VA Study Finds Chiropractic Linked to Lower Opiate Usage

We're all aware of the serious problem in the US with opiate addiction. According to the National Institute on Drug Abuse, 115 Americans die from opiate overdoses each day (about 43,000 a year), and we spend about $78 billion on the total costs of opiate abuse. Opioid addiction is crippling our economy and many communities.

Many people who become addicted to opiates are first introduced to them by doctors who prescribe them for chronic pain. A recent study in the American Journal of Psychiatry found that 60% of opioid overdoses first used these drugs when given a prescription for chronic, non-cancer pain: 59% of those patients were prescribed painkillers for chronic back pain and 24% were for chronic headache.

In summary: 36% of people who died from opioid overdoses were first given a narcotic because they had back pain.

Chiropractic: Working with the Root Cause of Pain

Chiropractic takes a different approach to pain by working to help the body repair the root cause of the problem rather than simply masking the symptoms, like opiates do. Remember: painkillers don't repair injuries or damaged tissue; they simply stop the brain from processing pain, leaving the underlying problem. If the problem isn't treated and the normal function isn't restored to the body, the pain will return.

Numerous studies have found that chiropractic care is equally (or even more) effective than medical care for a variety of pain conditions, including back pain, sciatica, headache, and scoliosis. And since chiropractors don't prescribe drugs or perform surgery, patients who get adjustments don't have to worry about the negative side effects that come with these treatments...including addiction.

Even the American Medical Association has acknowledged that chiropractic adjustments should be a course of treatment before surgery is considered for back pain.

The US Department of Veterans Affairs has also seen the benefits of chiropractic care in the treatment of pain and, over the last few years, dramatically increased the utilization of chiropractic for veterans.

Chiropractic Patients Use Fewer Opiates

Now a new study1 from the VA looked at the relationship between chiropractic care and opioid consumption in returning veterans. In this study, the researchers looked at the health records of 14,000 individuals who had received at least one chiropractic adjustment. The authors found:

  • One third of these patients were prescribed an opioid within six months of their chiropractic visit.
  • Patients were more likely to be prescribed an opiate if they had moderate to severe pain.
  • They were also more likely to receive an opiate if they had PTSD or depression.
  • The chiropractic patients, though, had a significantly lower usage of opiates after their chiropractic visits compared to non-chiropractic patients.

The authors write:

"The percentage of veterans receiving opioid prescriptions was lower in each of the three 30-day time frames assessed after the index chiropractic visit than before. Our work did not attempt to assess causation or otherwise explain this observation. Veterans may have been referred to chiropractic care as part of an opioid taper plan, or those who agreed to chiropractic care may have been inherently less likely to seek opioid prescriptions. However, it is also possible that the delivery of chiropractic care may have been a substitute for opioid use in our sample, which raises interesting research, policy, and practice considerations as the VA continues to expand chiropractic services. This is particularly relevant in light of other work that has shown a negative correlation between chiropractic use and opioid use in private sector populations."

This is not the first study to show that chiropractic patients are less likely to use opiates.

  • A 2016 study2 found that in areas where there are more chiropractors per capita, younger, disabled Medicare beneficiaries were less likely to obtain an opioid prescription.
  • Another 2018 study3 found that chiropractic patients had a 55% lower chance of using opioids than did medical patients.

It's clear from our public health crisis that we need healthy, non-addictive solutions to chronic pain in the United States. Many people with pain are prescribed opiates when there are solutions that are just as effective and safer than drugs. According to the literature, it seems that chiropractic can play an important role in helping these patients.

Medical References

  1. Lisi AJ, Corcoran KL, DeRycke EC, Bastian LA, Becker WC, Edmond SN, Goertz CM, Goulet JL, Haskell SG, Higgins DM, Kawecki T, Kerns RD, Mattocks K, Ramsey C, Ruser CB, Brandt CA. Opioid Use Among Veterans of Recent Wars Receiving Veterans Affairs Chiropractic Care. Pain Medicine 2018 Sep 1;19(suppl_1):S54-S60. doi: 10.1093/pm/pny114. PubMed PMID: 30203014.
  2. Weeks WB, Goertz CM. Cross-sectional analysis of per capita supply of doctors of chiropractic and opioid use in younger medicare beneficiaries. Journal of Manipulative & Physiological Therapeutics 2016;39(4):263-6.
  3. Whedon JM, Toler AWJ, Goehl JM, Kazal LA. Association Between Utilization of Chiropractic Services for Treatment of Low-Back Pain and Use of Prescription Opioids. The Journal of Alternative and Complementary Medicine 2018; Feb 22. doi: 10.1089/acm.2017.0131.