Using Physical Therapy to Battle the Pain Killer Crisis
“PT Over Pills” is a nationwide initiative to prevent the widespread use of pain killers to treat pain in favor of physical therapy. This article is part of a series on the history of the nationwide pain killer crisis.
For those not directly affected by it, the opioid crisis sounds like a faraway problem. But for millions of Americans, the opioid crisis is a runaway tragedy that impacts their lives every day.
In 2017, more than 130 people died every day because of overdoses. 11.4 million more people misused or abused prescription opioids, while more than 2.1 million were suffering from opioid addiction. These numbers aren’t getting better.
How Physical Therapy Helps Stop Opioid Abuse
At the root of all this suffering is one factor: pain. Since their inception, opioids have been used to help treat chronic pain. Since the 1990’s, healthcare focused their efforts on drugs that masked pain. That’s where physical therapy comes into play.
Aches, pains, and strains are often caused by incorrect movements of the body. As licensed clinical professionals, physical therapists are experts in human movement. They use their training to treat patients’ pain and maximize their mobility, which enhances their quality of life. Physical therapists can design treatment plans that are specifically targeted to treat chronic pain, which they view as a disease state. This is in contrast to acute pain, which often serves a useful purpose, such as alerting us to danger or incorrect movements, and is self-limiting.
The first thing physical therapists do during treatment is identify causes and contributors to a patient’s pain. Once this is identified, and the patient’s mobility and functional goals are clear, the therapist will design a treatment plan that deals specifically with the patient’s pain contributors. This is often a combination of exercise, manual therapy, stress management, sleep hygiene, and pain neuroscience education. New advances in healthcare technology, such as virtual reality, have allowed us to treat chronic pain even more efficiently through pain neuroscience education.
Research shows that patients who use physical therapy for pain treatment instead of opioids are more likely to avoid opioid abuse, and often avoid the need to be prescribed altogether. The sooner a patient starts physical therapy, the more quickly they’ll recover, and the less likely they are to misuse opioids.
However, to truly understand this epidemic, we need to look at two different factors: how the opioid crisis began and where.
A History of Pain Killer Abuse
At the turn of the 19th century, a German chemist created what came to be known as morphine from a substance he isolated from opium. Less than a century later, morphine was being delivered via hypodermic injection for minor surgeries. By the end of the 1800’s, Bayer developed heroin as a derivative of morphine and sold it general public as a “cough suppressant.”
In 1909, the U.S. Congress passed the Opium Exclusion Act, which eventually snowballed into a number of legislative acts that attempted to restrict or ban the usage and distribution of opiates. Many consider the 1909 act to be the beginning of what we know today as the “War on Drugs”. But when the U.S. Food and Drug Administration was created in 1938, that agency continued to mark many opioid medicines like codeine, morphine, and oxycodone as safe for prescription.
In the 1970’s, driven by decades of misuse, the U.S. experienced an intense fear of opioid use. This led medical professionals to try any other methods, including surgery and nerve-blocking operations, before prescribing opioids.
But this practice slowed when the American Pain Society began advocating for prescriptions for cancer-related pain in 1970, and then screeched to a halt in the early 1980’s when the FDA approved Percocet and Vicodin for prescription.
Despite this dark history, the opioid crisis persisted because of the marketing of Oxycontin. In 1998, Purdue Pharma spent a total of $207 million on marketing drugs, and pharmacists pushed the new opioid medication as safe, effective and non-addictive. This claim helped spiral the devastating epidemic that we face today.
The Future of Pain Killer Addiction and Treatment
This epidemic is deeply rooted in our history and culture, which will make it all the more difficult to root out. Ending the opioid crisis will require a combined effort from patients, families, providers, payers, and professionals. Since the epidemic was declared a national emergency in 2016, pain killer-related deaths, disorders, and dependencies have risen. Physical therapists must become central to this effort.
With their dedication to mobility and functionality, physical therapists are uniquely positioned to fight the opioid crisis. Every day, physical therapists are working with new technology and optimize methods to more effectively treat patients. “PT over pills” has become a rallying cry for our physical therapists dedicated to lessening the impact of the opioid crisis and spreading awareness.
Our physical therapists are also capable of working closely with other healthcare professionals to get patients to PT more quickly and can even act as a first point of care since patients are able to see a physical therapist directly, without needing a referral from their physician. This kind of collaboration and cooperation during a patient’s treatment is exactly what is needed in order to overcome the epidemic that lies before us. And while it may take combined efforts from many parties to end the opioid crisis for good, we believe it will be physical therapists who are leading the charge.