Guideline for Opioid Therapy and Chronic
SOURCE: CMAJ 2017 (May 8); 189 (18): E659–E666
Jason W. Busse, DC PhD, Samantha Craigie, MSc, David N. Juurlink, MD PhD, D. Norman Buckley, MD, Li Wang, PhD, Rachel J. Couban, MA MISt, Thomas Agoritsas, MD PhD, Elie A. Akl, MD PhD, Alonso Carrasco-Labra, DDS MSc, Lynn Cooper, BES, Chris Cull, Bruno R. da Costa, PT PhD, Joseph W. Frank, MD MPH, Gus Grant, AB LLB MD, Alfonso Iorio, MD PhD, Navindra Persaud, MD MSc, Sol Stern, MD, Peter Tugwell, MD MSc, Per Olav Vandvik, MD PhD, Gordon H. Guyatt, MD MSc
Jason W. Busse
Department of Anaesthesia
| New Canadian Opioid Guidelines Recommends
Chiropractic As Care Option
A new Canadian guideline published today (May 8, 2017) in the Canadian Medical Association Journal (CMAJ) strongly recommends doctors to consider non-pharmacologic therapy, including chiropractic, in preference to opioid therapy for chronic non-cancer pain.
The guideline is the product of an extensive review of evidence involving stakeholders from medical, non-medical, regulatory, and patient stakeholders.
The lead author, Dr Jason Busse DC, PhD is a graduate of Canadian Memorial Chiropractic College and is an Associate Professor in the Department of Anaesthesia at McMaster University. Other authors of the guideline include those from the fields of physiotherapy, dentistry, public health and medicine.
Chronic non-cancer pain (CNCP) is defined as pain lasting more than 3 months that is not associated with malignancy. It is estimated that up to 20% of adult Canadians suffer with CNCP and, the guideline says, is the leading cause of health resource utilization and disability among working age adults.
Behind the USA, Canada has the second-highest level of opioid prescribing in the world. It is an enormous issue, with a doubling of admissions to publicly-funded opioid-related treatment programs between 2004 and 2012. In 2015, over 2000 Canadians died of opioid overdose, with final figures expected to be higher in 2016. Many of these deaths were associated with Fentanyl, the same opioid cited as being the cause of death of the musician Prince in 2016. Other commonly used opioid drugs are Percocet, OxyContin, Dilaudid and morphine.