COVID has made the opioid epidemic worse and the relationship between doctors and opioids is being scrutinized
I still remember the morning two years ago when something caught my attention while I was browsing my newsfeed. “Opioids could kill nearly as many Americans in a decade as HIV / AIDS has killed since the epidemic began in the early 1980s.” We are facing a massive crisis in our nation, and it is not the coronavirus. However, the country’s COVID pandemic has made the country’s opioid epidemic worse, putting doctors and opioids in the spotlight. Opioids are a class of drugs that include the illicit drug heroin and legal (legal) prescription pain relievers such as oxycodone, hydrocodone, codeine, morphine, fentanyl, and others.
Getting worse, not better
In 2015, the number of deaths from opioids skyrocketed. This growing epidemic is devastating families of all socio-economic backgrounds and races.
Unfortunately, the opioid epidemic in the US is getting worse, not better. Between May 2019 and May 2020 (CDC, 2020) there were more than 81,000 deaths from drug overdose. Similarly, from March to October 2020, emergency admissions for conditions such as cardiac arrest decreased, but opioid and other drug-related overdose emergencies were higher than in the same period in 2019 (Holland, Jones & Vivolo-Kantor, 2021).
The Centers for Disease Control and Prevention (CDC) projections, released in July 2021, predict that more than 100,000 Americans will die from drug overdoses for the first time in 2025, up from a total of more than 1 million since 1999 ( CDC, 2021). As things stand, by the time the 2028 presidential election takes place, more Americans will be in the 21st century.
Doctors and Opioids: Prescribing Addiction
How did this happen? Studies with MD doctors and opioids show that 99% of doctors have prescribed highly addictive opioids, many for longer than the CDC recommended three days.
In 1991 doctors wrote 76 million prescriptions. By 2011, this number had almost tripled to 219 million, according to a report by the National Institute on Drug Abuse (Volkow, 2014).
In 1996 Purdue Pharmaceuticals launched OxyContin. This drug was marketed directly to doctors whose prescribing patterns indicated they were “over-prescribers.” OxyContin was also made available to patients free of charge for a limited time. As a result, doctors were encouraged to prescribe this new drug, which was also presented as a very low risk of addiction. Now we know better (Zee, 2009).
More chiropractic = less opioid use
The silver lining of this onslaught of new data is that the medical community is finally recognizing what is happening weather have known for years. Chiropractic is a non-invasive approach that is effective in treating chronic pain. Chiropractic not only has a high level of patient satisfaction, the costs of treating chronic pain with chiropractic are significantly lower. However, I don’t think most chiropractors in this country realized the magnitude of this opportunity.
In 2019, for example, researchers found that patients who received initial treatment for new low back pain from chiropractors or physical therapists were less likely to use opioids compared to patients who received initial treatment from non-chiropractic GPs (McAlister, 2021). . Similarly, a 2020 study found that patients with spinal pain who saw a doctor for chiropractic care were half the risk of filling out an opioid prescription compared to those who first saw a non-chiropractic GP (Whedon et al ., 2020).
The American College of Physicians updated its guidelines in 2017 to recommend chiropractic and other non-invasive, non-drug treatments for back pain before using prescription opioids (Qaweem, Wilt & McLean, 2017). This is a great asset to the chiropractic profession, once eliminated by the American Medical Association. This guideline has helped open more doors for the MD and DC collaboration to treat pain without prescription drugs for patients across America. Still, the numbers keep getting worse.
Affected by opioid abuse
This crisis weighs heavily on my head and heart. Not just because of the potential to save lives in my community, but because I know firsthand the effects of opioids on our bodies.
Someone I know and love suffered a prescription opioid injury that changed their life forever. And it’s not just my family who are affected. Speaking about the opioid epidemic during a team meeting, I quickly learned that everyone in my office knew someone whose life had been touched by doctors and opioids and subsequent opioid abuse.
As a Doctor of Chiropractic and a board member of the Foundation for Chiropractic Progress (F4CP), I have a keen interest in supporting their goal of reaching every consumer in the US with the message that chiropractic is a safer alternative to opioids. The F4CP promotes conservative, drug-free treatment, particularly chiropractic care, as the primary option for pain management, leading to improved clinical outcomes, reduced costs, and high patient satisfaction. They have published articles, created toolkits, and more to promote the effectiveness of chiropractic for non-pharmacological pain management. All of these resources are located on their website (f4cp.org) and are available to the entire profession. Each toolkit contains links to whitepapers, videos, and more.
Promotion of chiropractic care for pain management
See how the opioid epidemic was born over the past 100 years in the Crime of the Century documentary about doctors and opioids. While we cannot change the course of action that led to the fight against opioid addiction, we can now do our part to help.
As a profession, we all have different philosophies and techniques. But in this struggle we can speak with one voice about the value and effectiveness of chiropractic care in pain management and help millions of Americans win the war on opioid addiction.
RAY FOXWORTH, DC, FICC, MCS-P, is a certified Medical Compliance Specialist and President of ChiroHealthUSA. As a practicing chiropractor, he remains “in the trenches” and faces challenges with billing, coding, documentation and compliance. He was president of the Mississippi Chiropractic Association, a past chiropractor at GV Sonny Montgomery VA Medical Center, and a Fellow of the International College of Chiropractic.