A Chiropractic Solution for the Opioid Epidemic
Written by Craig Benton, DC   
Friday, September 21, 2018 01:54 PM

The Texas Chiropractic Association has a huge fight on its hands and lives are at stake in this fight. It’s a fight against the opioid crisis occurring in Texas and across the country. An estimate from the National Institute on Drug Abuse reported 49,068 deaths involving opioids in 2017. That means, on average, more than 130 people die each day in the U.S. due to opioid abuse and overdose. Chiropractic care is part of the solution to the opioid crisis and millions of Americans are counting on us. 

I recently had the honor to represent this profession before the Texas Senate Health and Human Services Committee and the Texas House Select Committee on Opioids and Substance Abuse. At these hearings, most witnesses testified about potential treatments for opioid addiction. While this is noble work, we must get out in front of this epidemic and divert people from being prescribed opioids in the first place. This is where chiropractic can shine. Sadly, despite current research in pain management being on chiropractic’s side, it seems many still don’t see us as part of the solution. 

A recent letter in the Annals of Internal Medicine stated that 28.5% of 31,000 opioid prescriptions had no diagnosis of pain. Think about that for a second. If that many opioid prescriptions were not prescribed for pain, what were they prescribed for? More specific to chiropractic, the letter listed the 10 most common pain diagnoses for office visits with an opioid prescription – No. 1 was lumbago and five out of the top 10 were back pain-related. Clearly, chiropractic is part of the solution.

Another study on veterans in the VA found that those patients who saw a Doctor of Chiropractic (DC) had less opioids prescribed. The study followed patients 90 days before seeing a DC and 90 days after seeing a DC using 30-day intervals. Each 30-day interval post chiropractic care demonstrated a reduction in opioid usage. Again, chiropractic is part of the solution.

Recently TCA President Devin Pettiet, DC, posted a response from BlueCross/BlueShield on documentation for chiropractic care reimbursement. It said chiropractic maintenance and supportive care are not medically necessary and will not be reimbursed – meaning once functional improvement can no longer be expected, they will not pay for care. What about the patient who has chronic pain and been on opioids for years? Research has shown that opioids do not improve function long-term, and they have dangerous side effects – including death. Yet, one of the largest insurers in Texas refused to look at the evidence of our effectiveness and safety.

Pain creates a quality of life issue that opioids have utterly failed to address. Where should patients turn instead to treat and manage chronic pain conditions? Research released recently stated that patients undergoing chiropractic maintenance care had less back pain days than those not receiving chiropractic maintenance care. 

The “Triple Aim” in modern healthcare requires patient satisfaction, low costs and effective treatment. Chiropractic care has high marks in all these areas, yet physicians and private insurers continue to opt for low value, ineffective care – like opioids –  that carry devastating consequences for patients and their families.

So, the Texas Chiropractic Association has a fight against opioids on its hands. Fortunately, part of the solution to the opioid epidemic is literally in our hands. Unfortunately, simply providing quality chiropractic care in your practice isn’t enough. You’ve got to act. You can start by joining TCA and encouraging your peers to join. You can also make sure I’m not the lone voice speaking about this in the Texas Capitol by joining me on Valentine’s Day, February 14, 2019, in Austin for TCA Legislative Day, the kickoff to the Texas Chiropractic Legislative Conference, where we’ll visit with legislators and legislative staff to educate them about the benefits of chiropractic and how it is part of the solution to the opioid crisis.

Let’s the get the message out about chiropractic. Hope to see you at TCA Legislative Day!

Craig Benton, DC
TCA Scientific Affairs Director