154- Increasing Chiropractic Decreases Opioids

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Hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. This week we have a great relevant piece of research for you, your patients, your community, your practice and the other healthcare providers in your community. We're gonna look at an awesome study that was released by JMPT pretty recently May 2016 that showcased an inverse relationship between supply of chiropractors and amount of opioid prescriptions that were script. It's a great piece. We're gonna break down why it matters, some quotes from it and more, all on this week's episode. But before we get started, I'll say a few words about Roc Tape. Roc Tape is revolutionizing the soft tissue world again with new Rock blades Mohawk. Featuring three tools in one, a surgical stainless steel hand polished tool and two attachments silicon sleeve and an ABS comb. Mohawk unlocks never before seen treatment protocols to reduce pain, improve mobility and address issues like nerve glide. They are 175 bucks. They have a great carrying case as so if you are looking for a cyber Monday style purchase, I would head on over to Rock Tape and pick up Mohawk. It's an awesome tool and today we are talking about opioids. So the title of the paper we're gonna analyze is cross sectional analysis of per capita supply of doctors of Chiropractic and opioid use in younger Medicare beneficiaries. Again this was released by the Journal of Manipulative and Physiological Therapeutics more commonly known as JMPT in of 2016 and this was actually I picked this paper to feature as part of what we talk about in our evidence based chiropractor research brief for all of our members. Because I thought it was that important to be able to get this information out to the other healthcare providers in your community. So as we know, the opioid epidemic has been one of the most discussed healthcare topics of the last few years. We also know that up to 30% of individuals who take a prescription, not not a street but a prescribed opioid, 30% of those individuals have are gonna be apt to misuse them. 30% of those people will go on to develop dependence and or addiction. So this is not like when we think of numbers, right? It's 0.1 out of 1,000 people. No, this is hundreds out of a thousand people. That are gonna misuse and, or eventually become addicted. And we're talking about tens of thousands of deaths per year as well. So this is real, real life stuff. Many leading healthcare organizations have published updated guidelines and algorithms encouraging physicians to seek non pharmacological treatment for musculoskeletal disorders. This has been one of those good things that's come out of it. We've seen the American College of Physicians, the American Pain Society and many more come out and stand against opioids as a first line defense or really as any defense regarding musculoskeletal and spine complaints. So that has been a welcomed change compared to what's gone on for the last five to 10 years. So many people who listen to this practice, you know, you've probably found a lot of success using what I'm gonna call an evidence informed approach. Whether it's a combination of decreasing inflammation through passive modalities in your practice, controlled active care, getting people up and moving, biopsychosocial as we've talked about, reassurance that they're going to get well and stay well is super soft tissue work can never be underestimated. Postural rehab and improved joint biomechanics, AKA adjusting and nervous system function regarding that impact on the central nervous system, I guess is more clear way to say that are all areas of focus that we have within our tool belt, amongst others as chiropractors. So it puts us in this very, very unique position where we have passive modalities, we have acto modalities, we have things that work segmentally, regionally and for lack of a better way to say holistically on the person in our tool belt that enable us to take care of people with spine and musculoskeletal issues in a way that nearly no other professions can. So that's where, in my opinion, we have a very, very big responsibility to get information like this out. I know, I've spoken with other healthcare providers and it can be challenging for them to know when, which direction to go. It sounds foolish to us, I realize this, but you have to put yourself in these other individual shoes. They're only trained medical doctors who've been in practice 20 years, only trained really in pharmacological treatment options. And when they're starting to see they're feeling downward pressure. Are people looking at how many scripts I'm writing for these things, am I going to have a patient that goes off the rails and encounters all these challenges that's going to come back on me? I was just speaking to A doc last week who they were surprised because they got out there and talking to other people in their community, other healthcare providers, healthcare providers, medical doctors were like, yeah, we don't know what to do. Of course we're sitting there screaming from the rooftops, hey, look over here. But that takes time. That's why it is all about building that bridge. They're not going to, it's very unlikely that they're naturally going to find you. It's a matter of getting out there, getting information like this in front of them and talking them through. Also what you do and what you don't do that can go such a long way towards bridging the gap and building that relationship. They're not gonna magically say chiropractic sien if they've never heard of it, never referred somebody, and have only relied on what I call myth and conjecture in the past. It's just not going to happen. But when you can systematically build the bridge, reduce the friction and break down those walls now, you put yourself in a fantastic position to start getting those referrals coming into the practice. Obviously that's exactly what we do with the members of the evidence based chiropractor. But whether you're a member or not, I would encourage you to get out there and do it. In my opinion, the effort that you put in, even if it seems overwhelming at first, even if it seems challenging now, we make it easy with, for all of our members, but if you're getting out there and you want to do it yourself, it can feel tough. But I think it's important to keep in mind, think about the one person, literally one person that you save from going down the road of NSAIDs that don't work, injections that don't work, opioids become addicted and the families break down because of that. Just saving one person from that road, in my opinion, is worth it. And with the amount of prescriptions out there, you can make an impact. In other words, there are hundreds of thousands of these prescriptions being given out each and every year to the tune of millions upon millions of pills. So I know everybody, if you're listening to this podcast, you're interested in making a change in your community. There's no question about that. And I'm here to encourage you and say you can. But you need to get out there, you need to be relentless and you need to make sure that you bridge the gap and showcase this to other healthcare providers. So without further ado, I wanna break down a couple important quotes from the study itself. So the researchers found, quote, addressing the opioid epidemic should be a public health priority. Spurred by a 16.3% increase in overdose deaths from legal opioids in 2014, the CDC has issued new guidelines to curb physician opioid prescriptions. Almost over 15% increase in overdose deaths from legal prescriptions in a single year is crazy. Research has also found, quote, initial use of chiropractic manipulative therapy for back pain has been associated with reduced disability rates at one year after injury. And avoidance of use of opioids has been associated with lower disability rates one year following injury. These are self fulfilling prophecies. And finally, the researchers found, quote, a higher per capita supply of DCs and Medicare spending on chiropractic manipulative therapy were inversely associated with younger disabled Medicare beneficiaries obtaining an opioid prescription. There you have it. Now, I want to be open and honest with you. I don't think a single paper is all of a sudden going to make our United States healthcare system and Medicare all of a sudden decide they want to start spending more money on chiropractic. Although that would be nice. But there are many people who are, who have insurance, they're willing to pay out of pocket, some combination of that. I don't want you to get tripped up and caught up just on the fact that this was looking at younger Medicare beneficiaries. I think this goes broad based. When chiropractic is showcased as an option, you will see opioid medications decrease. I'm excited at this paper because I think it's the start of many other papers to come. When people have a viable alternative that works, they're going to, by and large, they're going to avoid going down the riskier, more dangerous routes. The great thing about chiropractic is it works. As we touched on earlier, whether you're adjusting biomechanics, whether you're getting the disc decompressed, whether you're getting the facets moving, you're impacting the central nervous system, you're doing active care, you're doing soft tissue work. All of these things come together to give us the efficacy that we're known for. But the efficacy that we're known for needs to hit more than 7, 8, 10, 12% of the population. When we see millions of opioids being prescribed, when we see thousands of thousands of deaths per year, and we're talking 2014, a 15% increase in opioid deaths, that's outrageous. That tells us, you, me and everybody else out there that believes that's too much, that the onus is now on us to bridge that gap, to get out there to start these conversations and also to have these conversations with our patients as well so they understand that there are alternatives and when they hear somebody else speaking, whether it's a family member or at work, that they can have a good conversation with them about the care that they're getting in your office. Not everybody who comes into your office was on the verge of going onto opioids. So for some of those people it sounds foolish, but they might see somebody that's really hurting and say I just don't know if a chiropractor can help them. They have so much quote unquote pain, they, they don't realize the subjectivity of that. They don't realize that the higher the pain. Barring an acute injury or barring significant red flag, chiropractic office is the best place for 90, 95, maybe even 98 or 99% of those individuals. So getting that message out there to your current patients, bridging the gap with other healthcare professionals in your community, this is a paper to do that. I'm going to link it also in the show notes if you have any questions about it, sh shoot me an email jeffevidencebasedchiropractor.com I hope you have a great week in practice and I will talk to you soon.

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