The purpose of this study was to describe changes in opioid-therapy prescription rates after a family medicine practice included on-site chiropractic services. It was designed as a retrospective analysis of opioid prescription data. The database included opioid prescriptions written for patients seeking care at the family medicine practice from April 2015 to September 2018. In June 2016, the practice reviewed and changed its opioid medication practices. In April 2017, the practice included on-site chiropractic services. Opiod-therapy use was defined as the average rate of opioid prescriptions overall medical providers at the practice.
There was a significant decrease of 22% in the average monthly rate of opioid prescriptions after the inclusion of chiropractic services (F1,40 = 10.69; P < .05). There was a significant decrease of 32% in the prescribing rate of schedule II opioids after the inclusion of chiropractic services (F2,80 = 6.07 for the Group × Schedule interaction; P < .05). The likelihood of writing schedule II opioid prescriptions decreased by 27% after the inclusion of chiropractic services (odds ratio, 0.73; 95% confidence interval, 0.59-0.90). Changes in opioid medication practices by the medical providers included prescribing a schedule III or IV opioid rather than a schedule II opioid (F6,76 = 29.81; P < .05) and a 30% decrease in the daily doses of opioid prescriptions (odds ratio, 0.70; 95% confidence interval, 0.50-0.98).
The authors concluded that this study demonstrates that there were decreases in opioid-therapy prescribing rates after a family medicine practice included on-site chiropractic services. This suggests that inclusion of chiropractic services may have had a positive effect on prescribing behaviors of medical physicians, as they may have been able to offer their patients additional nonpharmaceutical options for pain management.
The authors are correct in concluding the inclusion of chiropractic services MAY have had a positive effect. And then again, it may not!
Cause and effect cannot be established by correlation alone.
CORRELATION IS NOT CAUSATION!
And even if the inclusion of chiropractic services caused the positive effect, it would not prove that chiropractic is effective in the management of pain. It would only mean that the physicians had an option that helped them to write fewer opioid prescriptions. Had they hired a crystal healer or a homeopath or a faith healer or any other practitioner of an ineffective therapy, the findings might have been very similar.
The long and short of it is this: if we want to use fewer opioids, there is only one way to achieve it: we must prescribe less.
6 Responses to Decreases in opioid-therapy prescribing and chiropractic – is there a link?
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EE: The long and short of it is this: if we want to use fewer opioids, there is only one way to achieve it: we must prescribe less.
Which appears to have happened in this study.
I’m glad you got at least taht point
Prof EE. Your continuous criticism of the chiropractic profession is tiresome. Get a life. If you are really serious about criticizing research that has been done by chiropractors or about chiropractors I suggest that you do the following.
In the southern hemisphere there are at least 50 chiropractors with PhD’s (proper doctors). These universities include Auckland University which is in the top 200 universities in the world. I suggest you contact this university or any of the others that have conferred PhD’s. Ask to see the research and theses and do a critical analysis of the research and methodology. Publish this analysis and see what happens. Good luck, because I know that you will not do it. Lazy. Your report card now reads, supposition and poor referencing, bordering upon incompetence. “F” grade.
https://edzardernst.com/2017/01/the-role-of-criticism-in-the-realm-of-alternative-medicine/
https://edzardernst.com/2020/01/how-do-proponents-of-so-called-alternative-medicine-react-to-criticism/
https://edzardernst.com/2013/10/five-methods-for-avoiding-progress-from-criticism/
Gibbles
A swift Google of “Auckland University Chiropractic PhD” only returns hits for the New Zealand College of Chiropractic.
Why don’t you let us know who some of these august and learned individuals are so we can have a look at their theses.
We’re still waiting on any demonstrable and testable studies on the effectiveness of chiropractors for all that they claim they can cure.
Ohwait.
Your continuous defense of your preferred esoteric version is as pitiful as people defending their preferred religions vs the others : demontsrate that it does what you claim it does, and then we’ll consider it.