What the Hulu series Dopesick did not tell you about the opioid crisis and why it happened.
The Sackler family and their company, Perdue Pharma is the main villain in this story of how America developed the Opioid Crisis.
While every story about bad things that happens to us needs a villain, the truth is that the greed they displayed ignores a much larger issue. There wouldn’t have been an Opioid Crisis if medical physicians with had a better understanding of the musculoskeletal system and why people were in pain. The truth is, they simply lack the training and while there have been conversations about the need to train future providers better, existing ones are not required to take continuing education in how to better understand and when to refer patients who have pain resulting from the musculoskeletal system, which makes up over 50% of the body systems. Dopesick is a dramatization of how the Sackler family and Perdue Pharma manipulated the system to assure America had a wide distribution of their drug which caused great harm to the unsuspecting public through physicians they trusted.
Ironically, one of the lead characters in the story played by Michael Keaton attempts to treat an injured mine worker with Oxycontin resulting in her addiction and ultimate demise. He too found himself in the same situation later on in the series and then required him to take another drug which eventually helped him resolve the addiction and then return to the practice of medicine.
The irony in all of this is that primary care continues to take a back seat to specialty care and patients with pain are given solutions to their mechanical problems while their doctors fail to understand why their problems exist. The reality is that our current system of segmented care has resulted in physicians who look at the thing or the disease rather than the person experiencing the problem. The idea of medicating pain when we don’t understand what we are treating was the true reason the Opioid Crisis occurred and you needed medical providers to make it happen. Many years later, having their problems mismanaged through over specialization, people live off pain killers when there is a better way to managed and treat these people cost-effectively, safely, and without drugs. This is common in the senior population after years of mismanaged musculoskeletal problems that have led to spinal degeneration, stenosis, damaged joints, and joint replacements that relieve pain, improve some function but ultimately fail to treat the cause of the problems.
It’s time to empower Americans to see the chiropractor first for painful problems.
The chiropractic profession has been trained in the holistic primary care approach to musculoskeletal system problems yet, is often thought of last by medical providers when the evidence is clear they should be the first provider the patient visits. The approach is about mobility, motion, and function. The tools include manipulation, methods to improve soft tissue muscular, fascial, and nerve function while rehabilitating the person rather than the part.
While some patients in pain have diseases, most have musculoskeletal dysfunction which can be adapted to, inherited or acquired from old injuries or a combination thereof. Growing evidence proves chiropractic saves money, reduces the overuse of procedures, and keeps people away from drugs. Patient satisfaction is high, Patients usually visit because of pain but those who listen to their chiropractors are introduced to a new world of thinking about the quality of their health. Pain is a great motivator, stiffness isn’t yet stiffness is often an early warning that pain will develop. Rather than treating pain, the chiropractor resolves the malfunction making you hurt improving or resolving the mechanism. This reduces the risk of other problems developing later on.
An example of this is problems in the shoulder which most often involve the legs the feet and the core. An orthopedic will evaluate your shoulder and then order an expensive test to look at the joint. The chiropractor will ask you about your shoulder and then search for other clues and evaluate everything. It is common in our office to find out the should complaint, the knee problem, the plantar fascia, and the chronic lower backache are all the same problems. This ultimately may reduce future risks to other problems of the musculoskeletal system and improve the quality of your life.
Ironically, many common procedures such as meniscus surgeries to the knees or impingement surgeries to the shoulders have been proven to be of little or no long-term benefit. Data shows we need a better approach and the Annals of Internal Medicine showed that drug-free approaches such as chiropractic are best while invasive procedures and drugs should be considered last resort. It is unfortunate that there exists a conflict of interest when primary care practices and many specialties are now owned by hospital systems who want very few people they treat seeing people outside of their systems. Doctors are highly encouraged to only refer inside the system to prevent what is called leakage or patients leaving the system. Hackensack Meridian in Norther NJ actually gives their employees a tiered Horizon Blue Cross plan that has a $100 dollar copayment which actually exceeds the cost of most chiropractic visits.
Insurers have the data showing the effectiveness yet they continue to play games with the reimbursement system, making it more difficult to see a chiropractor through tiered networks, higher copayments, and large yearly deductibles. Many patients who are insured this way often wait until their problems have worsened or take medications to relieve the pain which is only designed for short-term use and can cause sometimes devastating side effects years later. The opioid crisis was one of those side effects.
Studies continue to show seniors who see chiropractors first use fewer drugs and have high satisfaction with chiropractic care, yet Medicare still only covers manipulation of the spine only. Legislation to change this flaw from the 1970s is currently gaining co-sponsors in congress and will hopefully be brought up for a vote soon. This is known as the chiropractic modernization act.
If we truly want to reduce the use of drugs and reduce surgeries to different joints and reduce joint replacements, the path is simple; embrace chiropractic holistic primary care of the musculoskeletal system. These providers have proven their worth even to United Healthcare’s Optum division who has said they no longer need to study this; chiropractors should be seen first for back pain, neck pain, and many other types of musculoskeletal system problems.
If people want better care they must make better choices. An HSA can provide some of this as they will fund an account that allows them to go to anyone they choose. While not all of these costs may be covered, the HSA can pay for those costs. Going on the insurance exchange is often a letdown unless you make under a certain amount and can get a government supplement toward the cost of a healthcare plan. Some self-insured plans like those offered by NJBIA’s relationship with Assn Member Trust (AMT) will offer you insurance through better networks for less than the insurance exchange will.
If you need pain relief, all roads lead to the chiropractor. Book online today.