A new white paper from APTA makes one thing clear to anyone looking for strategies to combat the opioid crisis in the US: no lasting gains can be made in the fight until stakeholders and policymakers in the country's health care system embrace the value of nonpharmacological approaches to chronic pain. And that embrace, APTA says, must include policy changes that increase patient access to physical therapy, as well programs that make it easier for health care providers to work in underserved communities especially hard-hit by the epidemic.

In its new white paper titled "Beyond Opioids: How Physical Therapy Can Transform Pain Management to Improve Health," APTA points out how the rise of opioid misuse and addiction rates can be linked directly to the widespread use of prescription opioids for the treatment of pain. In the last few years, that stark reality has in turn led to "a growing realization that current strategies for managing pain have to change—that opioid-centric solutions for dealing with pain at best mask patients’ physical problems and delay or impede recovery and at worst may prove to be dangerous and even deadly."

APTA isn't a newcomer to the opioid fight. The association's involvement dates back to late 2015 and includes the award-winning #ChoosePT public awareness campaign. The white paper is a comprehensive summary of the problem and APTA’s recommendations to address it.

"Moving forward, the health care system must reexamine its approach to pain, including how causal factors are identified, what tools or measures are used to quantify its impact, and how the approach to treatment is aligned with the patient’s goals and values," the association says in the paper.

To help fuel that reexamination, the white paper provides a history of the use of opioids in pain treatment, an examination of concepts around pain, and case scenarios that demonstrate how treatment by a physical therapist (PT) can help patients reduce or eliminate opioid use. With context in place, the association then sets out 6 recommendations that it believes need to be part of "a comprehensive response to the opioid crisis:"

• Better public awareness of pain assessment and options for pain management
• Public and private health plans that include "benefit design, reimbursement models, and integrated team approaches that support early access to nonpharmacological interventions, including physical therapy, for the primary care of pain conditions
• Reduction or elimination of patient out-of-pocket costs and increased "access to and payment for person-centered, nonpharmacological pain management and treatment interventions"
• Stepped-up efforts by health plans to educate providers on the effectiveness of nonpharmacological approaches to pain treatment and best practices in assessment, treatment, and referral
• Greater attention by policymakers to what's working in pain management care, and a willingness to commit to lower patient out-of-pocket costs and innovative approaches, including bundled-care models and the use of multidisciplinary teams
• Federal and state student loan repayment programs that incentivize health care professionals to work in underserved communities, thereby increasing the availability of health care providers in areas disproportionately affected by the opioid crisis

"The opioid crisis is a complex societal and public health issue," said Katy Neas, APTA executive vice president of public affairs. "This white paper addresses a major factor that has fueled this crisis, but there's much work to be done on multiple fronts. APTA and its members can be key contributors in what is truly a life-or-death fight."