The Prescription Painkiller Epidemic

Numerous recent studies have shown the dangerous over reliance in the United States on prescription painkillers that simply mask pain, but do not cure it. This has tremendously increased Americans’ risk for overuse, and abuse of these drugs if taken for long periods. According to the Centers for Disease Control and Prevention (CDC), there were 16,235 deaths involving prescription opioids in 2013, an increase of 1% from 2012. Total drug overdose deaths in 2013 hit 43,982, up 6% from 2012.¹  The problem is so severe that the CDC has declared the abuse of prescription pain medications an “epidemic.”

This “epidemic” has a far-reaching impact on our nation, including the Armed Forces. Recent findings suggest the rising prevalence of chronic pain and/or opioid abuse by U.S. combat military personnel is cause for serious concern. A 2010 Department of Veterans Affairs (VA) report cites “diseases of Musculoskeletal System/Connective System,” such as back pain as the No. 1 ailment of Iraq and Afghanistan veterans accessing VA treatment. According to VA officials, more than 600,000 veterans use opioid painkillers, and experts say they often contribute to job loss, family strife, homelessness and suicide, as well as weight gain, diabetes and heart disease.2

To date, the failure to adequately address pain in today’s health care system has resulted in unnecessary suffering, exacerbation of other medical conditions, enormous loss of human potential, and massive financial and personal costs. According to a report from the Institute of Medicine in 2011, an estimated 100 million Americans are affected by chronic pain, with an estimated annual cost to American society of at least $560-$635 billion.3

While a multi-faceted plan to address the problem is needed, people in pain should be informed of all pain management strategies, including non-drug interventions, to reduce their risk of overuse and addiction. A January 2015 report released by an independent National Institutes of Health panel about the need for individualized, patient-centered care to treat and monitor the estimated 100 million Americans living with chronic pain, concluded that widespread opioid use does not provide an effective single approach for the chronic pain patient.4

Chiropractic’s non-drug approach is particularly relevant today in light of the rampant overuse and abuse of prescription opioid medications. Doctors of chiropractic (DCs) are experts in the treatment of neuromusculoskeletal problems and their natural approach can eliminate or reduce the need for drugs and surgery in some cases. The U.S. military is now investigating chiropractic services and other conservative treatment strategies to mitigate the alarming rate of opioid abuse and addiction among troops. Early results of that research show that combining chiropractic manipulative treatment with medical care provides significant improvement in lessening pain and enhancing solider readiness.

Health care quality organizations have also begun to recognize the value of a conservative, multidisciplinary approach. The Joint Commission, an independent non-profit organization that certifies more than 20,000 health care organizations and programs in the United States, including every major hospital, recently revised its pain management standard to include chiropractic services. Clinical experts in pain management working with the commission affirmed that treatment strategies may consider both pharmacologic and non-pharmacologic approaches. Since January 2015, services provided by DCs are now included in the standard of care for pain management.

In addition, medical associations are recognizing the problem and looking for strategies to deal with the disproportionate prescription and use of opioids in the United States. A report published last month in the  Journal of the American Academy of Orthopaedic Surgeons (JAAOS) pointed out that more than 80 percent of the world’s opioids are consumed in the United States and that primary care physicians, internists and orthopedic surgeons are the top three prescribers of these medications. JAAOS researchers themselves noted that the increased usage of opioids for the treatment of pain has led to several unanticipated aftereffects for individual patients and for society at large and called on orthopedic surgeons to “work together with all prescribers and patients to decrease the use of opioids for musculoskeletal pain.” 5

Each patient is unique, and care plans should be tailored to focus on what is the safest, most effective treatment for the individual. With this in mind, chiropractic physicians stand ready during National Chiropractic Health Month 2015 in October to address this epidemic and help create a #PainFreeNation.


1 CDC. 2013 Drug Overdose Mortality Data Announced.

2 Analysis of VA Health Care Utilization among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) Veterans, February 2010.

3 Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education: Relieving Pain in America, A Blueprint for Transforming Prevention, Care, Education and Research. The National Academies Press, 2011. 

4 Buckenmaier, C. & Schoomaker, E. (2014). Patients’ use of active self-care complementary and integrative medicine in their management of chronic pain symptoms. Pain Medicine, 15(S1), S7-S8.

5 J. Morris, H. R. Mir. The Opioid Epidemic: Impact on Orthopaedic Surgery. Journal of the American Academy of Orthopaedic Surgeons, 2015; 23 (5): 267 DOI: 10.5435/JAAOS-D-14-00163

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