Effect of electroacupuncture on opioid consumption by patients with chronic pain

INTERVENTION: Electrical acupuncture will be applied to the arms and legs. During the treatment, electrical current delivered with a battery‐operated eletrical stimulator is combined with acupuncture needle techniques to enhance stimulation of the acupuncture points. Each treatment session takes 25 to 30 minutes. The treatment will be given twice a week for four weeks followed by once a week for two weeks then once every two weeks for four weeks. In total, 12 sessions are delivered within 10 weeks. Participants in this group will also receive pain and medication management (i.e., standard care). CONDITION: chronic musculoskeletal pain use of opioid medications PRIMARY OUTCOME: The weekly dosage of opioid medicaitons (OM). This will be calculated based on the data recorded by the pariticipants in their Pain and Medication Diary. SECONDARY OUTCOME: 1) Number of participants who achieve 50% OM reduction 10) The proportion of neuropathic versus nociceptive pain assessed with the Self‐administered Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (S‐LANSS) 11) The Perception of EA Treatment Questionnaire will be given to the two electroacupuncture groups to assess the success of blinding 2) Type, severity and incidence of OM related common adverse events (AEs). Common AEs are somnolence, mental clouding, nausea and constipation. They are assessed with six‐point scales (0 = none, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe, and 5 = extremely severe) to indicate the severity of these events. The scales are included at the end of Pain and Medication Diary that is completed by the participants. 3) Pain intensity measured with Visual Analogue Scales (VASs; 0 = no pain; 10 = worst pain possible) and with the numerical scales included in the Brief Pain Inventory 4) Consumption of non‐opioid medications that are recorded by the participants in their Pain and Medication Diary. To make meaningful comparisons of non‐opioid medications use, the dosage of such medications will be calculated according to Medication Quantification Scale Version III (MQS). 5) Quality of life assessed with SF‐36v2 Health Survey 6) participants' attitude of paina as assessed with Survey of Patients Attitude. 7) The level of function assessed with the Roland‐Morris Disability Questionnaire (RMDQ) and the Brief Pain Inventory; 8) The presentation and severity of withdrawal symptoms assessed with Short Opiate Withdrawal Scale. INCLUSION CRITERIA: 1) age between 18 and 85 years at entry; 2) confident in conversational and reading English; 3) suffering from chronic musculoskeletal pain (CMP), regardless of the locations of pain; and 4) have taken opioid medication (OM) regularly for more than two months without dose limitation.