Manual medicine/body work (including chiropractic and massage)
Secondary Topic: Health Services Research/Cost Effectiveness
Tertiary Topic: Integrative medicine delivery models
Receipt of an opioid prescription among Veterans of recent wars using chiropractic care
Anthony J. Lisi, DC, Connecticut VAHCS, West Haven, CT, United States; Lori A Bastian, MD, MPH; Kelsey L Corcoran, DC; Eric C DeRycke, MPH, , West Haven, CT, United States; Christine M Goertz, DC, PhD, Palmer College of Chiropractic, Davenport, IA, United States; Cynthia A Brandt, MD, MPH, , New Haven, CT, United States
Late Breaker: No
This study aims to examine patient factors associated with opioid use among Veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who receive chiropractic care.
Cross-sectional analysis of a cohort study of OEF/OIF/OND Veterans who had at least one visit to a Veterans Health Administration chiropractic clinic between 2001-2014. Pain intensity (+/-90 days of the most recent chiropractic visit), based on the 0-10 numeric rating scale, was categorized as no pain/mild (0-3) and moderate/severe (4-10). Opioid receipt was defined as at least one prescription fill +/-90 days of the most recent chiropractic visit.
We identified 14,025 OEF/OIF/OND Veterans with a chiropractic care visit: mean age was 38 years; 15.8% were women; 56% reported moderate/severe pain intensity; 54.2% had a diagnosis of post-traumatic stress disorder (PTSD) and 47.6% had a diagnosis of depression. Overall, 4,440 (31.6%) Veterans received one or more opioid prescription. Moderate/severe pain (odds ratio [OR] = 1.88, 95% confidence interval [CI] = 1.73 - 2.04), PTSD (OR = 1.57, 95% CI = 1.43 – 1.71), depression (OR = 1.42, 95% CI = 1.30 – 1.55), and current smoking (OR 1.38, 95% CI = 1.26 – 1.51) were associated with a higher likelihood of receiving an opioid prescription.
Opioid use among Veterans receiving chiropractic care was common, and was associated with several clinical factors. This highlights the need to assess the characteristics and treatment outcomes of those Veterans receiving opioids before and/or after initiating chiropractic care.