By this time we have all been beaten over the head with the notion that the opioid crisis is out of control. It seems almost every night there is a news story sharing some new statistic or a story about a celebrity death related to prescription opioids. Politicians have turned the crisis into a talking point and the President has even deemed the crisis as a National State of Emergency. We all know something has to change. We also know that Health Care costs in this country are rising at an unsustainable rate. Very few feel confident that the gridlock in Washington will create meaningful and lasting change to a broken system.
While all the hyperbole in Washington and the attention-grabbing headlines in the news continue, research continues to be published that confirms ways we can actually help people get off of opioids or avoid using them in the first place. Unfortunately, these stories usually avoid making headlines. For some reason simple solutions to unfathomable problems seem unable to draw ratings.
The latest example of this is a new retrospective analysis recently published in Health Services Research. The study reviewed 150,000 commercial insurance claims of 18-64 year olds with the primary diagnosis of Low Back Pain in the Northwestern United States. Compared to patients that saw Physical Therapy later or not at all, those patients receiving early Physical Therapy were 89.4% less likely to use opioids, 27.9% less likely to receive advanced imaging and 14.7% less likely to make an emergency room visit. These patients also averaged significantly lower out of pocket costs (~$500) than those receiving delayed or no Physical Therapy. (Abstract – https://goo.gl/jtv19p)
This study has significance for the general population in addition to the Workers’ Compensation system. In states like Tennessee (Results’ home state) where direct access to Physical Therapy is permitted, consumers should take studies like these and others as a call to utilize Physical Therapy first when dealing with a musculoskeletal issue. It is the right path from both a clinical and financial perspective. The same applies to the Workers’ Compensation system. Many healthcare providers continue to take a “wait and see” approach to Physical Therapy as they view PT as a cost driver when in fact avoiding early PT can significantly add to the overall case costs.
This is usually where I would add a disclaimer such as “more evidence is needed” to solidify the concept of early intervention Physical Therapy. But the evidence is already there and has been reproduced numerous time across multiple payer sources and populations. As Physical Therapists, the time is now to be the change we want to see in Health Care and help get the opioid crisis under control.
