Opioid Research

Chiropractic Care Tied To Significant Reduction In Opioid Scripts

DENVER — Chiropractic care for musculoskeletal pain is associated with a significant reduction in opioid prescriptions compared with non-chiropractic care in this patient population, new research suggests.

In a new meta-analysis and systematic review, patients who visited a chiropractor for a musculoskeletal pain condition were 49% less likely to receive an opioid prescription than their counterparts who went to other healthcare providers.

Veteran Kelsey L. Corcoran, DC

"Preventing opioid addiction and overdose continues to be a significant public health priority; and as part of a strategy to lessen opioid use, clinical guidelines now recommend many non-pharmacological options to be considered as front-line treatment ahead of any medication," lead author Kelsey L. Corcoran, DC, VA Connecticut Health Care System and Yale Center for Medical Informatics, Yale School of Medicine, New Haven, told Medscape Medical News.

"Chiropractors provide many of the treatments included in the clinical guidelines for the initial treatment of low back pain, neck pain, and osteoarthritis of the hip, knee, and hand," Corcoran said.

The findings were presented here at the American Academy of Pain Medicine (AAPM) 2019 Annual Meeting.

“Chiropractic users were also less likely to receive an opioid prescription...”

Assessing "Downstream" Impact

Corcoran said the investigators knew of "a small but growing amount of scientific literature" suggesting that chiropractic care may be negatively correlated with opioid use.

However, "no study has systematically reviewed all of the available literature to determine if indeed there was an overall association between use of a chiropractor and receipt of opioids," she said.

"So we were curious to see if chiropractic care would have an impact on downstream opioid use," Corcoran added.

After reviewing all of the available literature on chiropractic use and opioid prescribing, the researchers selected six studies with a total of 62,000 patients to include in the current analysis.

The data showed that the use of chiropractic care ranged from 11.3% to 51.3%.

The proportion of patients receiving an opioid prescription was lower for chiropractic users (range, 12.3% - 57.6%) compared with nonusers (range, 31.2% - 65.9%).

Chiropractic users were also less likely to receive an opioid prescription, with a risk ratio of 0.51 (95% confidence interval, 0.44 - 0.59; P < .001).

The research was supported by the Department of Veterans Affairs, Health Services Research and Development, and the NCMIC Foundation. Corcoran and Hansen have disclosed no relevant financial relationships.

American Academy of Pain Medicine (AAPM) 2019 Annual Meeting: Abstract 107. Presented March 08, 2019.

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