New Research Indicates that Patients Should FIRST Seek Chiropractic Care for Chronic Lower Back Pain Prior to the Prescription of Medical Opiate Drugs

Review written by: James Demetrious, DC, DABCO


At PostGradDC, we focus on offering continuing education through current research that supports the chiropractic profession and the wellbeing of our patients.

In a new paper published in the journal Spine, Whedon et al. provide remarkable insight to the utilization of spinal manipulative therapy (SMT) in the treatment of chronic lower back pain in comparison to opioid analgesic therapies (Whedon et al. SPINE; 46,24:1714-1720.)

Despite receiving national attention regarding the morbidity and mortality rates associated with opioid use, the utilization of opioids has reportedly increased through 2018 amongst patients over 65 years of age. During this period, deaths due to opioid overdose increased. This reflects a dire national emergency.

The Whedon opiate study was highly powered having included an overall study sample of 28,160 patients. The authors provide significant insight into the manner with which chiropractic care benefits our patients and nation. Whedon et al reported:

Adverse Drug Events (ADEs):
• 18.3% of patients who received opiate therapies suffered adverse events.
• <1% of patients who receive SMT experience and adverse effect.

Opioid Dependence or Abuse:
• 14.3% of patients who received opiates developed opioid dependence or abuse.
• Only 0.3% of patients who receive SMT developed opioid dependence or abuse.

The authors concluded that the likelihood of ADEs is 42 times higher for the initial choice of opiate therapies versus the initial choice of SMT.

Clearly, chiropractic care has been established as safe and effective. SMT is vital to ensuring the health and safety of our patients nationally. To mitigate the national opiate crisis, chiropractic physicians should be the initial point of contact and gatekeepers for patients suffering chronic lower back pain.

Primary medical physicians and allied health professionals should initially refer their patients directly to chiropractic physicians as an established standard of care.

PostGradDC offers advanced post-graduate chiropractic continuing education. Our founder, Dr. James Demetrious is a nationally distinguished board-certified chiropractic orthopedist, educator, author and editor. For advanced, evidence-based and clinically intuitive CE Coursework, please go to: