On March 15, the Centers for Disease Control and Prevention
issued its new guidelines on chronic pain management to regulate the
onslaught of opioid prescription painkillers ravaging our country. However, the CDC ignored a few important points that diminished its report.
CDC Director Thomas Frieden said, "It's become increasingly clear that opioids (such as OxyContin, Vicodin, Hydrocodone, Percocet) carry substantial risk but only uncertain benefits -- especially compared with other treatments for chronic pain. We lose sight of the fact that the prescription opioids are just as addictive as heroin."
Sadly, this long-awaited guideline is too little, too late with the horses already out of the barn. Similar to "The Walking Dead," today we see millions of "The Walking Drugged" -- zombies from opioid painkillers -- and there is no stopping the spread of these medical zombies who now number 13 million users and 2 million abusers. Since 1999, 165,000 have died from opioid overdose.
Although the CDC is well-intentioned, it also omits the main cause and non-drug solution of this opioid abuse and addiction. Research shows for the majority of people prescribed opioid painkillers, their main complaints are neck and low back pain. This is where chiropractors enter this picture as the leading non-drug treatment for chronic pain.
The CDC also ignores the fact experts admit medical doctors are not trained in musculoskeletal disorders -- in fact, most M.D.s are no more qualified to treat chronic back pain than a dentist.
Scott Boden, M.D., director of the Emory Orthopaedic and Spine Center in Atlanta, also admits, "Many, if not most, primary care providers have little training in how to manage musculoskeletal disorders."
Another expert, Mark Schoene, editor of an international spine research journal, also questions the buffoonery to use medical doctors as the portal of entry for chronic pain patients considering they created this opioid epidemic in the first place. "Primary care physicians and pain specialists ... are the medical professions primarily responsible for the opioid overtreatment crisis. Are the two professions that helped create the worst pain management crisis in history of modern medicine capable of leading the way forward? That remains to be seen."
The CDC also ignored the recommendations by other experts to use non-drug treatments. In January, the Joint Commission updated its evidence-based guideline on pain management, Clarification of the Pain Management Standard, recommending "acupuncture therapy, chiropractic therapy, osteopathic manipulative treatment, massage therapy, physical therapy, relaxation therapy, and cognitive behavioral therapy."
The goal of the CDC guideline is to "help primary care providers ensure the safest and most effective treatment for their patients." If so, this would require M.D.s to refer these cases immediately to chiropractors or other providers rather than prescribing opioid painkillers and muscle relaxants as they typically do for chronic pain cases.
Just as doctors must refer patients with dental problems to dentists instead of prescribing opioids, so too should doctors refer patients with chronic pain to chiropractors as the guidelines suggest to "ensure the safest and most effective treatment."
J.C. Smith is a chiropractor practicing in Warner Robins.