A recent study published in a prominent internal medicine journal will give primary care providers more information about the value of chiropractic care – particularly as it relates to reducing opioid use, which remains a significant public-health concern.
Published in the Journal of General Internal Medicine,1 the study looked at how chiropractic care affects the likelihood of receiving opioid prescriptions among veterans with low back pain (LBP) in the large Veterans Administration (VA) healthcare system. (For various reasons, veterans are more likely to use, abuse and misuse opioids compared to the general population.)
The research team, led by Anthony Lisi, DC, focused on patients who were not previously receiving opioid prescriptions and followed them for one year after their first primary care visit for LBP.
Findings
Among more than 128,000 veterans, those who received chiropractic care were significantly less likely to get an opioid prescription compared to those who did not. Specifically, 13.0% of chiropractic care users received an opioid, compared to 16.8% of non-users. After accounting for patient differences, the analysis showed that chiropractic users had a 23% lower risk of getting opioids.
These findings suggest chiropractic care can play an important role in reducing opioid use among veterans with back pain. The results support using nondrug treatments as a first step in managing musculoskeletal pain in the VA system.
Discussion
This study adds to the existing scientific literature in two key ways. First, it used propensity scoring to match the chiropractic recipients to non-recipients, which results in both groups of patients being of very similar complexity, ensuring that the chiropractic patients were not “less severe” cases of LBP. Second, it measured the results of real-world chiropractic care as it is currently delivered in the VA healthcare system.
Taken together, these findings suggest if VA chiropractic care was provided to more veterans with low back conditions, they would likely have a lower chance of receiving new opioid prescriptions.
An important consideration is that the chiropractic patients were still part of the overall VA medical system during their care. So, although DCs do not prescribe opioids, the chiropractic patients could have received an opioid prescription from any number of other providers. This underscores the importance of medical providers having access to chiropractic care for their patients with LBP.
Additional Points
Reference
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