According to a report by the National Safety Council, Americans are now more likely to die from opioid overdose than in a car crash. Talk about devastating. The report states Americans, as a group, have a 1 in 96 chance of dying from an opioid overdose and a 1 in 103 chance of dying in a car crash.
Reliance on pain medication is widespread throughout many demographics, and no matter how or why the pills got in their hands, millions of Americans are learning the dire consequences of them.
“When you trace the roots, I think it started maybe 20 years ago, or perhaps less, when there was an actual concern that people’s pain wasn’t being sufficiently managed or even ignored,” says James Whedon, DC, MS, director of health services research at the Southern California University of Health Sciences. “Pharmaceutical companies started to jump on board with this idea and began engaging in some pretty aggressive marketing tactics. Now, we have a situation where many hundreds of thousands of opiod prescriptions are dispensed every day in the United States.”
In the midst of this crisis, stakeholders have devised a number of solutions intended to guide the public away from pharmacological pain-relief solutions. Many studies over the years have shown the benefits of chiropractic as a proven, cost-effective approach to musculoskeletal pain, but where does chiropractic fall in the fight against the opioid epidemic?
“There is a lot of context here as it relates to why chiropractic care as opposed to any other discipline,” says Jay Greenstein, DC, chairman of Clinical Compass. “I think it’s important to understand that in 2016, the Lancet published a paper looking at the global burden of disease. What has been proven in the scientific literature to be effective for the treatment of neck and low back pain is chiropractic. It made so much sense to evaluate chiropractic in the context of opiate utilization because neck and low back pain are literally the world’s biggest problems.”
The low back pain problem
A recent study in the Lancet Medical Journal found that back pain treatment is being mismanaged across the world. In 2009, a study found that opioids, which kill 35,000 people each year, were prescribed to 60 percent of patients who visit the emergency department due to low back pain.
“The burden from low back pain has reached a tipping point where the condition is growing rapidly, is poorly understood and is being mismanaged medically,” said Rachelle Buchbinder, MD, a professor who helped spearhead the study. With over 93 people per day dying from an opioid overdose, and 70 percent of those people being prescribed opioids for back pain, it is important to realize that there is a research-backed treatment proven to significantly reduce lower back pain.
The search for an answer
In 2016, his study, Association between Utilization of Chiropractic Services and Use of Prescription Opioids Among Patients with Low Back Pain, found a 55 percent reduction in the likelihood of people filling prescriptions for opioids in those who received chiropractic care as compared to those who did not. Furthermore, the charges for filling opioid prescriptions and providing clinical services for chiropractic recipients were 74 percent and 78 percent lower, respectively.
“That’s statistically significant, and it may be a highly clinically significant result as well,” Whedon says. “Seeing this from the point of view of a chiropractor, I would be inclined to say that these results quite possibly stem from the positive clinical changes, reduction in pain, reduction in disability, and so on, that chiropractic delivers these results for the patients and is responsible for the reduced use of opioids.”