successful, and a multidisciplinary approach is paramount to address the needs of patients at risk of developing or suffering from [opioid-use disorder],” Austin Fletcher, MD, with the Department of Radiology at the Columbia-based institution, and colleagues wrote Sept. 23. “Interventional radiologists trained to perform minimally invasive procedures with negligible downtime and post-procedure pain can help stem the tide of opioid related deaths and disability.”

Fletcher and co-authors offered up several such procedures that providers might offer. Those include vertebral augmentation, sacroplasty, thermal ablation of osseous metastasis, nerve blocks, gonadal vein embolization, and knee and shoulder embolization for osteoarthritis.

And there’s a value case for this work, too, the writers noted. Sacral fractures, for instance, are often underdiagnosed and undertreated, and prolonged immobility from these injuries causes “substantial financial cost to the healthcare system,” along with pain and disability. One recent review of all studies involving sacroplasty found the practice is safe and effective for treatment of such fractures, and provides long-term pain relief, the authors noted.

“Interventional radiologists performing minimally invasive procedures to treat chronic pain are favorably suited to provide relief for these patients and circumvent the vicious cycle of OUD,” Fletcher and colleagues concluded.

Read more of their thoughts in AJR here.