The opioid crisis began with a whimper and has yet to end even as it reaches a crescendo in healthcare and beyond. We need to understand what set the groundwork for this crisis so as to avoid another in the future. The finger pointing began with prescribers stating that they were misled into believing that opioids were not addictive by pharmaceutical companies. This was the first wave seen and it was a slow churning, barely palpable event. The second wave of the crisis manifested when, as a reaction to the first wave, prescribers stopped giving out opioid prescriptions to patients, who through time and dosage, had become addicted to the powerful painkillers. The third wave crested when, to meet the street demand, synthetic opioids such as fentanyl began to hit the streets either in a relatively pure form or as a “boost” to inferior street-grade heroin.
It is necessary for healthcare practitioners to understand how and why this crisis erupted and how the efforts to combat it failed so when in the future a similar circumstance arises history shall not repeat itself. Chiropractic care offers a way to potentially circumvent opioid addiction and yet chiropractors must be cognizant that there is a very high likelihood that their patient base presenting with chronic pain may already be addicted or on the path to addiction.