Chiropractic is associated with a significant reduction in opioid prescriptions compared with non-chiropractic care, new research suggests.
According to New Zealand Chiropractors’ Association spokesperson, Dr Hayden Thomas, chiropractor :`This is vitally important for New Zealanders as we encounter a worldwide epidemic of opioid addiction.’
There has been a tenfold increase in the number of people over 60 getting help for an addiction to opiate drugs. Figures released by the Ministry of Health this week show 530 people aged 60 or over are now getting what is called opioid substitution treatment.
“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).”
In a new meta-analysis and systematic review, presented at the American Academy of Pain Medicine (AAPM) 2019 Annual Meeting on 8th March, patients who visited a chiropractor to help manage a musculoskeletal pain condition were 49% less likely to receive an opioid prescription than their counterparts who went to other healthcare providers.
Ten years ago, almost no one over 60 had opioid substitution treatment, with just 42 people using it in 2008, but it has increased every year since. The Ministry of Health said the 530 people over 60 who got treatment in 2017 represents a 1200 per cent increase.
Dr Thomas comments :`We know there are many more New Zealanders who have a dependence on opioids but have not put their hand up for help. Drugs such as morphine, codeine, Tramadol and Fentanyl are too often given as pain relievers when there are other drug free ways to help manage pain, such as chiropractic.
‘Some people develop an addiction to these drugs, even when used under doctor's guidelines. Across the world preventing opioid addiction and overdose is a significant public health priority; and as part of a strategy to reduce opioid use, clinical guidelines in many countries now recommend many drug-free options to be considered as front-line treatment ahead of any medication.’
The study by the Yale Center for Medical Informatics, Yale School of Medicine, reviewed all 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 those under chiropractic care (range, 12.3% - 57.6%) compared with those not using chiropractic (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).
Dr Thomas notes: `Chiropractors provide many of the care recommendations included in the clinical guidelines for the initial management of low back pain, neck pain, and pain due to osteoarthritis of the hip, knee, and hand.
`The researchers said that they knew of "a small but growing amount of scientific literature" suggesting that chiropractic care may be correlated with a reduction in opioid use. But this is the first time a study has systematically reviewed all of the available literature to determine if indeed there was an overall association between the use of chiropractic care and receipt of opioids.’
Chiropractors are uniquely placed to provide care that specifically focuses on the health of the spine and the relationship between the spine and the nervous system.
New Zealand’s chiropractors are taking the lead to inform, and inspire people to prevent pain and disability by educating the public to have a greater understanding of the relationship between their spine and nervous system, improving their posture, addressing and preventing spinal problems, and engaging in physical activity.
The research was supported by the Department of Veterans Affairs, Health Services Research and Development, and the NCMIC Foundation.
American Academy of Pain Medicine (AAPM) 2019 Annual Meeting: Abstract 107. Presented March 08, 2019.