Physical Therapy Can Impact the Opioid Epidemic

Recently, an article in the Boston Globe was brought to my attention by a patient of mine. It was in reference to opioid-related deaths in Massachusetts.

“The report by the Massachusetts Department of Public Health found that nearly a quarter of overdose deaths in a five-year period occurred among people, mostly men, who work in construction. Farmers and fishermen also had higher-than-average rates of overdose deaths.

The common factor: Workplace injuries occur frequently in these occupations.”

The current method of pain management has a very unfortunate cycle. The article referenced above gives a disturbing example of how the management of pain MUST change. Based on this article, we can assume that there may be a relationship with injury / pain and opioid addiction-related death. The image below describes popular pain management after being hurt on the job (or getting injured in any manner):

Go to the doctor

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Prescribed pain medication (Opioids in most cases)

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Pain improves = more / continued medication

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Reliance on Pain medication

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Possible addiction… etc

What if there was existing treatment that has been proven to decrease the rate of opioid prescription?

A recent study published by Dr. Bianca Frogner discusses the effect of choosing Physical Therapy as the first line of defense to address low back pain. She reports that there was an 89.4% reduction in opioid addiction rates for patients who saw a PT to address their pain FIRST vs any other form of pain management.  Health News from NPR published a great article that helps summarize Dr. Frogner’s study. This is a staggering number! Physical therapy has been shown to dramatically effect this epidemic if it is chosen as the first line of defense. If we can begin to raise awareness on this topic, can there be a shift from opioid prescription to physical therapy prescription? I sure hope so.

References

Frogner et al. “Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs”. Health Serv Res. 2018 May 23.

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