Association Between Chiropractic Utilization and Opioid Prescriptions Among People With Back or Neck Pain: Evaluation of the Medical Expenditure Panel Survey.

OBJECTIVE

The purpose of this study was to assess the association between patients in the United States seeing a chiropractor and receiving an opioid prescription for back or neck pain.

METHODS

Medical Expenditure Panel Survey (Years 2012 to 2015) respondents for longitudinal panels 17 to 19 who participated in all 5 rounds were at least 18 years of age, did not have cancer, and reported back or neck pain. We defined chiropractic users as participants reporting at least 1 chiropractic visit for back or neck pain and opioid users as participants reporting purchase or receipt of a prescription classified as Multum Lexicon "60" and "191" for back or neck pain. We adjusted for socioeconomic and clinical variables using multiple logistic regression.

RESULTS

The sample contained 4686 people, 21% of whom reported an opioid prescription for back or neck pain. Among opioid users, 14% reported a chiropractic visit for back or neck pain compared to 31% of nonopioid users. The adjusted odds ratio for chiropractic use among opioid users compared to nonopioid users was 0.46 (95% confidence interval, 0.36-0.57).

CONCLUSION

Patients with back or neck pain who saw a chiropractor had approximately half the odds of reporting an opioid prescription compared to those who did not see a chiropractor.