For opioid treatment in PA, it’s time to just say non-

The opioid epidemic has touched too many families across Pennsylvania who know that the cycle of addiction rarely begins on a street corner. In countless cases, addiction is a disease that grows over time because of overreliance on prescription opioids. As a certified pain management nurse in West Philadelphia, treating severe and chronic pain is part of my job when caring for patients, so I’m especially sensitive to how quickly prescription pain medication can mutate from necessary relief to an addiction.

Despite encouraging news put out by the Centers for Disease Control that overdose deaths dropped nearly 30% from December 2023 to December 2024, we still lost 3,000 Pennsylvanians to overdoses during that period.

That’s why Gov. Josh Shapiro must take immediate action to expand Medicaid access to non-opioid pain management treatments, particularly for our most vulnerable, low-income communities where the crisis hits hardest. Pain treatment has evolved beyond the old approach of relying heavily on prescription opioids. Research shows that combining various non-addictive treatments like physical therapy, non-opioid medication and other proven methods delivers similar – if not better – outcomes.

Other states are already taking such action. In 2024, Maine enacted a law that has systematically removed barriers to accessing alternative pain treatments through Medicaid, including physical therapy, cognitive behavioral therapy, and newer non-opioid medications. Massachusetts has passed legislation and implemented comprehensive coverage policies that prioritize non-addictive pain management options to reduce the quantity of opioids necessary for acceptable relief. These states recognize a fundamental truth: The best way to prevent opioid addiction is to provide patients with multiple options and opioid alternatives to achieve pain relief. 

Despite having one of the highest rates of opioid use disorder in the country – over 2.5% per capita – Pennsylvania is falling behind in offering these alternatives. While our state has made admirable efforts in prescribing guidelines and education, we haven’t adequately addressed the insurance barriers that force patients and doctors into relying on opioids because they’re the only covered option. For chronic pain patients, opioids can be a necessary part of treatment. But research shows that using them alone, even at high doses, usually isn’t enough to achieve good pain control. The best results happen when they’re part of a broader treatment plan that includes other treatments.

The science is clear: Comprehensive pain management that includes physical therapy, behavioral health interventions, non-opioid medications and other evidence-based treatments is not only more effective for many conditions but also eliminates the risk and enormous cost of opioid addiction. Pennsylvania shoulders over $232 billion in opioid-related costs, with individual cases averaging more than $728,000 annually – higher than the national average. 

We have an opportunity to change this trajectory. By directing state agencies to expand Medicaid coverage for non-opioid pain management treatments, thousands of Pennsylvanians can avoid becoming addicted to opioids. This isn’t just about health care policy; it’s about giving families hope and doctors better tools to heal, rather than harm.

We can provide better, safer alternatives for the millions of Pennsylvanians living with pain – but we need to act now. Every day we delay expanding access to non-opioid treatments is another day closer to causing more families to face the choice between pain and the risk of addiction. 

The commonwealth’s recent 30% reduction in overdose deaths shows that progress is possible. However, we’re facing new challenges that make prevention even more critical. Addiction experts are warning that potential cuts to federal grant funding and other program changes at the federal level could significantly impact recovery programs across the country. This adds more urgency to preventing addiction before it starts, rather than relying on treatment after the damage is done.

By expanding non-opioid treatment access, we can change the narrative to create a future where healing doesn’t come with the risk of addiction, where families stay whole and where Pennsylvania leads the nation in evidence-based, effective pain management.