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The Opioid Epidemic

In reality, modern day opioid drugs are similar to slow release heroin. They are highly addictive, associated with major withdrawal symptoms, and they are killing more and more people every single year.

 Scientific research says opioids are not the answer for chronic pain

Chronic Pain

Chronic pain is pain that has been around for more than 3 months. As it turns out, Opioids provide minimal relief for long term pain like arthritis or chronic back pain. There is no good quality scientific evidence that shows they have good, long-term benefits for managing pain.


Current guidelines promote avoiding drugs and surgery if you have pain, and instead one of your first line choices should be a manual therapist like a chiropractor.


Video Transcript

We’ve all heard about the opioid epidemic, but what are opioids and why are they such a big problem?


Opioids are basically a type of pain killing drug. No-one likes pain right? So why wouldn’t you want to take drugs to help relieve it? I’m going to answer that question by asking another question.


Do you think heroin, which is an opioid drug, is good for you? In case you’re unsure how to answer that question let me first list some of the effects of taking heroin… nausea and vomiting, itching, insomnia, infections, abscesses, constipation, liver, kidney and lung disease, mental problems, problems with sexual function, and to cap it off… death. And I’m not just talking about a few deaths; heroin kills thousands of people every single year. I think we would all agree that this highly addictive drug is bad for you, right?


Well you might be surprised to know that heroin was produced over 100 years ago by pharmaceutical companies as an alternative to morphine, because morphine, which is also a  pain killer and another opioid drug, was causing too many problems with addictions and overdoses. It was thought at the time that heroin was less addictive than morphine, so it would be a better option. Now that thinking was simply wrong.


You may be wondering why I keep talking about heroin? Well, if we fast forward to about 20 years ago, new types of opioid drugs began to emerge and they were thought to be more beneficial and less addictive than heroin. You might have heard the names of some of these drugs…tramadol, oxycontin, codeine, and Vicodin just to name a few. In reality, modern day opioid drugs are similar to slow release heroin – they are highly addictive, and associated with major withdrawal symptoms, and they’re killing more and more people every single year.1 2


When they were released, these new opioid drugs were falsely marketed to doctors as being an effective pain reliever with a low risk of addiction3 and they quickly gained popularity for the treatment of chronic pain. Chronic pain is pain that has been around for more than 3 months. As it turns out, though they provide minimal relief for long term pain like arthritis or chronic back pain4 5, in fact there is no good quality scientific evidence that shows they have good, long-term benefits for managing pain. 6 What there is good evidence of is prescription opioids cause significant harm and thousands of deaths every single year. 6 7   In 2018 there were almost 50,000 opioid overdose deaths in the US alone!8 


This is why current guidelines say opioids are not the answer for chronic pain and they should be avoided. 5


So, I think we can all agree that opioids should not be your first choice option when you are in pain and should be avoided whenever possible because there are much better choices out there!8


So, what can you do if you are in pain? Current guidelines promote avoiding drugs and surgery if you have pain, and instead one of your first line choices should be a manual therapist like a chiropractor.8


Chiropractic care is well known in the research literature to help people who suffer with neck pain,10-12 back pain,13 14 and headaches.15 And research has shown us that people who go to see a chiropractor are far less likely to take opioid medication. In fact, a large recent high-quality study reviewed all of the scientific evidence about opioid use in people who see a chiropractor.16 When the researchers in this study put all of the evidence together they found that people with back pain who saw a chiropractor were 64% less likely to receive an opioid prescription. Considering how harmful opioid medications can be this is a really important finding!


If you go to see a chiropractor when you are in pain you are much less likely to need to take opioid drugs. That has got to be a good thing for you! And don’t forget that chiropractic care has so much more to offer than just helping you with your chronic pain. Chiropractic care is all about improving the communication between your brain and body so you can function at your best.


But if you are suffering from pain, don’t reach for a pill bottle – instead, do your best to stay positive, move often, eat well, sleep well, and go see your family chiropractor.


Video References

  1. Wolfe S, Bouffard DL, Modesto-Lowe EV. The Opioid Crisis and the Physician’s Role in Contributing to its Resolution: Step One–Prevention of Overdoses. Connecticut medicine 2016;80(6):325-34. [published Online First: 2016/08/12]

  2. Florence CS, Zhou C, Luo F, et al. The Economic Burden of Prescription Opioid Overdose, Abuse, and Dependence in the United States, 2013. Med Care 2016;54(10):901-6. doi: 10.1097/mlr.0000000000000625 [published Online First: 2016/09/14]

  3. Huyler F. United States of Chronic Pain: How a shift in health-care delivery and Big Pharma’s hunger for profits have driven the opioid epidemic. New York Times 2016.

  4. Osani MC, Lohmander LS, Bannuru RR. Is There Any Role for Opioids in the Management of Knee and Hip Osteoarthritis? A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken) 2020 doi: 10.1002/acr.24363 [published Online First: 2020/06/26]

  5. Mathieson S, Wertheimer G, Maher CG, et al. What proportion of patients with chronic noncancer pain are prescribed an opioid medicine? Systematic review and meta-regression of observational studies. J Intern Med 2020;287(5):458-74. doi: 10.1111/joim.13026 [published Online First: 2020/02/27]

  6. Centers for Disease Control. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 2016 [Available from: https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm accessed 26/1/2017 2017.

  7. Control. CfD. Prescription Opioid Overdose Data 2017 [Available from: https://www.cdc.gov/drugoverdose/data/overdose.html accessed 24/1/2017 2017.

  8. Shobbrook M, Amorin-Woods L, Parkin-Smith G. Mitigating the opioid crisis: An Australian perspective on the role of chiropractors (part 1). Chiro J Aus 2020;47(1)

  9. Massachusetts TUSAODo. Pharmaceutical Executives Charged in Racketeering Scheme 2016 [cited 2017 24/1/2017]. Available from: https://www.justice.gov/usao-ma/pr/pharmaceutical-executives-charged-racketeering-scheme.

  10. Gross A, Langevin P, Burnie SJ, et al. Manipulation and mobilisation for neck pain contrasted against an inactive control or another active treatment. Cochrane Database Syst Rev 2015(9):Cd004249. doi: 10.1002/14651858.CD004249.pub4 [published Online First: 2015/09/24]

  11. Gross A, Miller J, D’Sylva J, et al. Manipulation or mobilisation for neck pain: a Cochrane Review. Man Ther 2010;15(4):315-33. doi: 10.1016/j.math.2010.04.002 [published Online First: 2010/06/01]

  12. Bryans R, Decina P, Descarreaux M, et al. Evidence-based guidelines for the chiropractic treatment of adults with neck pain. J Manipulative Physiol Ther 2014;37(1):42-63. doi: 10.1016/j.jmpt.2013.08.010 [published Online First: 2013/11/23]

  13. Goertz CM, Pohlman KA, Vining RD, et al. Patient-centered outcomes of high-velocity, low-amplitude spinal manipulation for low back pain: a systematic review. J Electromyogr Kinesiol 2012;22(5):670-91. doi: 10.1016/j.jelekin.2012.03.006 [published Online First: 2012/04/27]

  14. Ruddock JK, Sallis H, Ness A, et al. Spinal Manipulation Vs Sham Manipulation for Nonspecific Low Back Pain: A Systematic Review and Meta-analysis. J Chiropr Med 2016;15(3):165-83. doi: 10.1016/j.jcm.2016.04.014 [published Online First: 2016/09/24]

  15. Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther 2011;34(5):274-89. doi: 10.1016/j.jmpt.2011.04.008 [published Online First: 2011/06/07]

  16. Corcoran KL, Bastian LA, Gunderson CG, et al. Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis. Pain Med 2020;21(2):e139-e45. doi: 10.1093/pm/pnz219 [published Online First: 2019/09/29]

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