Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries

J Manipulative Physiol Ther. 2016 May;39(4):263-6. doi: 10.1016/j.jmpt.2016.02.016. Epub 2016 Mar 28.


Objective: The purpose of this study was to determine whether the per-capita supply of doctors of chiropractic (DCs) or Medicare spending on chiropractic care was associated with opioid use among younger, disabled Medicare beneficiaries.

Methods: Using 2011 data, at the hospital referral region level, we correlated the per-capita supply of DCs and spending on chiropractic manipulative therapy (CMT) with several measures of per-capita opioid use by younger, disabled Medicare beneficiaries.

Results: Per-capita supply of DCs and spending on CMT were strongly inversely correlated with the percentage of younger Medicare beneficiaries who had at least 1, as well as with 6 or more, opioid prescription fills. Neither measure was correlated with mean daily morphine equivalents per opioid user or per chronic opioid user.

Conclusions: A higher per-capita supply of DCs and Medicare spending on CMT were inversely associated with younger, disabled Medicare beneficiaries obtaining an opioid prescription. However, neither measure was associated with opioid dosage among patients who obtained opioid prescriptions.

Keywords: Chiropractic; Key Indexing Terms; Medicare; Opioids.

MeSH terms

  • Age Factors
  • Analgesics, Opioid / therapeutic use*
  • Back Pain / therapy*
  • Chiropractic / statistics & numerical data*
  • Cross-Sectional Studies
  • Disabled Persons / statistics & numerical data
  • Fee-for-Service Plans / economics
  • Fee-for-Service Plans / statistics & numerical data
  • Humans
  • Manipulation, Chiropractic / economics*
  • Manipulation, Chiropractic / statistics & numerical data
  • Medicare / statistics & numerical data*
  • Neck Pain / therapy*
  • United States / epidemiology
  • Workforce


  • Analgesics, Opioid