Melzinnia Connolly, a 66-year-old grandmother in Norwood Park, Illinois has been struggling for the past 20 years with chronic pain that lasts throughout the day, beginning in the morning when she wakes up with a burning sensation in her feet. To go about her basic daily functions, such as picking up groceries and cleaning her house, she takes Percocet, an opioid-based medication. “It allows you to manage. At least you’re able to keep your house clean and go to the grocery store,” she says.
Her relief is now at risk. With the escalating opioid crisis, the federal government has been limiting the manufacture and distribution of these drugs. She’s been denied medication many times, and has had to travel to many pharmacies in different areas nearby in the hopes of filling her prescription. In her area, the number of opioid prescriptions has dropped in half over the past 8 years.
Addiction medicine physician Elise Wessol, DO, says people asking for opioid medications are often stigmatized. “‘Oh, this person is asking for opioids, they must be an addict, we can’t prescribe,’ instead of just viewing that they’re in pain,” Wessol says.
While the opioid crisis continues to ravage communities across America, many with chronic pain are in dire need of solutions. As a result, healthcare providers and researchers are urgently seeking alternative treatments for chronic pain management.
One innovative solution is the use of music therapy, particularly when enhanced by artificial intelligence (AI) and neurotechnology. This combination could offer a powerful, non-pharmacological intervention to help millions of Americans suffering from chronic pain while potentially reducing opioid dependence.
The Scope of Chronic Pain and Opioid Dependence
Chronic pain affects approximately 50 million American adults, or about 21% of the adult population. Definitionally, “chronic pain” is pain that persists for three months or more. It can severely impact daily functions and quality of life.
Many of these individuals rely on opioid medications for relief. But, the widespread use of opioids has led to alarming rates of dependence and misuse, contributing to the ongoing opioid epidemic.
In primary care settings, about a quarter of individuals prescribed opioids struggle with dependence, and annually, over 1000 patients are treated in emergency departments for opioid misuse. The opioid crisis has reached a critical point, with nearly 108,000 Americans dying from drug-involved overdoses in 2022 alone.
With pharmacies experiencing shortages and overdose-related deaths on the rise, finding effective non-opioid alternatives has never been more critical.
The Biopsychosocial Model and Non-Opioid Alternatives
The biopsychosocial model recognizes that pain is a complex experience influenced by biological, psychological, and social factors. Addressing chronic pain requires a comprehensive approach that goes beyond just medical history. This approach encourages the use of multidisciplinary interventions that address not only the physical aspects of pain but also the emotional and social components.
For instance, cognitive-behavioral therapy can help patients develop coping strategies and alter pain perceptions, while physical therapy can improve function and reduce pain through targeted exercises. Mindfulness and meditation practices have also shown promise in pain management by reducing stress and improving pain tolerance.
By incorporating these diverse strategies alongside innovative approaches like AI-enhanced music therapy, healthcare providers can create more comprehensive and personalized pain management plans that reduce reliance on opioids and improve overall patient outcomes.
Music Therapy in Pain Management
Untreated chronic pain can have profound impacts to one’s health - and therefore, it is critical to find solutions. Inadequately treated pain can lead to long-term changes in mood, mental health, cognitive processes, sleep, physical functioning, and disability.
Music therapy is a versatile intervention that can address various factors exacerbating chronic pain. It aims to reduce pain intensity, divert attention from pain, alleviate stress and anxiety, enhance mood, and help patients find meaning and control in their lives despite chronic pain. Music therapy is often employed in diverse contexts, from procedural pain relief to end-of-life care.
From a neurological perspective, music therapy's impact on pain perception is fascinating. The effectiveness of music therapy is rooted in its ability to engage the brain's reward system. Functional MRI studies have demonstrated that listening to preferred music activates the nucleus accumbens, a key structure in the brain's reward circuitry. This activation has been associated with a 21% reduction in reported pain intensity in some patients with chronic pain conditions.
Music enjoyment also releases dopamine, a neurotransmitter associated with pleasure, satisfaction, and motivation, which can blunt the pain response. In addition, music has anxiolytic effects, reducing stress and anxiety levels.
By increasing endogenous opioids in the bloodstream, music therapy can help patients transition from higher to lower doses of opioid therapy. It also enhances the psychosocial aspect of pain management by improving emotional arousal and reducing unhealthy thought patterns like catastrophism.
Personalizing Music Therapy with Artificial Intelligence and Neurotechnology
Artificial intelligence and neurotech are now poised to take music therapy to the next level by personalizing treatments for individual patients. AI algorithms paired with low-cost neurotech can analyze a patient's musical preferences, pain levels, and physiological responses to create tailored playlists and sound experiences that maximize therapeutic benefit.
Recent research focuses on personalizing music therapy to meet individual patient needs. This can be achieved through active personal curation or automated discovery, where AI plays a significant role. AI can mitigate intervention fatigue through collaborative filtering and content-based modeling. Collaborative filtering matches users with similar musical preferences, while content-based modeling uses machine learning to identify specific attributes in music, recommending new songs that align with user preferences.
Steps to Building a Neurotech-guided, AI-powered Music Therapy
CareYaya is actively building music therapy guided by neurotech and powered by AI to diversify and enhance treatment efficiency for chronic pain. AI applications can generate music in specific genres and with various instrument combinations, tailored to evoke and respond to specific emotions and sensations. Deep learning models can incorporate biological feedback, such as EEG and EMG signals from mobile neurotech devices, to refine the therapeutic quality of music.
Three key areas we’re working on where AI can enhance music therapy for chronic pain management:
1. Adaptive Playlist Generation
AI-powered systems can continuously learn from a patient's feedback and biometric data to refine and adapt playlists in real-time. This ensures that the music remains engaging and effective over long periods, addressing the challenge of "intervention fatigue" often seen with other non-pharmacological treatments.
2. Emotion-Responsive Compositions
Advanced AI models can generate original music compositions designed to evoke specific emotional states conducive to pain relief. These AI-created pieces can be fine-tuned based on individual patient responses, creating a truly personalized therapeutic experience.
3. Neurotech-guided Biofeedback Integration
By incorporating data from wearable devices like mobile EEGs and ones that monitor heart rate, skin conductance, and other physiological markers, AI systems can adjust music parameters to optimize the pain-relieving effects. This closed-loop approach allows for dynamic, responsive therapy sessions.
Beyond Opioids: Orchestrating Pain Relief with Neurotech and AI
Music therapy, particularly when guided by neurotech and augmented with AI, holds great promise for enhancing pain management. It represents a viable alternative to opioid medications, and a promising pathway to reducing opioid dependence. By integrating AI and neurotechnology with music therapy, we can offer personalized, engaging, and effective pain relief strategies. This type of intervention addresses the multifaceted nature of chronic pain and offers a holistic, patient-centered approach to pain management.
The potential benefits extend beyond chronic pain management. AI-enhanced music therapy could also find applications in acute pain settings, such as post-operative care or during medical procedures. By providing a non-pharmacological option for pain relief, this approach could help reduce the risk of opioid dependence following surgery or injury. As research and technology continue to advance, AI-driven music therapy could become an integral part of our healthcare system, providing a sustainable solution to the opioid crisis and improving patient outcomes.
As we continue to develop and refine this technology at CareYaya, we invite collaboration from the neurology community. Your expertise in pain pathways, neuroplasticity, and patient care is invaluable in shaping this promising intervention. Together, we can orchestrate a new era in chronic pain management - one that replaces the discord of opioid dependence with the healing power of personalized, AI-driven music therapy.
I can envision a future where prescribing personalized music therapy programs is as routine as prescribing medication.
REFERENCES
1. Chronic Pain Patients Suffer from Opioid Epidemic Overcorrection. News. WTTW. Published March 12, 2024. Accessed August 5, 2024. https://news.wttw.com/2024/03/12/chronic-pain-patients-suffer-opioid-epidemic-overcorrection
2. Centers for Disease Control and Prevention (CDC). Chronic Pain Among Adults — United States, 2019–2021. Published April 14, 2023. Accessed August 5, 2024. https://www.cdc.gov/mmwr/volumes/72/wr/mm7215a1.htm
3. National Institute on Drug Abuse (NIDA). Overdose Death Rates. Published May 14, 2024. Accessed August 5, 2024. https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates
4. American Academy of Family Physicians (AAFP). Chronic Pain Management and Opioid Misuse. Accessed August 5, 2024. https://www.aafp.org/about/policies/all/chronic-pain-management-opiod-misuse.html
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Neal K. Shah is the CEO of CareYaya Health Technologies, one of the fastest-growing health tech startups in America. He runs a social enterprise and applied research lab utilizing AI and neurotech to advance health equity, with a focus on neurological care for elders with dementia. Shah has advanced AI projects to improve neurological care with support from the National Institutes of Health, Johns Hopkins AITC and Harvard Innovation Labs. Neal is a “Top Healthcare Voice” on LinkedIn with a 40k+ following.