Melissa Anderson, PT
Every Canadian who consumes news, in print, on TV, or via the internet has heard of the opioid crisis. The number of people it touches is staggering, and the stories of loss are heart-wrenching. And this crisis, it seems, does not discriminate - literally anyone could be impacted. It seems that British Columbia is hardest hit at present- the number of deaths has actually decreased the life expectancy in that province.
From an advocacy perspective, the issue of the opioids crisis is an interesting one as it has both federal and provincial/territorial implications. The federal government is interested in the public health aspect of the crisis. It has spent a lot of money on assisting those currently at greatest risk of dying from drug overdose by loosening the legislation concerning safe-injection sites and by making naloxone more readily available. It is looking at changing legislation surrounding the importation of pill presses and packages from overseas.
The federal government realized that it could not combat the opioid crisis on its own. It brought together provinces, territories and organizations that have a stake in the opioid crisis and created the Joint Statement of Action on the Opioid Crisis, of which CPA is a signatory. This joint statement brings together each stakeholder’s commitment to help ease the crisis and reports regularly on their progress.
Provincial and territorial governments also have a huge role to play in a crisis like this, as they are responsible for delivering health care in their jurisdiction. It is these governments that make decisions about the delivery of mental and physical health care that could help impact the crisis at a local level. The decisions to add greater access to addiction services, mental health counselling, or pain management services is made at this level.
It is at this local level where the provincial and territorial branches of CPA are positioned to advocate for change. The branch volunteers and staff are knowledgeable about the needs of the population and the resources required to help. The branches are able to mobilize their members and encourage grass-roots lobbying efforts. It is here where changes to health care delivery are made.
The structure of CPA was designed to take advantage of the federal/provincial/territorial divide in government. Nationally, we can advocate to the federal government on issues that are relevant to the health of Canadians. Locally, the branches can advocate to the provincial and territorial governments on issues related to the delivery of health care. Success in one jurisdiction can spread to other jurisdictions when everyone works collaboratively.
CPA acknowledges that the opioid crisis is far bigger than any one profession, and that it will take a multi-pronged approach to solve this health crisis. One area where we believe that we can make an impact is in the upstream treatment of pain. If physiotherapy and other conservative pain management strategies can be optimized, there may be fewer initial prescriptions for opioids necessary.
To date, these are the initiatives that CPA has been involved with:
- Was a signatory on the Joint Statement of Action on the Opioid Crisis
- Partnered with Pain Science Division to create a pain management self-assessment tool
- Founding member of the Coalition for Safe and Effective Pain Management (CSEPM)
- Completed several Rapid Reviews of literature with Canadian Agency for Drugs and Technology in Health (CADTH)
- Released a joint statement with the American Physical Therapy Association (APTA)
- Made Pain Management the theme of National Physiotherapy Month in 2017
- Participated in a panel discussion at Montreal18
What else can Canadian physiotherapists do to help provide upstream solution to the opioid crisis?
What knowledge or skills do you need to be able to respond to the needs of the patients that you are seeing?