Opioids and Pain Management

For the past two decades, Canadians have been told that prescription opioid medications are safe, effective, non-addictive solutions for acute, chronic and persistent pain. The use of prescription opioids has grown in Canada and has now reached a crisis level. Canada is the second largest per capita user of prescription opioids in the world. Lack of access to physiotherapy and interdisciplinary pain care is an important contributor to this crisis.

Physician prescriptions for opioids have become the first line of defence for pain management in the last 20 years. The crisis itself has been driven by the marketing of the pharmaceutical industry, despite limited evidence for the efficacy of these drugs for musculoskeletal pain. In fact, opioids have not demonstrated a clinically important change in pain level for many people with pain.  In contrast, there is evidence of clinically important effects for physiotherapy, exercise and interdisciplinary care for people with complex pain problems—but people living with pain and their primary care providers often don’t have access to effective pain management and conservative non-pharmacological therapies.  

The answer to this crisis can be found upstream.  Simply put, the first prescription for opioids to treat acute musculoskeletal pain needs to be prevented.  Prior to any opioid being prescribed, conservative pain management, including physiotherapy, needs to be optimized.

The federal government is leading a National strategy to address the opioid crisis, which has resulted in a joint statement of action.

How Physio Can Help

As the federal Minister of Health commits to supporting better prescribing practices and better treatment options for patients, the Canadian Physiotherapy Association is committed to:

Call to Action

To help promote the message that physiotherapy is a safe, effective alternative to opioid prescription, there are several things that you can do to help.

  • Be informed: For many of us, pain management was part of our entry-level program, but we may have done little to improve our skills since then.  Become familiar with the current evidence on pain mechanisms and pathways. Read the latest research and keep yourself current in pain management.  Pain is one of the main reasons that people seek physiotherapy, so we need a membership that is engaged and informed. Stay tuned for education and resources for patients and members.

  • Key Messages

  • Become a member of the Pain Science Division: Members have access to PSD newsletters, podcasts and blogs.  This is knowledge mobilization in action- information is presented in understandable language and can be easily incorporated into your existing practice. 

  • Reach out to your provincial/territorial branch: Your branch staff and volunteers are perfectly positioned to advocate to their provincial/territorial governments on your behalf.  Health care decisions are made at this level, and your branch leadership can help promote the need for improved access and funding for physiotherapy. 

Resources

 

Posters

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