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Non-Drug Alternatives Replace Opioids in Treating Ohio's Pain

illustration of pain prescription sources
Practice Analysis of Chiropractic 2015, NBCE
American Chiropractic Association
Health-care providers increasingly try to measure the benefits and risks of opioids and alternatives.

The number of prescriptions doctors are writing for opioid pain killers is down and not just because they’re pulling back in the face of the addiction crisis.  Alternative approaches to pain treatment are finding greater acceptance in mainstream healthcare.  

Patrick Ensminger DC
Doctor of Chiropractic, Patrick Ensminger

Patients are looking for change
Bob Jones of Trumbull County has recurring pain from an old injury but isn’t going to be getting opioids.  He never wanted them anyway, and found his own solution for pain relief. 

That includes visits with chiropractor Patrick Ensminger.  

“All I do is take the joint to its normal end range, which is about there. And I apply a little additional push. And you felt a little bit of a pop or click there. And then we do the same procedure on the other side," Ensminger explains.

Jones responds, “That felt good. And no medication. That’s a good thing.”  

Treating the causes of pain
Ensminger says chiropractic treatment is increasingly popular with patients like Jones because it works by stopping musculoskeletal and nerve pain from happening as opposed to blocking, masking or altering perceptions of it as drugs do.

“The chiropractic role is to provide a valid, evidence-based, effective and an alternative to opioid prescribing.” 

Prescription writing trends down

'I cannot be on any kind of prescription medication because I have to operate company equipment.'

Nationally the number of opioid prescriptions written over the last five years has dropped nearly 9 percent, and in Ohio, it’s down almost 29 percent.  

Non-drug pain treatment patient Tony Robins
Professional driver Tony Robins

Patients like Bob Jones are turning to chiropractic treatment because of concern over the addiction risks with opioids.  However, chiropractic and other non-traditional practices are gaining popularity for another reason.

As a practical matter, drug-based pain treatment doesn’t work for people like professional driver Tony Robins. “With my occupation, I cannot be on any kind of prescription medication because I have to operate company equipment. And also, the side effects, when I did take some after some surgeries I had, there would be no way I could stay on those and go back to work.” 

Attention from the mainstream
Until recently, alternative pain treatment has typically not been available from tradition healthcare providers.  But, Patrick Ensminger, who is also president the Eastern Ohio Chiropractic Society, says based on recent conversations with Mercy Health, which is Ohio’s largest hospital system, changes are coming.

“Mercy group has taken it upon themselves to work pro-actively towards a referral, or even in-patient, program to offer chiropractic services to provide alternatives to opioids.” 

Frank Beck, Mercy Health
Credit Mercy Health website
Mercy Health website
M. Frank Beck, DDS, Mercy Health

New methods of practice
Frank Beck is the head of dental services at Mercy Health and is leading the hospital organization’s task force on pain. He says the change not only recognizes the need for alternative paint treatment options, but also that different kinds of pain need different approaches. 

“If they’re dental, they get shipped down here. If their musculoskeletal we have a physical rehabilitation medicine institute, where the chiropractic piece is going to fit in. So as we look at the alternatives to opioids, there’s a whole bunch; acupuncture is one as well. “ 

The healthcare industry
As a whole, the healthcare industry also taking steps to expand alternative pain treatment options.  The Joint Commission -- the national hospital accreditation organization -- now requires considering alternative treatments before prescribing opioids. So do many states.

Bobbie D’Amato, is CEO of a medical billing and coding service based in Youngstown. 

“In the state of Ohio, there are four bullet points, a chiropractor, acupuncturist, and behavior, or cognitive therapist. They have to reach out to before they’ll be put on opioids.” 

Logo of The joint Commission
Credit Joint Commission website
Joint Commission website
The Joint Commission, a national accreditation organization, now requires consideration of alternatives.

New policies
D’Amato, says some states are being more aggressive. West Virginia recently passed a law requiring health insurers to cover a minimum of 20 visits to alternative treatment providers for patients needing pain relief.  

New Engagement
In Ohio, there are new efforts underway to bring alternative pain treatments into the mainstream.  A group of major health insurers participating in a state task force released a list of recommendations this month for battling the opioid crisis.

It includes increasing coverage of non-drug pain treatment.  And University Hospitals will be holding a symposium in September focusing on non-pharmacological approaches to pain management.