There’s been a lot of discussion lately about New Jersey’s opioid addiction epidemic, and the problems prescription painkillers can cause. But what’s the alternative?

An increasing number of doctors are starting to explore different options.

“There are a whole host of treatments to consider,” said Dr. Shai Gozani, a chronic pain doctor and president of NeuroMetrix.

“There are many techniques that broadly fall under the umbrella of what’s called cognitive behavioral therapy.”

He said this can help people understand and develop coping mechanisms for their chronic pain.

“Although that may sound kind of simplistic, it’s actually been evaluated in pretty rigorous clinical studies,” he said.

“If you can get someone to reduce anxiety and stress associated with pain, that actually reduces their pain physiologically.”

Gozani said there are other types of treatments to consider.

“Things like yoga and physical therapy and exercise and acupuncture — physical therapy-type interventions which can be very effective,” he said.

“Yoga has been getting more and more attention and it’s actually been evaluated, particularly for low back pain.”

And then there are a variety of electric solutions for chronic pain.

“They can range from fairly simple devices you can pick up for under $50 at your pharmacy, all the way up to implantable devices that directly stimulate your spinal cord,” he said.

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Gozani says pain-killing drugs mimic the action of endorphins in the body. “But it turns out you can actually increase your body’s production of these natural pain blockers by electrical stimulation.”

He said chronic pain in particular is a very individualized experience: It’s influenced by your genetics, your physiology, your behavioral and psychological makeup.

“Different pharmacologic approaches and different alternative interventions are going to work on various levels in different people, so it’s important to work with your doctor and build a toolbox of approaches that work for you,” he said.

Joseph Costabile, a surgeon and member of the Medical Society of New Jersey, agrees.

He said alternative methods of dealing with pain can be effective for some, but one potential problem is “a lot of times, insurance companies aren’t going to pay for it because it’s more expensive than if you prescribe Tylenol with codeine or Percocet to a patient.”

He says to deal with this, “We’ve got to get everybody on board, including the insurance companies.”

Costabile adds that the medical community has become “more mature” about accepting alternative treatments.

“When you’re taking care of people there isn’t a one size fits all. What works for one person may not work for another person.”

You can contact reporter David Matthau at

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