Chiropractic Care and the Opioid Epidemic: A Conservative Approach to Care

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It’s impossible to watch the news without seeing some reference to the opioid epidemic. It’s a health and addiction crisis that has become a major problem. The primary culprit in the epidemic is a failure by the medical community to recognize the highly addictive nature of opioids and the harm they could do if prescribed too often.

How Big a Problem Are Opioids?

What does it mean when people refer to opioid addiction as a crisis? According to the Centers for Disease Control (CDC), up to 25% of people who are prescribed opioids for pain struggle with addiction to their medication.

The CDC’s data also shows that deaths from opioid overdoses have quadrupled since 1999. In 2014 alone, more than 14,000 people died of opioid overdoses. Even more alarming is the number of people who abuse opioids, which the CDC estimates at two million.

Is Addiction the Only Risk with Opioids?

Reading these numbers, you might think that addiction is the biggest risk associated with use of opioid drugs. However, that’s not true – there’s another risk that should concern both doctors and patients.
Opioid drug use may trick patients with chronic pain into thinking that their condition is not serious – or that things are improving even when they aren’t. The false sense of confidence engendered by the drugs may lead patients to take risks that can lead to further damage.

The Value of a Non-Drug Approach to Pain

One reason that the opioid epidemic has reached the level of a national health crisis is that, for some doctors, prescribing pain medication was seen as the first line of defense against pain. Thanks to the issue with opioids, there’s a new respect for a non-drug approach to pain management.
As of 2017, the American College of Physicians changed its guidelines for the treatment of both chronic and acute low back pain to recommend non-invasive, non-drug therapies be used before pain medication. If those therapies don’t work, they recommend anti-inflammatory drugs like ibuprofen and muscle relaxants be tried before opioids.

The CDC has followed suit, creating a new set of standards for prescribing opioids and recommending non-drug therapies be tried first.

The Benefits of Conservative Care

Another way of looking at these changes in the way opioid drugs are prescribed is to say that the medical community at large is finally catching up to what chiropractors have known all along. The American Chiropractic Association (ACA) asks both patients and providers to exhaust all conservative forms of pain management before considering opioid drugs.

The ACA’s policy statement regarding opioids, adopted in 2016, supports:

  • The investigation and use of non-pharmacologic interventions for pain in every healthcare setting and patient population.
  • The promotion of evidence-based non-pharmacologic pain therapies for pain management, within best practice models designed to protect patients.
  • Improved access to providers of non-pharmacologic therapies for all patients.
  • A system of interprofessional training to improve the efficacy and efficiency of pain management teams.
  • Public health campaigns to increase awareness of drug-free treatment options for chronic and acute pain.

These five statements are intended to educate both patients and providers about alternatives to opioid prescriptions for pain management.


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