Mike McInally’s recent editorial (Opinion, Oct. 30) highlighted our national opioid crisis that President Trump deemed a national health emergency.

Oregon is leading the nation with its restrictive opioid prescribing guidelines, coupled with recommendations for non-pharmacological approaches as first-line pain treatment, with opioids only considered if these and non-opioid pharmacological treatments are ineffective.

Oregon’s new policy appears to already be working, since the first quarter of 2016 Oregon’s controlled substance prescribing has been decreasing. Coincidentally, in July of 2016, the state implemented a new policy allowing Oregon Health Plan patients to begin receiving non-pharmacological treatments for back and spinal pain with chiropractic spinal manipulation, the first-line treatment of choice. Of the non-drug treatments recommended by the State of Oregon, only spinal manipulation is suggested for the first four weeks of an episode of low back pain where first-start opioid prescribing has historically occurred.

According to the State of Oregon's Evidence-based Low Back Pain Management Guidelines, spinal manipulation is also recommended for the subacute phase (4 to 8 weeks) and chronic phase (8 weeks and beyond). How much of the decreasing opioid prescribing is due to non-pharmacological treatments will now be studied with a $5.7 million grant provided by the Patient Centered Outcomes Research Institute. This 3-year study will be conducted by the Kaiser Permanente Center for Health Research.

This exciting study will examine how Oregon’s new policy implementing non-pharmacological treatments such as chiropractic spinal manipulation and our adjunctive physiotherapies will effect first-start opioid prescribing and opioid use within chronic low-back-pain patients.

Vern Saboe, Jr, DC.

Albany (Oct. 31)

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