Blog, Chirosecure Live Event April 3, 2021

Non-coverage of Evidence-based Chiropractic Treatment

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I’m Judson G. Sprandel II I am from Ohio I have been in practice for 39 years, I have done two previous shows regarding veterans seeking chiropractic treatment in the community. Today’s is use of discussion or slightly different. I’m going to discuss the opioid epidemic that which is worsening. I am going to provide a research which supports our theme of chiropractic first, which stops opioid abuse. I’m going to provide copies of national treatment recommendations, which support the use of chiropractic treatment. Um, I’m a supply on my recommendations and strategy to fight back against the opioid pharmaceutical epidemic. Uh, I’m going to highlight the foundation for chiropractic progress, information packets, which are awesome. And I’ll combine that with my experiences too. So, all right, let’s go to the slides. Okay. Um, opioid overdose deaths are increasing across the nation. During the months of the COVID pandemic. There’s a report by the office of the national drug control policy dated January 19th. Their strategy has three related elements, which includes prevention, treatment, and recovery. The policy actually States that preventing drug use before it starts as a fundamental tenant of a comprehensive approach to drug control. There’ve been recent articles that have reported that officials are putting more emphasis on stopping people from using drugs to begin with. There was an article in a Columbus lion newspaper with States. It’s no brainer, fewer people using fewer people becoming addicted, less demand for product the streets.

So prevention is one of their action steps, but it’s been my experience. I don’t see much action with prevention. There is a lot of information regarding, or a lot of action steps regarding treatment and recovery, but not prevention and prevention is where our chiropractic profession can, um, can shine. So the following information I have is just showing you the data what’s going on with this opiate epidemic and how bad things are. And it’s getting worse. The data shows that 80% of the heroin addicts reported that they began using oxycodone and hydrocodone for pain control in 2017, 70,000 people died from drug overdoses, making the leading cause of injury related death in the United States of those deaths, about 68% involve the, a prescription or illicit opioids and adults between the ages of 25 and two 54 years old had the highest rates of opiate deaths. Now in 2017, there was one and 91 million opioid prescriptions written in the United States, which is six times more than in 1999 went away. Okay. Now recently in February at 2020, 21, uh, opioid overdoses were determined to be 29% higher than they were in, in 20, in 2020. Um, no, as I said that the opioid overdose were higher in 2020 than they were in 2019. This study also stated that there were 70,000 lives lost due to drug overdoses in 2019.

Uh, this, this study was from the months of March to October of 2020, and it identified that the overall emergency room department of business for opioid overdose were about 29% in 2020. Now, according to the AMA, more than 35 States reported increases in opioid related mortality on August 14th and 2020, the AMA submitted an updated report and stated as the COVID 19 pandemic continues. So does the nation’s opioid epidemic now recently, too, this was out of dynamic chiropractic. It States that, um, patients with acute pain were significantly more likely to transition to chronic pain when they were exposed initially to non concurrent pharmaceutical diagnostic testing and medical subspecialist treatment recommendations. Um, non concordance is divided into three categories, any prescriptions which include opioids were considered non concordance non-Korean diagnostic imaging includes x-rays CT scans and MRIs and non Gordon’s medical subspecialty referral includes the referrals from non-surgical or surgical specialties, which are the psychiatrists, the orthopedist and neurologist, the neurosurgeons and the pain specialists. But actually the study is actually showing that patients were significantly more likely to transition to chronic pain if they can, if they chose their medical proficient initially, or medical physician initially. And actually the report States that among the potential factors leading to chronicity, the authors considered non-conforming care or care, not consistent with established guidelines, which we’ll talk about later, but not because of some of the SAS guidelines, the, um, care was, uh, changing these people into chronic pain patients, which are, which they do, uh, rely upon the prescription way of treatments.

Now I have three, three, three slides here, which has 13 references to, um, research, which, which, um, documents or substantiates, uh, chiropractic first stops, opioid abuse. These research articles ChiroSecure will send after completion of this program. But these, I mean, the research is just phenomenal. I mean, I never seen so much positive research for chiropractic treatment. Um, as an example, Optum States that we can save $230 million if patients choose us first also States that we can reduce opioid use prescribing by 26% a year. The other study that I’d like to highlight is that it’s, um, which included 200,000 patients in States that are patients using chiropractic first, we can reduce the likelihood of opioids by 90%. So the data here is, is phenomenal. And again, this is in a separate paper, which I put together really it’s a table, which I sent to ChiroSecure, which they will send upon completion of this program.

And, um, these articles are referenced to, for you. Well, there’s 13 references too. So that’ll be a part of the paper. Now there’s also positive guidelines out there. There’s national guidelines, which again, state that, that, um, non-pharmaceutical pain treatments should be utilized, which includes chiropractic manipulation as well as acupuncture. And it States the chiropractic manipulation is recommended for both for first-line treatment options for acute pain and recommended for subacute and chronic pain. These guidelines are from the centers of disease control, the American college of physicians, the federal drug administration, and the joint commissions of the hospitals.

So you can see that the opioid epidemic is worsening. We have research data that says that chiropractic is awesome. We have guidelines which state that they should use chiropractic treatment first, but you know, nothing, none of this is happening. I don’t see, I don’t know if any of you are in the same boat, but we don’t, we don’t see the increase in involvement in treating patients and have coverage for that. This is what we got to change. You know, I liked this quote from Edward Burtt. It says the only thing that’s safe for the triumph of evil is for good men to do nothing. So I changed it just a 10 it’s. I feel it’s time for DCS, both good and good men and women to focus on issues that affects all of us in our practices. All the DCS needed to be on board.


Our focus in my opinion, should be on emphasis on education, focusing on the benefits of what we do. You know, we cannot continue to ignore the ongoing and now worsening nation and statewide opioid overdose, the drug epidemic. We need consistent plans to educate employers, local unions, military veterans, and in our communities, our job is to shed the light on our third-party payers refusal to improve and, or just add chiropractic Fullscope and acupuncture treatment to their benefit packages.


So recommendations, um, these recommendations are more of a grassroots effort. If we can get everybody to at least start using some of the FRC information is a step in the right direction. The whole issue is about education. So my recommendation is we need to rely upon the foundation for chiropractic progress, marketing recommendations, their chiropractic information. And at least we need to send out their social media information, which is usually four times a month. There’s no excuse for not doing this. I’m sure not most, most, uh, national DCS are not using the foundations information. In my opinion, all DCS need to be all to be a member of the foundation for chiropractic progress. At least they need to sign up for the foundation as the bronze member, which is a $25 fee. They have silver and gold membership levels, which increases our ability to use what they have. Their information is just top-notch. They’re about the best organization in the country. It will help promote chiropractic, and we should all be numbers of their foundation, what we’ve done in my, at our meetings. But we have a district meetings. I represent five counties in Ohio. We have a special 15 minutes, 20 sessions every, every month. And we highlight the, uh, the foundation’s programs. This kind of reinforces our commitment to educate the community. And we find out that not everybody is using their information, which is just crazy to me.

What we need to do is create the same message for all these needs to be on the same page. Uh, our first goal is to create an information packet, which can be used at every meeting and or encounter with the beginning dependent upon the group or the individuals that we are talking to. Now, I have completed several papers. These are not completed yet. I need to work with foundation to improve them or make them look presentable. But, um, the papers that I put together is a slow explanation of chiropractic care and employer letter, uh, another letter regarding workman’s compensation, general statements, chiropractic recommendations, uh, research based, uh, um, data that I talked about earlier, that’s in a table, uh, there’s also a table with cost sharp rate of cost effectiveness, uh, articles. I have included the national or national state treatment or guidelines into a table. Um, I created a paper, um, titled all the opioid overdose deaths increasing across the nation. I put together a national Ohio prescription overdose drug data. And from 1999, through 2017, I put together a veteran’s information, PowerPoint and a veteran’s research information, a letter. So these will work on a once I get to completed, I’ll share them. So, uh, I haven’t completed all of this yet, but we’re working on

Well, we have a major, major, major complicating issue. Nationally Americans do not have the ability to choose non-pharmaceutical chiropractic treatment due to the third party payment, um, bear and party covers limitations. In my opinion, our third party payer benefit coverage fills the opioid epidemic, limiting and having no or no freeze for evidence-based chiropractic treatment.


They’re prepares includes Medicare and Medicaid must acknowledge that restricting our treatment results in, um, or fuels the adverse effects. So the ongoing drug reliance and drug addiction that, uh, affects the, the opioid epidemic. The third party payers must recognize that treatment recommendations from the national stakeholders, which will increase coverage for what should increase coverage for evidence-based non-pharmaceutical chiropractic treatment. I’ve had the opportunity to go to community meetings. There was a meeting from a pain management group in my hometown, and we had the opportunity to have input during the meeting. And we basically just say to the chiropractic treatment is a, there’s an option for, instead of drug use. And many of the attendants would say that they would consider chiropractic no coverage and pain management first in their trying then patients to listen. They, they are, but when the patients enter the office, they have no coverage. So this limited third-party payer coverage limits our ability to help fight back against the Zippo, this opioid epidemic. We need to convince them to open up their packages.


Um, part of the education process that I had done in the past and what we’re doing in the office is, is, is using the tools from the foundation for chiropractic progress resources.

The foundation

Has outstanding posters and for grams, brochures and white in white papers, it’s, it’s a good idea to have eye catching displays in your offices, in a community functions. The foundation has created military veteran rights posters and created a chiropractic information hospital brochure, which is top notch. And they’re easy. They’re easy reads and they’re, and they’re beautifully well done. What should be done is the foundation posters are going to be, shouldn’t be hung up in your clinics and they should be handed out to the patient. This is all part of the grassroots effort that we need to continue


Now, this kind of gives you an example of what goes on in my office. It’s just a display and you can see, we have posters. We have brochures, we have opioid buttons. So we have white papers from FRCP extra. We have multi-colored pens, uh, at least display that works in the office. And these displays should be utilized if you have any, um, any, uh, tables set up at community functions. Multi-colors this just brings attention, uh, to attendees.

Now FRCP has standing information. Like I said, this, this is an example of one of their, they call them in for grams. It stays combating the opioid epidemic. It’s very well done. Um, and that, uh, has, is factual information. Uh, these can be laid out in your office. You can send them out on your social media. I mean, they are just, they’re a plus in my opinion, okay. This is an example of some of the buttons we use. We have a, I don’t know, one of our, one of our DCS kind of, um, made these up, uh, it’s a, it’s a, um, red line to the opioids and it States chiropractic. It should be utilized first. We pass these out to all clinics and we pass it around through the community. And we, where there’s an a in the office on a frequent basis. This is another example of an Infogram that the foundation puts together. And it thinks chiropractic is a safer strategy and opioids, very colorful, very well done, very top notch. This, this again is information and you can put out in your clinics or, or, um, put out on your social media again, another Instagram is very colorful. Um, it has the facts in there. It’s, it’s, uh, these get lots of attention. If you put them in areas where your patients can see them, or if you go to a community function where you have a table or have a booth putting these on a table, um, always generates interest.

This is part of what everybody should do. Now. Like I said, previously, the foundation has put together a, um, veterans rights information brochure. This is the front and back of it, very well done. It’s very simple. You know, it’s either an easy to read. I have any of these throughout the office. Uh, we’ve provided these at our meetings before. It’s, it’s a top-notch brochure, and this is the guts of the, of the brochure. And it’s basically, it’s, it’s real basic information. This is what does a doctor of chiropractic you do the benefits of chiropractic and then restriction the research is not extensive, but it’s pretty basic. Again, it gives you the idea of what we do as good. I mean, when I give these the veterans, they just can’t believe that, uh, uh, they have access to this.

Now what we did, um, also we created a local chiropractic district website. It is Ohio Um, but we did is we added fight back information against the opioid epidemic. Our website included the one-page opiate facts sheet, how to work with the media articles to educate patients, sample load, some different providers, simple letters to insurance companies, recent articles of interest. We have a lot of the foundations for Cochrane progress, videos, foundation, PowerPoint presentations, and a few of ours in there. So I recommend pulling up our, our website, Ohio, and take a look at our information. This is what has to be done in my opinion, across the country.

Now we had, we had meetings. Uh, what we did was we, our County had a, uh, opioid task force, monthly meeting that we, that we found out about it and we attended. And some of the things that we experienced with that is that what we did better was just a small group of DCS to when we had more than two, it seemed that there was, there was, we were not well accepted. They were more comfortable, just two of us to be there and we’ll get as we, we made it to these two DCS, which I was one of them. We went to all the meetings. We went to all the community functions we created the boosters, you know, were, we were in the boosts all the time. And it was very important for us that these outside groups got to know us. You know, when we went to the meetings too, it is imperative to listen to what they’re talking about.

We did not walk in there and saying how wonderful chiropractic is and all the things that we do, we listen. And we just, one of the United way with the climate was, you know, we attended these meetings and we introduce ourselves at the meetings. When there were questions proposed to providers and medical professionals, we spoke up, I messaged was always very, very simple. And to the point chiropractic the first stop opioid abuse. Now I was asked why we were there because they are saying that as chiropractic physicians, you guys don’t prescribe. I said, no, we’re here. We’re here to say that there’s a non-pharmaceutical way to help you. And that’s chiropractic and chiropractic first can help reduce the, the, uh, um, opioid abuse and throughout our community. Once we said that we’re X, we were accepted,

The community group members were very interested in our thoughts center and they all, they wanted to know what our action steps with, not what should be completed. They, the group members were definitely interested in what we’re doing locally. Uh, we provided an update, each meeting we did that get into discussion about chiropractic, specific issues. You know, we stuck basically, um, we stayed the course and, and, um, that we can stop addiction by treating the community, to present with musculoskeletal pain and dysfunction. First, our message was always the same. We repeat it over and over again. And we brought all of the foundation’s information to every community meeting. And then about every meeting, somebody was asking us for more copies.


We always talked to him to the community about being able to treat musculoskeletal pain and his functionality and not getting into other issues. And also this thing that we also did was to, um, every meeting that we went to or legislative functions, we brought the foundation for chiropractic progress, posters, and brochures and other materials. Again, their information is top notch and it’s just good, good, um, material to pass out to somebody.

So, you know, my final thoughts for the day, and I’ll talk a little bit about the veterans in a minute, but a big, big issue is that third party coverage for chiropractic care, in my opinion, is a major stumbling block to increase community access to non-pharmaceutical chiropractic care, full scope. Our focus across the country must be educating the employers in our communities to inform them that, that the current status of the opioid drug overdose epidemic is continues, and that if they can increase chiropractic coverage, we can benefit this ongoing strategy tragedy. So, you know, the only way we can get things done is work as a group and work as a grassroots effort. And we need to use the information that’s available to us and use it, not do it on a repetitive basis.

Now, lastly, before I finish is that, uh, I had two previous shows about veterans seeking chiropractic care, and it remains the fact that our veterans do not know that again, they can see it, they have the right to seek chiropractic or acupuncture treatment. The veteran must be eligible through the VA, has the VA numbers, D C must be certified through optimums. And to treat the veteran, the veteran has to actually, um, obtain a consult with the primary care physician or the pain management position. Um, then at the reasonable center, uh, request to the VA, the VA will then send authorization to the treating DC. This is, this is not an easy process. Everybody. It’s not, it’s, it’s, it’s a lot of red tape, a lot of headaches, but there’s 10 million veterans in the United States. There’s almost 800,000 veterans in Ohio, and these are veterans needing to so bad. Most of the veterans respond well to our treatment plan, which I use acupuncture. In addition to chiropractic, we really have to work on educating the veterans that they need to come see us. And remember in 2018 that there’s the, the veterans health administration did, they did a chiropractic directive with, uh, with a number of 12, 10. Um, this was released on May 25th, 2018, and States that chiropractic care and acupuncture are included now in the, in the medical benefits packages, the standard health benefits plans general available to all VA enrolled veterans.

Now the director actually lists some pro chiropractic comments. It States the patients receiving chiropractic care are less likely to use other healthcare services and are more constantly and have greater risk such as opioid epidemic or opioid medications, spinal imaging, and injections and elective, spinal surgeries. The directive States that patients receiving chiropractic care have a lower overall healthcare costs for episodes with operative spine related disorders. So in a nutshell, everyone, it’s just about education and it’s about being a grassroots effort. We all have to roll up our sleeves. It’s not too hard to use the foundations information, which is the key to, um, to our educating our employers and our communities. So most continue to do that. So, um, this, this concludes my, um, my presentation. I want to thank Jairus for asking me

To do the show. Do not forget that our host next week we, Mike Miscoe. Thank you for your time. You all have a nice weekend. Thank you.