When Portland resident Doris Keene raised her four children, she walked everywhere and stayed active. But when she turned 59, she says, everything fell apart.
鈥淢y leg started bothering me. First it was my knees.鈥� She ignored the pain, and thinks now it was it the sciatic nerve acting up, all along. 鈥淚 just tried to deal with it,鈥� Keene says.
But eventually, she went to a doctor who prescribed Vicodin and muscle relaxants. 鈥� more than 900,000 people. The state currently leads the nation in nonmedical use of opioids. And about a third of the hospitalizations related to drug abuse in Oregon are because of opioids.
Keene says the drugs helped her, but only to a degree.
Doris Keene (right) at Portland鈥檚 Quest Center for Integrative Health. (Photo by Kristian Foden-Vencil/Oregon Public Broadcasting)
鈥淢y body was saying, 鈥榃ell, if I take another one, maybe it鈥檒l work.鈥� So, I mean, that鈥檚 just human nature. Especially when you鈥檙e in the kind of pain I was in. You get to the point after months and months of pain where you鈥檙e begging for anything 鈥� anything 鈥� to relieve the pain,鈥� she says.
In the end, Keene says, she became addicted. Her doctor ended up cutting off her supply of pills.
鈥淚 got very upset. I said, 鈥榃hat do you mean? You gave them to me. Why鈥檇 you give them to me and then tell me that I couldn鈥檛 have them?鈥� I was begging,鈥� she says.
Then Keene went to the , a pain management center in Portland.
Lying on a fold-out chair in a darkened room with several other people, Keene has about a dozen acupuncture needles in place.
鈥淚 come in here wearing back braces, and knee braces and a crutch, and Dr. Dave told me, 鈥楪et rid of them! They鈥檙e just weakening your muscles,鈥� 鈥� Keene says. 鈥淎nd when I could walk out of here after the first acupuncture [treatment], I wanted to grab him and kiss him.鈥�
is Keene鈥檚 鈥淒r. Dave,鈥� and executive director of the Quest Center. He is board certified in and acupuncture, and says doctors need to stop thinking of opioids as a first line of defense against pain.
鈥淭here should be an array of things for people to choose from,鈥� Eisen says, 鈥渨hether it be chiropractic care, or naturopathic care, or acupuncture, nutrition, massage. Try聽those things 鈥� and if they don鈥檛 work, you use opioids as a last resort.鈥�
Doris Keene says acupuncture treatments ease her pain at least as effectively as the Vicodin and muscle relaxants she once depended on. (Photo by Kristian Foden-Vencil/Oregon Public Broadcasting)
Oregon wants more patients to take this approach. , coordinator of the Oregon Pain Management Commission, says Medicaid鈥檚 traditional way of dealing with back pain involved advising bed rest and prescribing painkillers.
鈥淭he only thing that might have been covered in the past was narcotics,鈥� Taray says. 鈥淏ut treatments such as acupuncture, chiropractor, massage therapy, physical therapy and rehab would never have been covered.鈥�
But starting in January 2016, the state will fund many of these back-pain treatments for patients who get their health care via Oregon鈥檚 version of Medicaid 鈥� the . While the treatments may cost more than a course of pain pills, the hope is that money will be saved by reducing the number of people who become addicted to opioids or abuse them. And pills as some people assume.
鈥淩esearch is out there that suggests that with back conditions we鈥檙e spending a lot of money on health care treatments and services that aren鈥檛 improving outcomes,鈥� Taray says.
Oregon also has not found overwhelming evidence that acupuncture, yoga or spinal manipulation work better than other options. But, as Taray points out, these alternatives don鈥檛 involve drugs.
This story is part of a partnership that includes , and Kaiser Health News.