Could Osteopathy Help Tackle The Opioid Crisis?

Despite increasing public and professional awareness, revised pain-management guidelines and other signs of change, the numbing numbers still stand out: an estimated 130 deaths a day due to an opioid overdose.


Could a lasting solution be as simple as visiting a doctor of chiropractic or other conservative care provider first? You probably know the answer, but now research is proving it. Case in point: a new national study comparing first provider choice with early- and long-term opioid use in patients with low back pain.

Published in BMJ Open, this study evaluated short- and long-term opioid use based on initial provider type seen: conservative care practitioner (chiropractor, acupuncturist or physical therapist) or primary care medical physician (PCP). Participants included 215,000-plus U.S. adults diagnosed with new-onset low back pain and "opioid naive."
The study defined early opioid use as "an opioid fill within 30 days of the index visit" and long-term use as "an initial opioid fill within 60 days of the index date and either 120 or more days' supply of opioids over 12 months, or 90 days or more supply of opioids and 10 or more opioid prescriptions over 12 months."
Researchers evaluated inpatient / outpatient claims from patient visits and pharmacy claims to correlate first provider type seen with opioid use, finding that LBP patients whose initial visit was with a DC were a staggering 90 percent less likely to use opioids early compared to patients who saw a PCP first.
Significantly reduced odds for early opioid use were also noted for acupuncture and physical therapy patients. LBP patients who first visited a doctor of chiropractic or other conservative provider were also less likely to use opioids long term compared with patients visiting a PCP.
ER physicians, orthopedic surgeons, neurosurgeons and rehab physicians were also included in the analysis. Patients visiting any of the above MD specialists first also had lower odds of early opioid use compared to primary care physicians (although not as significant as visiting a conservative-care provider), with the exception of ER physicians (dramatically higher odds for early use compared with PCPs). However, odds for long-term use were not significantly different compared to primary care providers for all of the above specialist types, with the exception of rehab physicians (still significantly lower odds compared to PCPs).
If that's not enough proof, a second study, this one published in Pain Medicine, reviewed six previous studies involving more than 60,000 participants with spinal pain, finding that patients who saw a chiropractor were 64 percent less likely to use opioids compared to patients who visited another type of health care provider.
It makes sense that patients who visit chiropractors are less likely to use opioids, since chiropractors provide nondrug, nonsurgical care. But the bottom line is, visit a chiropractor, reduce your risk of using a dangerous opioid! In light of the sobering statistics on opioid deaths, visiting a chiropractor for your pain could be a life-saving decision.