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Insider's Insight

James Edwards, DC

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The Opioid Epidemic: It's Time We Stand and Fight

While I am not an expert on opioids or the opioid epidemic, I do have personal insights on this important subject. In 2009, I suffered a burst appendix on a cruise ship and had to undergo an emergency – and life saving – surgery in the small town of Progresso, Mexico. Subsequently, I was prescribed opioid medication that greatly relieved my pain.

In 2014, I fell and shattered my right humeral head into eight pieces, requiring two surgeries. The opioid medication was a "Godsend" for me because the pain would have been intolerable without it.

Fortunately, my good friend and past ACA president Glenn Manceaux, DC, PT, warned me both times to be extremely careful about taking opioids because they are extremely addictive. Based on his sage advice, I only took them when the pain was intolerable and did not get addicted. And also fortunately, the pills did not give me the "high" so many people get.

On the other hand, a large number of people do take opioids in order to get that "high." A patient of mine was not acting rationally, so I investigated and learned 1,500 doses of hydrocodone had been prescribed during the previous 12 months.

Armed with that information, I called all the prescribing doctors to warn them they should immediately stop all prescription of opioids, which ultimately resulted in the patient entering an intensive, inpatient rehabilitation program. Again and fortunately, my patient did not become one of the 91 Americans who die every day from opioids and has now been "clean" for well over a year.

Statistics No One Can Ignore

If you do not believe the seriousness of the opioid epidemic, then fasten your seat belt and read what the Centers for Disease Control and Prevention (CDC) states on its website:

"Drug overdose deaths and opioid-involved deaths continue to increase in the United States. The majority of drug overdose deaths (more than six out of ten) involve an opioid. Since 1999, the number of overdose deaths involving opioids (including prescription opioids and heroin) quadrupled. From 2000 to 2015 more than half a million people died from drug overdoses. 91 Americans die every day from an opioid overdose.

"We now know that overdoses from prescription opioids are a driving factor in the 15-year increase in opioid overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Deaths from prescription opioids – drugs like oxycodone, hydrocodone, and methadone – have more than quadrupled since 1999."

The Irony Is Thick

Having disclosed those personal experiences in regard to opioids and the CDC's terrifying statistics, I want to give my insights and strong recommendation to the chiropractic profession.

For those of you who have studied the history of the chiropractic profession (or lived through it), you recall the American Medical Association's "Committee on Quackery," whose goal was to contain and eliminate chiropractic. In fact, a local medical radiologist personally delivered an AMA "Quack Pack" to my office in 1974 when he learned I was considering entering chiropractic college.

In the "Quack Pack" I received, there was a comment about how chiropractors may seem like cute puppies, but they are really rabid dogs. What a historical reversal, since it now turns out that 91 Americans are dying each day as a result of opioids. Some might say the AMA, prescribing physicians and the pharmaceutical industry truly have blood on their hands and are the ones who are actually "rabid."

Our Professional Mandate

So, what should the chiropractic profession do in order to save American lives from this scourge? The answer is to stand and fight! This ongoing disaster is truly the chiropractic profession's golden opportunity to become part of the solution. While some have discussed this peripherally in fluff public-relations pieces, it is time for state and national chiropractic associations to stand and fight by lobbying for and passing legislation on both the state and federal levels that requires a regimen of nondrug, conservative care before opioids are prescribed.

While that might sound complicated, it really isn't. State and federal legislative language can be as simple as this:

"Unless a patient presents with an emergency or life-threatening condition, the prescription of an opioid medication by a medical provider is prohibited unless and until an appropriate regimen of nondrug, conservative care has been employed and documented to have failed. Nondrug, conservative care includes, but is not limited to, chiropractic, physical therapy, naturopathy, homeopathy, acupuncture, massage, psychological counseling, hypnosis and biofeedback."

If our state and national chiropractic associations are successful in their efforts, the opioid epidemic will essentially end. However, if our chiropractic associations continue to just put out "feel good" PR releases without applying the financial and political muscle necessary to pass the needed legislation, then 91 more Americans will continue to die every day.

I urge every reader to contact every state and national membership association you belong to and tell them to "show their teeth" by doing anything and everything possible – and for as long it takes – to pass state and federal legislation that requires nondrug, conservative care before opioids are prescribed.

If You're Not Part of the Solution...

The African proverb made famous by Eldridge Cleaver states, "If you're not part of the solution, you're part of the problem." So I ask each and every doctor of chiropractic, on behalf of the patients you serve, which "part" will you choose to be: the problem by doing nothing or the solution by taking action?

As you think about your decision, remember the orders given by West Point graduate and then-Civil War General J.E.B. Stuart when he told his troops: "Do not wait for orders from headquarters. Mount up everybody and ride to the sound of the guns." I can think of no better advice for the members of the chiropractic profession, because needlessly losing 91 American lives every single day is truly "the sound of guns" and it is time for all of us to "mount up" and stop this tragedy.

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