The Canadian Chiropractic Association (CCA) has expressed support for the new recommendations on the use of opioids that were issued by The Michael G. DeGroote National Pain Centre at McMaster University. These recommendations were developed on behalf of Health Canada.
Reducing the pressure to prescribe is a critical first step. Now, we need to address why opioids are being prescribed in the first place, and a leading reason is back pain, the CCA said in a statement.
“There is compelling evidence that opioids are often prescribed for musculoskeletal conditions like back pain,” said Dr. Jason Busse, associate professor, McMaster University. “Shifting away from opioids as first-line options to help manage pain is key to reducing the number of new opioid users. Ensuring access to evidence-based, non-opioid alternatives will be an important part of this strategy.”
Canada is the second-highest consumer of prescription opioids in the world and half of all annual drug-related deaths in this country are prescription opioid-related.
Recognizing the important role of chiropractors as a means to address this, the CCA said Health Canada asked the profession to be part of Canada’s opioid action plan late last year. The federal government, seven provincial health ministries, medicine, nursing, pharmacy and dentistry associations, and 30 other partner organizations that have a role in reducing the impact of opioids have signed this plan.
“Chiropractic services are an important alternative to opioid prescribing,” said Alison Dantas, CEO of CCA. “We are committed to working collaboratively to develop referral tools and guidelines for prescribing professions that can help to prioritize non-pharmacological approaches for pain management and reduce the pressure to prescribe.”
More can be done to manage pain without immediately turning to opioids, the CCA added.
Chiropractors play a major role in managing back pain and other musculoskeletal conditions, however there are significant barriers for Canadians to access alternative care. Not all Canadians have the option of non-pharmacological alternatives like chiropractic care and this can make it more likely to turn to opioids.
“We are looking to build an understanding of how to better integrate care that is already available in communities across Canada,” Dantas said. “Integrating chiropractors into interprofessional care teams has been shown to reduce the use of pharmacotherapies and improve overall health outcomes. This effort is even more important now because the new draft Canadian prescribing guidelines strongly discourage first use of opioids.”
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