Chiropractic Patients Have Increasing Success in Reducing Opioids

In 2018, chiropractic lowered opioids by 55%.

In 2025, they were lowered by 64%

By Mark Studin, DC, FPSC, FASBE(C), DAAPM

Citation: Studin M. (2025). Chiropractic Patients Have Increasing Success in Reducing Opioids, Chiropractic Economics, Retrieved from: https://www.chiroeco.com/chiro-patients-have-increasing-success-in-reducing-opioid-prescriptions/

Since 1999, the opioid epidemic has been prevalent in the United States. From 1999 to 2010, there was a substantial increase in opioid-related deaths, with prescriptions accounting for approximately 50%. In 2015, there were 33,091 opioid-related deaths. The level of opioid use deaths is escalating. Additionally, there are approximately 2,000,000 people in the United States who have opioid use addiction.[i] Emergency rooms are a prime source of opioid use, where 60% of low back pain (LBP)patients will be treated with opioids.[ii] In the primary care setting, the opioid prescription rate is 30%, and a large number of patients who saw a primary care physician for LBP received care that is inconsistent with evidence-based clinical practice guidelines.[iii]

Treating low back pain is 1 area most chiropractors have in common globally. No matter the focus of chiropractic practices, neck and low back pain, based on my independent research, is one of the most common maladies treated in chiropractic. When considering outcomes for LBP care paths, patient satisfaction, increased drug use, and overdose hospitalizations are prime areas of consideration.

Although LBP remains an epidemic worldwide,[iv] and the cost of managing back pain is increasing substantially[v], with consistently poor outcomes, medicine has dogmatically held onto the label of "non-specific low back pain." Non-specific low back pain is defined as low back pain not attributable to a recognizable, known specific pathology (e.g., infection, tumor, osteoporosis, fracture, structural deformity, an inflammatory disorder, radicular syndrome (discs), or cauda equina syndrome). It represents approximately 95% of all back pain and is persistently labeled non-specific because medicine cannot define a specific diagnosis.[vi]

The core of the issue with low back pain is that medicine cannot diagnose the problem; therefore, it chooses to treat the symptoms and not the cause of the problem, and has only pharmacology as a direct solution. The problem is rooted in biomechanical pathology, where no pharmacological solution exists for a mechanical pathology. Chiropractic is an art, science, and philosophy based on biomechanical pathology.

Ntedan (2020), in a 4-year study and a cohort of 8,023,162, reported that 96% of chiropractic recipients were satisfied with their outcomes, including LBP and other spinal maladies.[vii] As medicine is highly trained in anatomical pathology, its education lacks chiropractic’s forte, training in diagnosing and treating spinal biomechanical pathology with non-pharmacologic care.

The utilization of pharmacological (opioid and benzodiazepine (Gabapentinoids) management of LBP revealed that the incidence of drug-related overdose hospitalization was 200% less for both drug users and non-pharmacological treatment that included non-pharmacological treatments. For those using only non-pharmacological treatments, there was a 300% reduction in the incidence of drug-related overdose hospitalization.[viii] This study “lumps together” chiropractic and physical therapy, which deliver care differently and render disparate outcomes. However, with the above study, it has been found that physical therapy alone using mixed modalities increases opioid use by 80% in 89.9% of the patients[ix], leaning toward chiropractic as the best solution.

In 2018, the evidence revealed that chiropractic reduced opioid use by 55% and opioid costs by 74%.[x]  In 2025, a VA study with a cohort of 128,377 patients reported that chiropractic care users were found to have a 64% lower odds of receipt of opioid prescriptions than non-users.[xi] These outcomes give strong evidence as to why chiropractic must be the first-line provider for low back pain, both acute and chronic, which will contribute to lowering opioid use overdose, and deaths.

[i]Schuchat, Anne, Debra Houry, and Gery P. Guy. "New data on opioid use and prescribing in the United States." Jama 318.5 (2017): 425-426.

[ii]Heard, Kennon, Caroline M. Ledbetter, and Jason A. Hoppe. "Association of emergency department opioid administration with ongoing opioid use: a retrospective cohort study of patients with back pain." Academic Emergency Medicine 27.11 (2020): 1158-1165.

[iii]Kamper, Steven J., et al. "What is usual care for low back pain? A systematic review of health care provided to patients with low back pain in family practice and emergency departments." Pain 161.4 (2020): 694-702.

[iv] Balagué, Federico, et al. "Non-specific low back pain." The Lancet 379.9814 (2012): 482-491

[v] Government Accountability Office. Medicare Part B imaging services: rapid spending growth and shift to physician offices indicate the need for CMA to consider additional management practices. Washington, DC: Government Accountability, 2008

[vi] Oliveira, Crystian B., et al. "Clinical practice guidelines for the management of non-specific low back pain in primary care: an updated overview." European Spine Journal 27.11 (2018): 2791-2803

[vii] Ndetan, H., et al. "Chiropractic Care for Spine Conditions: Analysis of National Health Interview Survey." Journal of Health Care and Research 2020.2 (2020): 105

[viii] Dow, Patience M., et al. "Association of Pharmacologic and Nonpharmacologic Management of Acute Low Back Pain with Overdose Hospitalizations: A Nested Case-Control Study." Journal of Integrative and Complementary Medicine (2025)

[ix] Shawn Farrokhi, DPT, PhD1,2,3, Laura Bechard, DPT1,2,4, Sara Gorczynski, DPT1,2,4, Charity Patterson, PhD5, Joseph Kakyomya, MS5, Brad D. Hendershot, PhD1,3,6, CDR Rachel Condon, DPT, DSc, FAAOMPT 7, LTC Matthew Perkins, PT, DSc, FAAOMPT 6, Daniel I. Rhon, PT, DSc, PhD, FAAOMPT 3, Anthony Delitto, PT, PhD5, Michael Schneider, DC, PhD5, Christopher L. Dearth, PhD1,3,6

[x] Whedon, J. M., Toler, A. W., Goehl, J. M., & Kazal, L. A. (2018). Association between utilization of chiropractic services for treatment of low-back pain and use of prescription opioids. The Journal of Alternative and Complementary Medicine, 24(6), 552-556

[xi]Lisi, Anthony J., et al. "The Impact of Chiropractic Care on Opioid Prescriptions in Veterans Health Administration Patients Receiving Low Back Pain Care." Journal of General Internal Medicine (2025): 1-9.