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ISCR - April 2020 - Chiropractic and Opioid Reduction

Chiropractic management of mechanical spine pain is not only receiving increased attention within the healthcare system it is also realizing increased evidence of success in the scientific literature. In a recent study by Whedon, et al. (2020), the authors reported, “Utilization of non-pharmacological pain management may prevent unnecessary use of opioids. Our objective was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spinal pain.”(pg 1) In further support of the published evidence they write, “Increasing attention is being paid to the potential of non-pharmacological pain treatment as an upstream strategy for addressing the opioid epidemic.”(pg 1) 

The trend of the chiropractic profession playing an increased role in the management of spine pain is further supported by medical associations and agencies across the country. The authors indicate, “The Institute of Medicine has recommended the use of non-pharmacological therapies as effective alternatives to pharmacotherapy for patients with chronic musculoskeletal pain.”(pg 2) They continue by stating, “Recently published clinical guidelines from The American College of Physicians recommend non-pharmacological treatment as the first line approach to treating back pain, with consideration of opioids only as the last treatment option or if other options present substantial risk to the patient.”(pg 2) Chiropractic is the third largest health profession in the United States and this paper outlines, “Doctors of Chiropractic (DCs) provide non-pharmacologic treatment for spinal pain, using a multi-modal functional approach that typically includes spinal manipulation and exercise, in accordance with international clinical practice guidelines.” (pg 2) 

In relation to specific data, the authors report, “A retrospective claims study of 165,569 adults diagnosed with low back pain found that utilization of services delivered by DCs was associated with reduced use of opioids. The supply of DCs, as well as spending on spinal manipulative therapy, is inversely correlated with opioid prescriptions in disabled Medicare beneficiaries under age 65.” (pg 2) Additionally, “Among patients with spinal pain disorders, for recipients of chiropractic care, the risk of filling a prescription for an opioid analgesic over a six-year period was reduced by half, as compared with nonrecipients. Among those who saw a chiropractor within 30 days of being diagnosed with a spinal pain disorder, the reduction in risk was greater as compared with those who visited a chiropractor after the acute phase had passed.” (pg 6) In conclusion, the authors report an incredible statistic, “Additionally, the protective effect of chiropractic care was sustained beyond 1,200 days after the index date in Massachusetts and beyond 1,500 days in the other states, indicating that once chiropractic treatment has been engaged in the acute phase, patients experience a lasting benefit that is measurable in years.” (pg3) 


Whedon, J. M., Toler, A. W., Kazal, L. A., Bezdjian, S., Goehl, J. M., & Greenstein, J. (2020). Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain. Pain Medicine.