The Vital Role of Chiropractic in The Opioid Epidemic
Studies show that opioid abuse kills an average of 130 people each day and costs the US economy an estimated $78 billion a year. Opioids are now responsible for more deaths than automobiles or guns and are about equal to suicides in the US. Many organizations, both government and private sector, are looking for ways to combat the effects of opioid abuse. Through different laws and addiction treatment programs, the aim is to curtail the reliance on opioids. Treatment for opioid addiction now surpasses alcohol abuse in America.
While finding productive treatment is a noble ambition, it is equally important to find out why the surge in opioid addiction occurred in the first place. If we don't identify the causes and learn from them, we are doomed to repeat their mistakes. A major cause stems from the promotion of pain to an essential vital sign in the early 2000s.
Before pain's inclusion, the 4 vital signs were Body temperature, Heart rate, Respiratory rate, and Blood pressure. In the 1990s a campaign led by a group called The American Pain Society pushed for the addition of pain to the vital sign list. The campaign declared that pain was being ignored by doctors. The American Pain Society even copyrighted the phrase, “Pain: the 5th Vital Sign.”
Investigation into the American Pain Society found out that the group was taking kickbacks from pharmaceutical companies—corporations such as Purdue Pharma were some of their biggest backers. Purdue Pharm just so happens to be the maker of Oxycontin. The American Pain Society took over 1 million dollars from Purdue Pharma to be their pain cheerleader.
With medicine now in the pockets of Big Pharma, the availability of prescription painkillers peaked in 2012 at 81 prescriptions per 100 people. As of 2017, that number was down to 59 prescriptions per 100 people.
So where does Chiropractic care fit in the opioid epidemic? How does Chiropractic help manage pain? Before answering these questions, we have to answer two other questions: “What is pain?” and “What is an opioid?”
Pain is the body’s main signal to let you know that something internally went wrong or is going wrong. Pain is like a smoke detector in your home. The design of pain is to alert you to a potential or actual problem. Pain itself is not the problem. Pain is the alarm to let you know of a problem. Pain is a normal function of the body. Yes, pain can get stuck in a bad loop and become abnormal, but for the most part, it is designed to benefit the body.
An opioid is a pain-numbing drug. Opioids numb the sensation of pain by inhibiting the Nerve System. Inhibition occurs because the compounds found within opioids mimic analgesic neurotransmitters. Neurotransmitters are chemical compounds used by the Nerve System to communicate with the body. Neurotransmitters such as endorphins and enkephalins have natural analgesic properties. This means they provide pain-numbing relief, along with a feeling of calmness and sedation to our breathing and mood.
An analogy: If your home smoke detector started going off, taking an opioid would be like trying to suppress the sound of the alarm without trying to locate the source of the smoke. The opioid would falsely mimic the pain-numbing relief naturally provided by the neurotransmitters. Suppressing the smoke detector doesn't stop the smoke. Suppressing the pain doesn't stop the cause of the pain signals. If suppressing pain is the only solution, then the real problem will continue to burn.
When it comes to actual pain management, the Chiropractic objective differs from the medical approach. Chiropractic does not aim to inhibit pain through any type of drug. Chiropractors do not prescribe pharmaceuticals. In fact, Chiropractic doesn’t treat pain at all. Chiropractic instead focuses on the optimization of the Nerve System at the spinal level.
Chiropractors focus on the spine by the adjustment of a vertebral subluxation. A subluxation is a misaligned spinal bone that impinges nerves. This impingement disrupts how the Nerve System communicates with the rest of the body. Nerve disruption can negatively effect functional outcomes.
A subluxation is a great example of something going wrong with the body that can trigger pain signals. But there is a caveat: not all vertebral subluxations are predicated on the existence of pain. You could have pain resulting from a subluxation OR have a subluxation presenting with no pain at all. If that wasn’t enough, you could also have spinal pain and no subluxation. Even though pain is a great signal to let us know of a potential problem, pain is not the “end all be all.”
A vertebral subluxation is only correlative to pain. How is this possible? Let’s look at the definition of a subluxation again. A subluxation is when a bone of the spine misaligns and puts pressure on nerves effecting their function. But, pressure on what nerves? Not all nerves relay the feeling of pain. Not all our nerves are designed to “feel” in the sense of the word.
Nerves can be categorized into two groups: Motor nerves and Feeling nerves. The motor nerves control skeletal muscles, blood vessels, organs, and glands. Motor nerves make up around 90% of the total number of nerves. The other 10% of the nerves feel or sense. The feeling nerves sense for communication, posture, temperature, and pain. Our sense of feeling pain is experienced through this 10% nerve group.
If a subluxation is putting pressure on a nerve that senses pain, then that nerve will elicit the feeling of pain. But what if a subluxation is putting pressure on one of the motor nerves? What would a pressure on those nerves feel like? The pressure wouldn’t feel like pain. The pressure might feel like muscle weakness or tightness, problems with breathing or digestion, or just an overall sense of fatigue or low energy. The pressure though might not feel like anything at all.
Would it be beneficial for your body if pressure wasn’t on any nerve? When nerves can’t function at their greatest potential, then you can’t function at your greatest potential. No matter who you are: a 5-month-old baby, a 15-year-old teenager, or a 55-year-old adult.
Everyone deserves to function at a healthier level. Using chiropractic for pain is only using 10 percent of your health potential. Utilizing chiropractic care for wellness is a great way to reach 100 percent of your optimal health expression.
- Jarek Esarco, DC, CACCP
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