The National Institute for Health and Care Excellence has issued guidelines which exclude painkillers for chronic pain and instead recommend acupuncture for chronic pain, along with exercise, CBT and antidepressants.
The draft recommendations will be open for consultation until 14th September 2020 and the final guidelines will be issued in January 2021.
The background to this lies not only in the widely discussed opioid crisis in the UK at the moment, but also that around one third of the UK population suffers from chronic pain and two thirds of those have time off work because of it. Interestingly, this guideline looks specifically at chronic primary pain which is characterised by emotional distress and functional disability so patients with conditions that have previously not been well diagnosed or treated such as fibromyalgia, myofascial pain, chronic neck pain and chronic pelvic pain, for example, would benefit directly from these changes if they go through.
So what would this mean in practice?
If these guidelines were to be adopted, it would make it far easier for GPs to recommend acupuncture and potentially for acupuncture to be offered on the NHS. However, in order to stay below the threshold of being ‘cost-effective’ the acupuncture would be limited to 5 hours of treatment per patient (could be 10 x 30 minute sessions) and be carried out in the community, not hospitals, by NHS band 6 or 7 staff or equivalent (BAcC Members would hope to be recognized at this level).
Whilst I am absolutely delighted by this news, I do intend to raise concerns that because all styles of acupuncture are covered by this, it means that a GP who has done less than 70 hours of training in acupuncture would be on an equal footing as someone who has done a full time 4 year degree course, such as myself. In very simple terms, what this means is that if you go to a GP you will be given antidepressants for your mood and acupuncture as an alalgesic. If you come to me for treatment, I will be able to use the full specturm of what Traditional Chinese acupuncture has to offer for your mental and emotional well-being as well as the physical pain. High MacPherson conducted extensive research into Acupuncture and the treatment of depression known as the AcuDep report which indicates that acupuncture and CBT yielded better results than anti-depressants.
However, this revision of the guidelines is a very positive move indeed and at the very least, acupuncture will ‘first do no harm’, unlike the opioids that have been over-prescribed for far too long.
