The Opioid Epidemic and Chiropractic

13 Sep 2018 Blog

On October 26, 2017, the opioid crisis was declared a public health state of emergency. According to the Center for Disease Control and Prevention (CDC), in 2016, opioid overdoses were claiming the lives of 115 people a day across the nation. Opioid overdoses continue to rise and have become the leading cause of death for people under 50 years of age (42,249 in 2016), 40% involving opioid related prescriptions. To put this in perspective, opiate-related deaths are beginning to reach heights similar to the HIV epidemic at its peak.

With this has come a staggering increase in the number of babies being born addicted to opioids, from 5,000 in 2003 to 27,000 in 2013, because of maternal usage. When pregnant women use opiates, it elicits a condition called Neonatal Abstinence Syndrome (NAS). A horrific condition, NAS  causes newborns to endure withdrawal-like symptoms such as tremors, seizures, high pitched crying, rapid breathing, diarrhea, vomiting, and even death. Thousands of these children are being raised by their grandparents/relatives and if they are not available, then they are placed into an already overburdened foster care system or put up for adoption. The damaging effect on families has been astounding.

Opioids are a class of drugs that include the illicit drug heroin as well as the licit (legal) prescription pain-relievers, oxycodone, hydrocodone, codeine, morphine, fentanyl, and others. Opioids are chemically related and interact with opioid receptors on nerve cells in the brain and nervous system, producing pleasurable effects and relieving pain. Addiction is a primary, chronic, and relapsing brain disease characterized by an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Through heavy medication marketing by drug companies, society has developed a belief that medication is the first go-to for just about every healthcare problem. This medication culture combined with the ease of availability has led to a widely accepted practice of doctors who were very willing to write opioid prescriptions in the early 1990’s. By 2004 the Drug Enforcement Agency (DEA) reported the presence of absurd amount of “Pill Mills” where patients had limited examinations, were in and out, and receiving one or more opioids, muscle relaxants, and anti-anxiety pills. Morphine prescriptions increased by 73 percent, Fentanyl by 226 percent, and Oxycodone by a whopping 402 percent. Addicts began to doctor shop within cities and outside of cities, even going to the ER with fake injuries to get their fix. As soon as addicts were unable get their pills any longer, they switched to heroin and fentanyl.

This crisis has hit home! In New York State the age-adjusted rate of all opioid overdose deaths per 100,000 doubled between 2010 (5.4) and 2015 (10.8), with heroin deaths increasing to over five times from 1.0 in 2010 to 5.4 in 2015. In Erie County alone, opioid deaths have skyrocketed from 103 in 2012 to 301 in 2016. As per the Erie County Department of Health, this unsettling data is predominantly composed of Caucasian males between the ages of 20 and 39, residing in the suburbs (45 percent) and is Fentanyl related (64 percent).

The alarm has finally been raised and we have seen increased efforts to educate the community through several outreach programs and the Erie County Opioid Task Force. Twenty-nine drug drop-off locations have been established in the county (visit google maps for Sheriff’s locations, or call 716-472-1998 to find one nearest to you), Methadone clinics developed and Narcan (opioid overdose reversal medication) training has become available to anyone and everyone. Additionally, healthcare providers are becoming more aware of alternative approaches to pain relief. Among them, an important non-pharmacologic approach in helping to solve this crisis is chiropractic care.

For the overwhelming number of people who suffer with chronic pain, chiropractic care offers a drug-free, non-invasive, and cost-effective alternative to opioid drugs. Chiropractors are equipped with the tools to make a significant impact on patients with musculoskeletal pain and patient satisfaction rates with care are very high. Through adjustments, exercises (stretching/strengthening), functional assessment, modalities (heat, ice, cold laser) and soft tissue muscle work, chiropractic can relieve pain symptoms and achieve sustained relief without the side effects of pharmaceuticals. In addition, chiropractors can recommend nutritional, musculoskeletal, and anti-inflammatory pain relief guidance.

As obvious as it sounds, we must remind one another that opioids are powerful drugs with a high tendency for addiction. They should be avoided at all costs and most certainly never be used for recreational or non-clinical reasons. Calls have come from the Center for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the institute of Medicine (IOM) for a shift away from opioid use toward non-pharmacologic approaches to address chronic pain. Now is the time to make a change, now is the time to educate those around you, now is the time to turn toward natural, alternative, pain management through Chiropractic.

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