Over the past few decades, growing opioid misuse across the United States has led to increases in overdoses, addictions, and even deaths. According to a 2015 study, between 21% and 29% of patients who are prescribed opioids misuse them. Because opioid addiction typically stems from the need for pain treatment, could using non-pharmacological methods to treat pain, such as acupuncture, Ayurveda, or chiropractic care, lead to a reduction in opioid usage? Southern California University of Health Sciences (SCU) recently received an impactful grant from the Anton B. Burg Foundation to answer this very question through research. Opioids: A Brief History In the early 1980s, when a study discovered that pain was being undertreated in certain groups, including women, minorities, and those of lower socioeconomic status, the medical community was urged to pay closer attention to pain treatment. Following close on the study’s heels was the beginning of the HIV epidemic, which drew even more attention to pain treatment. Over time, pain levels became known as another vital sign, such as pulse rate or body temperature. In 1996, the American Pain Society officially declared pain to be the “fifth vital sign.” During this time, a new opioid claiming to be the best pain medicine available was released. Pharmaceutical companies reassured the medical community that patients wouldn’t become addicted to this new type of prescription drug. As a result, more opioid prescriptions were written to improve quality of care. In 2017, opioid prescriptions were written for nearly 58% of Americans. Filling the Evidence Gap Today, when solutions to the opioid epidemic are discussed, they’re typically “drug solutions for a drug problem,” as Dr. James Whedon, DC, MS, director of health services research for SCU, describes. Those solutions can take the form of other drug types, different prescribing practices, or regulations regarding pharmacy practices. There’s currently a lack of evidence supporting the effectiveness of non-pharmacological therapies as a potential solution to the opioid epidemic (although there is evidence to support the effectiveness of these therapies as a whole). “Many integrative healthcare therapies and approaches need to hurdle a higher bar when it comes to scientific evidence,” explains Dr. Whedon. The Anton B. Burg Foundation grant will help SCU fill this evidence gap by evaluating the impact of chiropractic care on the use of opioids among U.S. Medicare beneficiaries, who typically have limited access to chiropractic service coverage. In collaboration with the Dartmouth Institute for Health Policy and Clinical Practice, which has a highly secure database of Medicare administrative claims for research purposes, SCU will access data through a secure web connection. The data features information about beneficiaries’ encounters with the healthcare system and therapeutic interventions, including medication, procedures, and care services. Research Timelines and Goals Expected to inform improvements in the quality and value of care for patients with low back pain, the goal of SCU’s research is to accelerate the adoption of effective, non-pharmacological options to address spine pain for Medicare beneficiaries. Once the data is analyzed and the results are compiled, they will be published. The goal is to finish the analysis within the next nine months and submit it to a peer-review journal by the end of 2019. The analysis will build upon recently published research by Dr. Whedon and his team, which reports that chiropractic care is correlated to reduced use of opioids among New Hampshire residents suffering from low back pain. Healthcare has to be based not only on value, says Dr. Whedon, but also on humanistic values, respect for the patient, and valuing each patient as a unique individual while caring for him or her with attention and compassion. “Those humanistic values are woven into integrative medicine, which is why SCU is producing evidence for its effectiveness, safety, and value through this grant.”