Low back pain is one of the most common conditions Americans seek care for—and one of the more common reasons for an opioid prescription. In the face of the opioid use disorder crisis, the American College of Physicians and the Centers for Disease Control and Prevention (CDC) now recommend first trying non-pharmacological treatments for low back pain.
Now, a new Boston University School of Public Health (BUSPH) study finds that patients who first saw a primary care physician (PCP) for low back pain were 79 percent more likely to use prescription opioids than patients who first went to a chiropractor, and 71 percent more likely than those who first went to a physical therapist.
The study was published in BMJ Open.
“To reduce the risks of short- and long-term opioid use, insurers should incentivize patients to see physical therapists or chiropractors first or early on following a bout of low back pain, before seeing PCPs,” says study lead author Dr. Lewis Kazis, professor of health law, policy & management at BUSPH.
Dr. Kazis and his colleagues looked at commercial insurance and Medicare Advantage claims data from the OptumLabs database for 216,504 adults across the country who were diagnosed with new-onset low back pain between 2008 and 2013 and had not been prescribed opioids before the diagnosis.
Previous research has only compared short-term opioid prescribing for low back pain in a handful of states, and/or only considered PCPs versus physical therapists.Friday Letter Submission, Publish on October 04