Promoting Physical Therapy as a Safe Alternative to Opioids
Physical Therapist have long known the capability of progressive exercise and movement therapy to combat persistent pain. Now the nation’s chief healthcare agency says physical therapy may work better than often prescribed — and often abused — opioids like hydrocodone and oxycodone in managing chronic pain.
Under mounting pressure to address an epidemic of opioid abuse, the Centers for Disease Control and Prevention released new guidelines intended to alter the painkiller-prescribing habits of primary care practitioners. The guidelines, published in March, include 12 recommendations for physicians, physician assistants, and nurse practitioners. The first recommendation, which the agency labeled “of primary importance,” encourages prescribers to consider non-pharmacologic treatments for long-lasting pain, including physical therapy and non-opioid pain relievers.
Opioid abuse has taken a heavy toll across the country in recent years. The CDC reports that deaths associated with prescription pain medications and heroin tripled between 2000 and 2014. In 2014 alone, opioids accounted for 61% of all deaths from drug overdoses. Roughly 40 Americans die every day from overdoses of prescription painkillers, the agency says.
The new guidelines are voluntary, but CDC Director Thomas Frieden, MD, MPH, urges prescribing practitioners to consider them carefully.
“We know of no other medication routinely used for a nonfatal condition that kills patients so frequently,” he told USA Today following the release of the guidelines. “We hope to see fewer deaths from opiates. That’s the bottom line.”
The guidelines do not cover conditions that cause patients acute pain, including active cancer or during end-of-life care. For most chronic pain, however, the CDC says there’s little evidence demonstrating the efficacy of prescription opiates in the management of pain lasting more than seven days.
Not surprisingly, some members of the pharmaceuticals industry, along with patients who experience chronic pain, have questioned aspects of the guidelines; but the medical community has pushed back, too. Most objections among physician organizations have centered on the strict dosage and duration recommendations contained in the guidelines. Others, though, have voiced concern over reimbursement for physical therapy and other non-drug treatments. According to members of the editorial board of Practical Pain Management, the nation’s top physician organization, the American Medical Association, as well as the American Pain Society, have noted, “the widespread lack of reimbursement for non-pharmacological therapies deters clinicians from ordering them.”
Regardless of the skepticism, the American Physical Therapy Association has quickly moved on the concept of physical therapy as an effective alternative to prescription painkillers. Its #ChoosePT campaign is designed to raise awareness among the public and prescribing clinicians about the risks of opioid use and the benefits of physical therapy for managing chronic pain.
Why Choose Physical Therapy?
A #ChoosePT toolkit offers resources, ranging from a website to handouts, patient stories, fact sheets, and position papers, that any PT or PTA can use to promote the campaign among their patients, colleagues, friends, and family members.
In a nod to the fast-moving social media space as an effective messaging tool, the campaign offers Physical Therapist the opportunity to download a cover photo for their Facebook and Twitter pages. A handful of highly designed graphic messages are also available as downloads for posting on both social media platforms. APTA says additional graphics will be coming soon.
The association encourages Physical Therapist to promote the campaign across their social media channels using the #ChoosePT hashtag.
APTA also reminds PT professionals that September is National Pain Awareness Month and October is National Physical Therapy Month — both ideal opportunities to promote physical therapy for safe, effective chronic pain management.
To learn more about the #ChoosePT campaign and access resources, visit the campaign’s dedicated website.
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Originally posted on 9/8/2016