The APTA launched a new campaign this week, called #ChoosePT – the goal of which is to raise public awareness about the roll Physical Therapy plays in safe pain management compared to opioid medications. The risks associated with long term opioid use have been well documented by the CDC, who published new opioid prescription guidelines earlier this year. From an outpatient orthopaedic stand-point, a high percentage of patients that I treat are either actively taking an opioid, or have been prescribed one for their condition. There are certainly times when properly dosed opioids are the appropriate course of treatment, such as in the first few days after a major surgery like a joint replacement. However, there are many common ailments that opioids just should not be used – mainly chronic conditions, osteoarthritis, and fibromyalgia. As physical therapists, we are inherently aware of this, and know that we can change our patient’s pain, but we should still take this time to become better advocates for our patients.
Here in Massachusetts, the opioid epidemic is well documented. Police officers carry Narcan in every cruiser, and it is available over the counter at most CVS and Walgreens stores; there is also a new law on the books to protect individuals who call 911 to report an overdose. Unfortunately, many of these individuals who become addicted started with legally prescribed medications. In a state with direct access, there is a growing level of responsibility to manage these patients effectively, which includes identifying opioid overuse, and providing safe alternatives to opioid use like quality Physical Therapy.
This starts with patient education, from initial evaluation to discharge, for every patient. Specifically, educate them on the risks of prolonged opioid use and pain science. Be able to recognize when patients are on a prescribed opioid, and have an educated conversation with them about it. Increase patient buy-in by demonstrating that you can reduce their pain with manual therapy, corrective exercise and movement. Encourage patients to discuss alternatives to opioids with their physicians, including consulting a PT prior to starting on opioid medication.
As the epidemic grows, Physical Therapists are primed to step in on the front lines and offer a safe, viable alternative to opioids for a variety of acute and chronic painful conditions. As a profession, we must be up to the challenge. For more information and patient education materials, visit the APTA #ChoosePT guide, and follow the hashtag on social media.