Canada faces an unprecedented opioid-related health crisis that affects people from all walks of life, in every community across Canada. Since 2016, there have been over 44,000 opioid-related deaths, leading many to question the effectiveness of current strategies to contain this crisis.

Occupational therapy is one intervention that is often overlooked and needs to be made more widely available to Canadians currently using or exploring pharmacological interventions to manage pain. Occupational therapists (OTs) work in various settings, including hospitals, communities, rehabilitation centres, homes, workplaces, and virtual environments.

How can OTs help? 

OTs work to understand an individual’s pain experience and implement a tailored pain management strategy to address the physiological, psychological, and social aspects of pain. 

Our interventions provide an effective alternative, or complement, to pharmacological pain management, and have the potential to minimize opioid use, reduce the need to increase dosages, reduce the number of new opioid users, and prevent the development of opioid-dependence.

The Canadian Association of Occupational Therapists (CAOT) recognizes that while opioids and other pharmacological treatments must remain available to those who need them, non-pharmacological interventions in pain management are underused and critical to reducing reliance on opioids. According to Health Canada’s Action Plan for Pain in Canada, people who use substances and their families report a lack of appropriate pain care as a contributor to their substance use and as a barrier to treatment and recovery.

To date, strategies to address opioid use have focused on treatment, harm reduction, and law enforcement. There has been little attention paid to prevention through increasing awareness of non-pharmacological interventions, such as low-cost, high-impact occupational therapy services. 

At present, occupational therapy services available through extended health benefits are sporadic at best, leaving many people in Canada with little to no coverage. 

This lack of coverage and awareness results in people not experiencing the benefits of occupational therapy in addressing pain management and instead perceiving opioids as one of the only solutions to treat chronic pain. Integrating equitable access to non-pharmacological pain management interventions within health care should be a key part of the response to Canada’s opioid crisis.

While the reasons for the crisis are many, opioids have quickly emerged as one of the primary means for managing acute and chronic non-cancer pain. In addition, the lack of system coordination in Canada and increased demand for services amid chronic staffing shortages (in both hospitals and community centres) further complicates access to alternative pain management services.

As such, the federal government, in concert with the provinces and territories, must support the integration of pain management services within primary care settings, especially in rural, remote and Indigenous communities.

With increased federal investments in primary care settings, early intervention and timely access to care, including non-pharmacological pain interventions, Canada has an opportunity to transform the current broken, expensive, and hospital-centric care model to a client, patient, and community-centric, health and wellness-based model of care — with an emphasis on health promotion and injury and disease prevention.

Finally, inclusion of occupational therapy in all primary care settings across Canada can work to fill gaps and help to address and relieve multiple stressors on the healthcare system, including in pain and chronic disease management, the provision of mental health services, and injury/disease prevention. In an ideal situation, an OT can be part of a primary health team and, by understanding an individual’s pain experience, implement a preventive and forward-thinking approach, necessary to effectively manage pain and prevent and reduce opioid use.

---

Hélène Sabourin is the CEO of the Canadian Association of Occupational Therapists (CAOT). Hélène has 40 years of experience working in Canada’s health care system, including 25 years as a registered nurse in several settings such as acute care, community care, occupational health and safety and correctional services.