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Chiropractors, Physical Therapists Prescribe Fewer Opioids

Odds of short- or long-term opioid use higher for initial visits with physicians for low back pain

TUESDAY, Oct. 22, 2019 (HealthDay News) — Patients who initially see a physical therapist or chiropractor for low back pain rather than a primary care physician are much less likely to be prescribed opioids, according to a study recently published in BMJ Open.

Lewis E. Kazis, Sc.D., from Boston University, and colleagues evaluated outpatient and inpatient claims from patient visits, pharmacy claims, and inpatient and outpatient procedures for patients with new-onset low back pain from 2008 to 2013. They assessed the association of initial provider treatment with early and long-term opioid use.

The researchers found that short-term use of opioids was 22 percent. There were decreased odds of short-term and long-term opioid use among patients who received initial treatment from chiropractors or physical therapists versus those who received initial treatment from primary care physicians (adjusted odds ratios [aORs], 0.10 and 0.15, respectively). Initial chiropractic and physical therapy visits also were associated with decreased odds of long-term opioid use in a propensity score-matched sample (aOR, 0.21 and 0.29, respectively) compared with primary care physician visits.

“To reduce the risks of short- and long-term opioid use, insurers should incentivize patients to see physical therapists or chiropractors first or early on following a bout of low back pain, before seeing primary care physicians,” Kazis said in a statement.

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