Thursday, August 27, 2015 Painkiller Abuse to Heroin Addiction: Can Physical Therapy Help Stop It Before It Starts? An alarming rise in opioid abuse is sparking an important related conversation about the effectiveness of physical therapy and other nondrug approaches to treat pain. Recent coverage has been driven by a US Centers for Disease Control and Prevention (CDC) report that documents a resurgence in heroin use, with rates more than doubling for individuals aged 18-25, and females in particular. The CDC report coincided with an announcement from the White House of a new $13.4 million program to battle heroin trafficking. The CDC report links the rise in heroin use to increased rates of addiction to opioid painkillers, an addiction that often begins with legitimate prescriptions to treat pain. That link, in turn, has prompted discussion about the importance of nondrug approaches to pain treatment. Increasingly, coverage of the opioid abuse epidemic includes at least a mention of alternatives to drug therapies for chronic pain. The popular Everyday Health website, for example, recommends that physical therapy and other nondrug approaches be seriously considered as a first-line pain treatment, writing that, at the very least "a team that includes pain specialists, physical therapists, mental health professionals, and primary care providers, tends to be best for patients with chronic non-cancer pain, who often also have mental health concerns such as anxiety or depression." Similarly, a recent edition of Neurology Now calls for health professionals to "rethink chronic pain" through multidisciplinary approaches that include exercise prescriptions. The role of physical therapy as a bulwark against painkiller abuse was also noted by the White House Office of National Drug Control Policy, which recently met with APTA President Sharon L. Dunn, PT, PhD, OCS, and Mandy Frohlich, APTA vice president of strategic communications and alliances, who at that time was the association's vice president of government affairs. APTA has long advocated for the role of the physical therapist (PT) in pain management, using its MoveForwardPT.com website to educate the public on about it, and featuring new approaches to pain treatment being used by PTs in a 2014 feature story in PT in Motion magazine. More recently, the August issue of Physical Therapy (PTJ), APTA’s peer-reviewed journal, includes a discussion of how to interpret the burgeoning effectiveness evidence from recent clinical trials and systematic reviews on pain treatment.