June 06, 2016—The Foundation for Chiropractic Progress (F4CP), the voice of the chiropractic profession, announces the release of a positioning paper, Chiropractic: A Safer Strategy Than Opioids, which articulates the value of a conservative, non-pharmacologic approach as an important option for pain management—particularly for back, low back and neck pain, headaches, neuromusculoskeletal and other related conditions.
Citing evidence-based research to validate the positive outcomes, cost effectiveness, high patient satisfaction and other benefits of chiropractic care, the white paper follows on the recent recommendations from the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the Institute of Medicine (IOM) which call for a shift away from opioid use toward non-pharmacologic approaches to address chronic pain.
“According to a study reported by the Agency for Healthcare Quality and Research, the problem remains that opioids frequently are prescribed for acute and subacute low back pain, despite low quality or inconclusive supporting evidence for their use in this circumstance,” say co-authors Laura Carabello, principal, CPR Strategic Marketing Communications; Gerard Clum, DC, former president of Life Chiropractic College West and William Meeker, DC, MPH and president of Palmer College of Chiropractic – San Jose Campus.
“Furthermore, there are no randomized control trials that have shown opioids to improve function, and there is an overriding national public health concern regarding widespread abuse, misuse and diversion of prescription pain medications.”
An estimated 126.6 million Americans (one in two adults) are affected by a neuro-musculoskeletal condition—comparable to the total percentage of Americans living with a chronic lung or heart condition— costing an estimated $213 billion in annual treatment, care and lost wages, according to a new report issued by the United States Bone and Joint Initiative (USBJI).
“With millions of Americans suffering with nonspecific low back pain, it is of special note that an additional research report published by AHRQ shows that spinal manipulative care effectively and significantly reduces pain and improves function for these patients,” says Meeker. “It is estimated that doctors of chiropractic (DCs) perform the vast majority of spinal adjustments in the U.S.”
Chiropractic is the largest, and best recognized of the complementary and alternative health care professions. In fact, patient surveys reported in the Annals of Internal Medicine show that chiropractors are used more often than any other alternative provider group and patient satisfaction with chiropractic care is very high. There is steadily increasing patient use of chiropractic in the United States, which has tripled in the past two decades.
According to Jan Chambers, president, National Fibromyalgia & Chronic Pain Association, “As an organization, we promote integrative health care for fibromyalgia and chronic pain, and recognize the importance of spinal health. Appropriate chiropractic care as a non-pharmacological pain treatment in a biopsychosocial model of care is recommended.”
The white paper issues several calls to action:
- Prescribers should heed CDC guidelines and begin prescribing safer alternatives such as chiropractic care for chronic pain management.
- Pharmaceutical manufacturers should institute more responsible marketing and physician education that will result in improved prescribing habits.
- Hospital emergency rooms should evaluate their options for managing patients’ pain without the use of opioid painkillers.
- Payers and plan sponsors – both government and commercial – should make chiropractic care an accessible, affordable, option for chronic pain relief, with reimbursement of DCs as covered providers.
- Chiropractic services should be expanded in the Department of Defense and veteran’s health care systems since neuro-musculoskeletal pain is one of the leading causes of disability in the active military and veteran populations.
“The United States has awakened on every level to the crushing impact of the opioid use/abuse epidemic,” concludes Clum. “This examination offers a greater understanding of the issues driving overprescribing of narcotics with corresponding initiatives that will help to extricate ourselves from this current, dangerous and often fatal reality.”
As primary care professionals for spinal health and well-being, doctors of chiropractic – who receive a minimum of seven years of higher education – are specifically trained to diagnose, evaluate and provide non-pharmaceutical care and rehabilitation to individuals suffering from acute and chronic back, low back and neck pain, headaches, neuro-musculoskeletal and other related conditions.