Opioids – F4CP Exit Plan

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F4CP (Foundation for Chiropractic Progress) is closely involved with chiropractors such a Dr. Dave, looking for ways and making recommendations for raising public awareness of the benefits of chiropractic care.

The foundation has completed a followup study, which resulted in some recommendations that will be used to raise public awareness about an opioid exit plan.  Here is some information about their process and recommendations:


It is by well known that there is a continuing and growing problem of opioid use, abuse and addiction. It is essential that this information is understood and appreciated as it clearly calls for a wholesale change in the approach American health care providers and patients bring to the care and management of pain.

No matter what is done to address the use, abuse and addiction associated with opioids it is a fact of life that opioid containing products will continue to be required by individuals suffering severe, intractable and unrelenting pain.

The issue, then, is not about the cessation of all opioid use, rather it is about not turning to opioids before they are required, and not until all less onerous approaches to pain management have been exhausted.


The opioid crisis has provided a wake-up call for regulators, policy experts, clinicians and payers nationwide. As the support for complementary health techniques builds, interdisciplinary and integrative approaches to chronic pain management are considered best practices.

While the Centers for Disease Control and Prevention’s Guideline validates the need for a shift away from the utilization of opioid prescription painkillers as a frontline treatment option for pain relief, the mention of chiropractic care as a safe, effective and drug-free alternative is omitted.

Instead, CDC recommendations encourage utilization of physical therapy, exercise and overthe-counter (OTC) pain medications prior to prescription opioids for chronic pain.


“Though the guidelines are voluntary, they could be widely adopted by hospitals, insurers and state and federal health systems.” — CBS News64

The CDC rarely advises physicians on how to prescribe medication — which further adds to the significance of their pronouncements.  Many payers and state legislators have already added these findings to their coverage on the use of opioids.

With the likelihood of major players in the industry adopting the well-respected guidelines, it is critical that chiropractic care receives the consideration it deserves.

Chiropractic care has earned a leading role as a pain relief option and is regarded as an important element of the nation’s Opioid Exit Strategy: a drug-free, non-invasive and cost-effective alternative for acute or chronic neck, back and musculoskeletal pain management.

For individuals who may be suddenly “cut-off” from painkillers, chiropractic offers a solution. But access to care will depend upon several important factors:

  • Pharmaceutical Industry “Re-engineering”: A change toward responsible marketing and physician education.
  • Physician Referrals to Ensure Access to Chiropractic Care: Physician prescribing of chiropractic care rather than opioids.
  • Benefit Coverage and Reimbursement for Chiropractic Care: Government and commercial payers as well as plan sponsors have a responsibility to offer patients the option of chiropractic care – and reimburse DCs as participating providers.
  • Access to Chiropractic Care for Active Military and Veteran Populations: Chiropractic care should be expanded in the Department of Defense and veterans’ health care systems.


As a nation, we have all come to recognize that pain is a complex, multifaceted condition that impacts millions of Americans, their families and caregivers. Unfortunately, the lessons learned about long-term opioid therapy for non-cancer pain have been deadly and heartbreaking. We now understand that there is little to no evidence to support their effectiveness for ongoing chronic pain management.

It is now incumbent upon all stakeholders to increasingly explore the appropriateness, efficacy and cost-effectiveness of alternative pain management therapies and embrace these solutions as a realistic opportunity for America’s Opioid Exit Strategy.


This article was extracted from a white paper published by F4CP for Dr. David Jensen



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