Multimodal Pain Management: Considerations for Clinicians Treating Pain

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Chronic pain is a common health concern in the United States, and is expected to further increase in
prevalence due to higher incidence of associated conditions within a larger aging population.1 To treat
chronic pain, clinicians often prescribe opioids, which, while shown to be effective, are also associated
with significant side effects. Long-term use of opioids can also result in physical dependence, addiction,
overdose, and death. The increase in opioid prescriptions in the United States has contributed to the
current opioid crisis, where an average of 128 people a day die as a result of an opioid overdose.

Chronic pain is similarly a common problem among the population dually eligible for Medicare and Medicaid, but there is a greater incidence of chronic pain than the general population. Dually eligible
older adults have higher levels of chronic pain compared to older adults covered by Medicare or Medicaid only, private insurance, or the Veterans Health Administration.

The dually eligible population uses prescription opioids at a higher rate compared to Medicare-only
beneficiaries, and thus, are at a higher risk for opioid misuse or addiction.

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