Friday, June 14, 2019 News From NEXT: A Moving Account of a Journey Out of Pain and Addiction—And a PT's Crucial Role "I failed my marriage. I failed as a father. I failed my career. And I didn't even know it was happening." That's how Justin Minyard describes the lowest point in his life, when, after experiencing 2 spine fractures and receiving multiple surgeries, he became addicted to the opioids prescribed to him. He found himself consumed by his pain and his meds—how many he had on hand, when he could take the next one, where he needed to go to get refills. His addiction led to a suicide attempt and 2 accidental overdoses. But most devastating for Minyard was that his addiction hurt the people he loved the most. "I let them down," Minyard said. "You didn't want to be around me at that time." Now things are different. With the help of an interdisciplinary care team that included a physical therapist (PT), Minyard said he learned how to "make pain a footnote, not the header" of his life and defeat his addiction. He'll be 8 years' clean in July. Minyard's moving story was delivered as the keynote address at the opening event for APTA's NEXT Conference and Exposition, held June 12-15 in Chicago. The retired Army Master Sergeant recounted the injuries he received—first during a rescue attempt at the Pentagon during the 9-11 attacks and then while on a mission in Afghanistan—but focused more on what happened afterward: the multiple fusion and other surgeries, the intense pain, and his eventual slide into addiction. "I didn't wake up one day and say, 'this sounds great,'" Minyard said of his use of opioids; however, he believes his passive approach to exploring treatment options played a role in his use of drugs. "I was not an educated patient; I didn't ask questions," he told the audience. After more than 2 years of attempting to manage his pain through opioids and other medications—and becoming addicted along the way—Minyard began to see options for change. His last fusion surgery kept him in the hospital for 3 months. Then a physician who called Minyard a "hot mess" offered him another avenue: a pain management program that involved 9 different professionals including a psychologist, psychiatrist, a pharmacologist—and a PT. Minyard took him up on the offer, and moved from what he describes as a "pain-centric to a patient-centric model of care." Minyard credits his PT as helping him to accept the idea that, yes, he may be in pain for the rest of his life, but he could work to find ways to manage the pain to make it "more of a footnote, less of a header." Now Minyard says that on most days his pain level is moderate but manageable, around a 3 on the pain scale. Minyard also feels that it wasn't just about the physical therapy itself. He thinks his relationship with his PT was also a major factor in his recovery. "She wasn't just my PT, but my psychologist, my sounding board, my marriage counselor, my educator of my options, and my kick in the ass," Minyard said. "She was all of those things." That recovery included taking his PT up on a suggestion that he try handcycling. He liked it—so much so that he wound up medaling in traditional upright cycling at the Invictus games. Even more important for Minyard is how the changed approach to pain management gave him back his life with his family. "I am my 11-year-old daughter's soccer coach," Minyard said. "I get to be her coach. I don't know a damn thing about soccer, but I get to be her coach. But I almost lost that. I was this close, multiple times." While Minyard credits a single PT with a major role in his own recovery, he told the NEXT audience that the entire profession should be proud of the life-changing work they do. "You're going to continue to make such a tremendous impact on countless other patients," Minyard said. "Choose PT."