Thursday, October 13, 2016 US News: Time for Chronic Pain Treatment Without Opioids – and Policies That Make it Possible Two researchers believe that when it comes to pain treatment, if the US truly wants to alter the future, it could do well to look to the preopioid past—and then make policy changes that would increase patient access to nondrug approaches to chronic pain. In a recent opinion piece published in US News and World Report, authors Jason Doctor, director of health informatics at the USC Leonard D. Schaeffer Center for Health Policy and Economics, and Joan Broderick, senior behavioral scientist at the University of Southern California Center for Economic and Social Research, write about the ways pain treatment should change in light of the Comprehensive Addiction and Recovery Act passed by Congress earlier this year. That act, aimed at battling the opioid abuse epidemic, includes the establishment of a Department of Health and Human Services task force that will review and modify best practices for pain management. Broderick and Doctor assert that simply reducing the amount of opioids prescribed won't by itself address the issue of what to do for the millions of Americans who will continue to suffer from chronic pain. That, they argue, will require the HHS task force to take a kind of back-to-the-future approach. "The task force needs to look back prior to the [opioid abuse] epidemic when the first-line treatment for chronic pain was not drugs," they write. "Teams of occupational and physical therapists, social workers, physicians, and psychologists—frequently operating in multidisciplinary centers—addressed the social, psychological, economic, and physical components of pain." When it comes to the treatments themselves, Broderick and Doctor don't mince words. "They worked," they write. "They made patients physically stronger and gave them the self-management skills that helped them lead more fulfilling and productive lives." The problem, they write, is that the current health care environment stacks the deck against nondrug approaches—something that must change. "That earlier era of chronic pain management can be revived with less expensive avenues of access, better incentives, and improved reimbursement," they write. "Medicare can lead the way in making pain coping skills widely available. Most important, it needs to create billing codes that make the services reimbursable." Broderick and Doctor also argue for quality performance standards "that would promote integrative solutions." The changes advocated by Broderick and Doctor echo the policy changes identified by APTA as crucial to improving patient access to PTs for treatment of pain. Those changes include the repeal of the Medicare therapy cap, more extensive direct access provisions, better private insurance coverage, and limits on physician self-referral. APTA's #ChoosePT campaign, which targets the opioid abuse epidemic, is at the center of the association's activities during National Physical Therapy Month. Housed at MoveForwardPT.com/ChoosePT, #ChoosePT resources now include a video public service announcement, as well as other targeted advertising and media outreach. APTA is also a member of the White House’s working group addressing the opioid epidemic.