Assembling The Right Pain Management Lineup – HME Business

Assembling The Right Pain Management Lineup

What options should a DME pharmacy make available to customers who are looking for non-prescription and non-drug options for relieving their pain?


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With pain sufferers becoming more aware of the dangers of strong painkillers and seeking non-addictive alternatives, pharmacies are in a good position to offer consumers non-prescription and non-pharmacological solutions for managing pain. Alternative options include over-the-counter painkillers, CBD products, TENS and EMS units, hot and cold therapies, braces, compression and kinesiology tape.

And pharmacies have good reasons to offer those options. Where customers are concerned, much of the desire for alternatives is born out of the opioid epidemic, or people wish in general to cut down on the number of medications they are taking.

Besides that, non-drug options give pharmacists the opportunity to increase revenue streams by offering different options. It makes a ton of business sense to respond to that market desire by educating patients on the best products to decrease pain without pills, and then serve up those options.

There are a variety of alternative pain management product categories that DME pharmacies should consider carrying. Let’s look at some key offerings you should consider stocking:


CBD is the alternative pain management product that has certainly received the most recent media attention, and for a good reason: patients want it and it offers a variety of delivery formats, such as oils and creams. To put it simply, CBD embodies the business case for alternative pain. That said, it also requires some understanding.

CBD is one of the compounds called cannabinoids produced by the cannabis plant. The cannabinoid most everyone has heard of is THC, the psychoactive component in recreational marijuana. CBD, also known as cannabidiol, is the cannabinoid often used in managing chronic pain, insomnia and anxiety. Using CBD to manage pain is analogous to using an over-the-counter pain killer; the pain is simply diminished and there is no “high.”

CBD products are sold in varying dosages that might or might not contain very small percentages of THC, as well. The products range from oil tinctures taken under the tongue, capsules, gummies and lotions. Consumers can buy them online and, depending on what state a person lives in, her or she can buy it at retail establishments.

An initial point of trepidation for many providers when it comes to CBD is the law. From a legal and cultural perspective, cannabis has been so stigmatized that some providers might think there’s something illicit about CBD. There isn’t. In fact, the Federal government has made it a point to legitimize CBD when it comes to the law.

The 2018 Farm Bill, which was signed into law at the very end of the 115th Congress in late December 2018, removed industrial hemp production from the Controlled Substances Act. This gave Federal protection to both hemp farmers and CBD sellers for producing industrial hemp and hemp-derived products, such as CBD, that contain less than 0.3 percent THC.

Also, there are still state statutes to keep in mind. Fortunately, there has been an evolution over the last two years. At present, 33 states have legalized medical marijuana, and CBD usage is legal in some form in every U.S. state. Some states have specific restrictions, and there are special guidelines pertaining to food items that incorporate CBD. Also, if a CBD product is derived from marijuana rather than industrial hemp, that too can complicate matters. Various online guidelines, such as can help you better understand where you stand in your state.

Assuming we’re talking about industrial hemp-derived CBD, there are different types of CBD. Some CBD products are based on an isolate of CBD, meaning that it is just the CBD and nothing else. Other products are what is called full- or broad-spectrum CBD products. This means the CBD is harvested and packaged in a product in such a way that it contains other chemicals found in the cannabis plant that work together with the CBD in a way that experts say increases its efficacy.

Bearing that in mind, it will be important for HME providers to ensure that both their patients and staff have the right understanding about CBD in terms of options, benefits and use. This starts with educating staff so that they are completely on top of the product options and benefits available to patients just like any other product that a provider might offer. Then they want to ensure that their marketing communications and advertising to patients continues with that educational approach.

And, like many HME offerings, the vendors of CBD products are often there to help with educational materials and pamphlets, and some even offer sales support in the form of advisors that can help steer patients to the most sensible, appropriate solution for them.

Also, providers do need to keep in mind that there is an inventory expense component to the CBD equation, and they will want to pay attention to retail turn times to ensure their inventory overhead doesn’t complicate their cash flow.


Standing for transcutaneous electrical nerve stimulation, TENS devices use electrodes attached to the user’s skin via adhesive pads. TENS therapy is based on two theories of pain relief:

First, the electrodes send electrical impulses that flood the user’s nerves and make it hard for the nervous system to transmit pain signals. So the brain interprets the pain signal in a different way. The result is that the user either no longer feels the pain, or no longer feel the intensity of that pain.

Second, there is a theory that using the TENS devices help endorphin production, where endorphins are released as a result of the TENS waveform, so that users actually get a physiological benefit after TENS use. Anecdotally, it’s not uncommon for TENS users to cite a sense of relief after using a TENS device.

This article originally appeared in the DME Pharmacy December 2020 issue of HME Business.


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