Congress, the Opioid Epidemic, Pain Management and OT

By Heather Parsons posted 08-28-2018 23:07


In 2016 Congress passed the Comprehensive Addiction and Recovery Act (CARA). This bill was an initial step to help address issues related to drug addiction and treatment with a focus on opioids.  Specifically, the bill focused on access to medications to treat opioid overdoses, the development of evidence-based treatments and interventions and medication-assisted treatments.

Over the last two years, the current Congress has recognized that CARA was only a first step.  Over the course of 18 months the House and the Senate have held dozens of hearings on the opioid crisis. The House has passed multiple pieces of legislation as have Senate Committees.  These hearings and legislation have had a wide focus on law enforcement aspects of the opioid crisis, stopping the pipeline of prescription and non-prescription opiates, access to opioid inhibitors, the effects of the crisis on children and more. Some of the discussion has focused on access to substance-use disorder treatments and expanding access to these services.

Throughout this Congress AOTA’s goal has been to make sure Member of Congress understand the role of occupational therapy in the non-pharmacological management of pain, and assuring that any legislation including studies or funding for these alternatives, include occupational therapy. While many people understand the role of physical therapy in the management of chronic pain, most do not immediately think of occupational therapy. However, with a small introduction, the link between chronic pain and the ability to participate in desired activities becomes apparent. Staff understand the important role of occupational therapy practitioners in teaching people how to prioritize and pace their activities, modify tasks and completes those tasks without triggering pain.

These education efforts have paid off.

When the House of Representatives passed multiple opioid-related bills, two of these bills included occupational therapy. One bill specifically looks at opioid use in acute care, across acute care services, and how to reduce opioid use in this setting (HR 5774), the other takes a broader look at how non-pharmacological pain management strategies (including OT) are currently incentivized or disincentivized under Medicare (HR 6110).  The major bill moving through the Senate (no bill number) would require the Center for Medicare and Medicaid Services to update their guidance to states, regarding mandatory and optional items and services state Medicaid programs may provide for non-opioid treatment and management of pain including evidence-based non-pharmacological therapies such as occupational therapy.  These provisions are all meant to shift the status quo in how opioids and pain are treated under Medicare. Should the bills be signed into law, the inclusion of occupational therapy services within this legislation means occupational therapy will continue to be a key part of integrated-pain management for both acute and chronic pain.

We believe Congress pass final legislation in the time period after the elections and before the new Congress in January, known as the “lame duck”. Action is possible as early as this September. We will continue to keep you on the status of this legislation. 

Do you provide clients with acute or chronic pain rehabilitation services? Are you part of an integrated-pain management treatment team? Let us know about your work by e-mailing us at:

#PublicAffairs#FederalAffairs #Policy #Opioids #ChronicPain



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