Prescription Drug Abuse Increasingly Seen as a Major US Public Health Problem
The headline above is from a PEW Research Center article published on November 15, 2017. According to Wikipedia, "The Pew Research Center is a nonpartisan American think tank based in Washington, D.C. It provides information on social issues, public opinion, and demographic trends shaping the United States and the world."
Lately, there has been more stories on the issue of prescription drug abuse. Although most of the focus has been on opioid abuse, there have been a number of stories about the overuse of prescription drugs in general. The abundance of stories, coupled with recent Washington proclamations and mandates, have made the public more aware of this issue. However, though the public begins to recognize the increasing importance of this issue, the numbers of fatalities and cost of the crisis continues to grow.
The press release from the PEW on this issue begins by noting, "Americans' concerns about prescription drug abuse have risen over the past four years, with some of largest increases coming among well-educated adults." The PEW research points out that currently, 76% of the public see prescription drug abuse is an extremely or very serious public health problem.
This number is a significant increase from just a few years ago. In 2013, only 63% considered prescription drug abuse to be as serious as they do today. The study notes that the largest gains in awareness have come from those who have a higher education level, but equally for Democrats and Republicans considering political breakdowns.
The perspective of Americans concerning other health issues has remained fairly consistent from 2013 to today. Similar now to 2013, about 80% of Americans see cancer as a serious health issue. Additionally, the numbers remain steady with other issues such as obesity, where 71% see this as a serious health concern, as do 52% of the population with respect to alcohol and 51% for smoking.
Interestingly, the PEW survey did note that there were differences in the views on this issue based upon race. According to the study, 79% of whites saw prescription drug use as a serious concern, but only 73% of non-whites felt the same way. The difference was more pronounced for other health issues, where 66% of non-white Americans felt smoking was an extremely serious or very serious health issue compared to only 42% of whites who viewed smoking the same way.
Even though there is an increased awareness of this issue, the problem continues to grow. The CDC lists on their website that since 1999, the number of drug death has quadrupled. Between the years 2000 and 2015, more than half a million people have died from drug overdoses. Opioids account for the largest portion of these deaths with approximately 91 Americans dying every day from an opioid.
Improved Health Outcomes in a Patient with Multiple Sclerosis
Undergoing Chiropractic Care
The Annals of Vertebral Subluxation Research published a case study on November 20, 2017, documenting the improvement in quality of life and health outcomes for a patient with multiple sclerosis undergoing chiropractic care.
The study authors begin by defining multiple sclerosis. "Multiple Sclerosis (MS) is a neurological disorder in which focal areas in the central nervous system (brain, spinal cord) undergo demyelination." Demyelination is when there is damage to the protective covering surrounding nerve fibers in your brain, optic nerves or spinal cord. These coverings are known as the myelin sheath. When the myelin sheath is damaged, nerve impulses slow or can even stop, causing a wide variety of neurological problems. Some of the symptoms that can occur include numbness, tingling, stiffness, weakness, visual problems, dizziness, gait problems, depression, fatigue or thinking issues.
Although MS can develop at any age, it is most common between the ages of 20 and 40 years. The Multiple Sclerosis Foundation estimates that there are more than 400,000 people in the United States suffering from MS. Worldwide that number is about 2.5 million people with MS. About 200 new cases are diagnosed each week in the United States alone.
In this case, a 57-year-old woman suffering from a number of symptoms went to a chiropractor. Her complaints started with the sudden onset of bilateral foot numbness. She also began noticing numbness in her right hand, neck pain, headaches, ringing in her ears, and what she described as "blotchiness" in her vision.
Due to the sudden vision issue, a neurologist suspected MS and ordered an MRI to be performed. The MRI confirmed the presence of lesions in various parts of her central nervous system indicative of MS.
A chiropractic examination was performed which also found a number of motor-function and balance issues. Postural asymmetries were also noted and spinal palpation showed areas of edema, increased muscle tension, restricted motion, and reduced joint play. Spinal x-rays showed areas of degenerative disc disease and mild osteoporosis throughout the woman's entire spine. From the findings, it was determined that multiple subluxations were present in the woman's spine.
A series of specific chiropractic adjustments were given to address the subluxations according to specific chiropractic criteria. An evaluation was done after the first 12 visits to monitor the response to care. The woman reported that she felt 70% improvement in her symptoms. A re-examination confirmed that her muscle strength had returned to normal. Additionally, her deep tendon reflexes had improved from where they were before chiropractic care. The woman reported that her vision issues and the numbness in her feet remained, but the sensory dysfunction in her hands had been resolved.
In their discussion and conclusion, the authors note the woman's improvement and offer a possible explanation. They state, "The patient in this case study reported positive health outcomes while receiving chiropractic care." In explaining they continue, "The main question requiring an explanation is how a mechanical input such as chiropractic adjustments could produce neurophysiological changes such as reducing MS symptoms in a human body." The explanation they offer is that vertebral subluxation cause interference with the input signals entering the nervous system. This could then lead to aberrant responses and adaptations by the body resulting in symptoms. Correction of subluxations can help to reverse this process.
Heart Rate Variability Improved Under Chiropractic
A study published in the November 16, 2017, issue of the Annals of Vertebral Subluxation Research showed how heart rate variability was improved with chiropractic care for patients enrolled in a study. Heart Rate Variability (HRV), is variation in the time between each heart beat. During the day, the HRV should change as your activity and mood change.
The study authors note that, “Unlike heart rate, having a higher HRV is a sign of healthy cardiac function.” They stress how important a healthy heart is by reporting, “According to the American Heart Association, 31.9% of deaths, about 1 of every 3 in the United States is due to coronary vascular disease, which makes it the leading cause of death and a major cause of morbidity worldwide.” According to this study, more than 2,150 Americans die every day due to some form of cardiovascular disease. This averages to about one death every 40 seconds.
Since having a high HRV is good, the purpose of this study was to see if chiropractic care could improve the HRV score on a group of patients. The heart rate is controlled in part by the autonomic nervous system. Anything that changes the HRV is a reflection on the function of the autonomic nervous system. The premise of chiropractic is correction of subluxations that cause interference with the function of the nervous system. Correction of subluxations allows the nervous system to function free of inference and should therefore have a positive affect on HRV scores on patients.
In this study, 62 sequential chiropractic patients were studied. The patients had a variety of health concerns that brought them to the chiropractor. In addition to a chiropractic examination and x-rays, a HRV study was performed on each patient initially before starting chiropractic care. Follow-up HRV studies were performed at 90 days after chiropractic care was started, then again at 6 months and after one year of chiropractic care. Of the 62 patient initially enrolled 46 of them had completed enough care to get a 90 day follow up HRV test for the purposes of this study. The initial and 90 day scores were analyzed for this study.
After the data was collected, a score was given to determine HRV activity for comparison. The data was broken down as follows: a score of 95-100 is considered excellent, 90-94 is very good, 80-89 good, 70-79 transition, 60-69 challenged, 0-59 very challenged.
In this study, the pre-chiropractic HRV score was 70.48. This number increased to 73.87on the 90 day test. On average women had a higher HRV score before chiropractic care then did the men. After 90 days of specific chiropractic care, the scores for both men and women showed an increase with the men showing a larger increase than the woman. When the researchers looked at those subjects who started with a less healthy lower HRV score, they saw a significant improvement from the initial scores to the 90 day scores for these patients.
The researchers point out that improving the HRV scores on all individuals is a positive health outcome. However, improving these scores on those who scores were initially low could have a profound effect on the patient’s health, and society overall. They concluded, “Cardiovascular disease is a significant contributor of morbidity and mortality worldwide. Males make up the majority of those deaths. Recent research shows that HRV is an accurate tool in analyzing and monitoring cardiovascular health and autonomic nervous system function. This study demonstrates that (chiropractic) care may be an effective method for people to improve their autonomic nervous system function through adjustment of vertebral subluxation, reorganizing spinal tension patterns and decreasing physiological stress.”
Addition of Chiropractic Helps Cancer Patient Undergo Medical
The Journal of Upper Cervical Chiropractic Research published a case study on December 7, 2017, documenting the addition of chiropractic care to medical care for a patient being treated for metastatic melanoma. According to the Melanoma Research Foundation, "Metastatic melanoma, also known as Stage IV melanoma, is used when melanoma cells of any kind have spread through the lymph nodes to distant sites in the body and/or to the body's organs."
The study authors begin by describing the seriousness of this condition, "Melanoma can begin in a mole but can also arise from other pigmented tissues such as the eye or intestinal tract. It is the most severe form of skin cancer as well as the least common." There are four stages of melanoma. Stage IV is the most severe meaning that the melanoma has spread to distant parts of the body.
Malignant melanoma is the fifth most common type of tumor in the U.S. for men, and the sixth most common for women. The study notes that in 2013, approximately 76,690 new cases were diagnosed and 9,480 people died from this condition.
In this case, a 34-year-old woman with metastatic melanoma presented herself for chiropractic care. The woman had been previously diagnosed with metastatic melanoma and treated medically. After treatment, she was declared cancer-free.
Three months after being declared cancer-free, the woman got suddenly and severely ill. In the study, she described her ordeal, "One night in December I started having lighting flashes occurring on the right side of my vision. Then my head on the right side felt like it was going to explode. I sat down, then my arms became numb and tingling and after a few minutes the numbness and tingling traveled down into my left foot."
Over the next 3 months, the woman continued to get worse till finally her doctors ordered a PET-CT scan. The scan showed ten small lesions in portions of her brain, and whole brain radiation was started. An additional PET-CT scan found that the cancer had spread to multiple areas in her body.
It was at this serious stage of her condition, and while suffering with a multitude of symptoms, that she sought chiropractic care. She received a chiropractic examination prior to care being started. After her first adjustment, the woman reported an increased in her energy levels resulting in her did not needing to nap as frequently as before. After additional adjustments, she reported that a number of her symptoms decreased. She reported that she could walk without needing to rest.
The patient then started a combination of medical care and chiropractic care. Four months into her combination of medical and chiropractic care, another PET-CT scan was performed to check on her progress. The radiologist who read the report commented on the improvment he noticed by stating, "There has been a dramatic response to therapy since the prior PET-CT scan." He reported that many of the lesions had reduced in size. He also commented that, "No new lesions are present."
Unfortunately, the study reports that, due to the seriousness and advanced state of the woman's condition, she passed away about 2 years later. However, the study authors did report that the time she had left was made more comfortable. They noted, "She was virtually symptom-free up until her final months when her symptoms escalated."
Adding chiropractic to medical treatment of cancer is becoming more common, the authors noted in their discussion, "There are multiple cancer treatment centers that include chiropractic care as part of their integrative medicine programs." The researchers explain this by saying, "About half of cancer patients do not receive adequate pain relief throughout the course of their treatment or even post-treatment. Complications of prolonged bed rest, chronic pain due to radiation, chemotherapy-related neuropathies, and gait or functional abnormalities are among the complaints that cancer patients may have. A chiropractor can help manage these conditions and potentially decrease the patient’s need for pain medication."
Adolescent Idiopathic Scoliosis Reduced with Chiropractic
The Journal of Physical Therapy Science published a case study on November 24, 2017, documenting the improvement of adolescent idiopathic scoliosis under specific chiropractic care. According to the National Institute of Health website, "Adolescent idiopathic scoliosis is an abnormal curvature of the spine that appears in late childhood or adolescence. Instead of growing straight, the spine develops a side-to-side curvature, usually in an elongated "S" or "C" shape; the bones of the spine are also slightly twisted or rotated."
Adolescent idiopathic scoliosis (AIS) affects about 5.2% of children and adolescents and is the most common spinal disorder in the age group. When severe, AIS is treated medically with spinal surgery. This type of surgery is a very involved process that should only be used in the most severe cases and after all other methods have failed. Conservatively, AIS is treated using physical therapy, exercise, bracing and chiropractic. The goal of care for AIS is to stop the curve from getting worse or to reduce the curvature if possible.
In this case, a 15-year-old girl, who had been diagnosed with AIS, was brought to the chiropractor. In addition to her scoliosis, she was also suffering from chronic left-side body pain, lower back pain, and headaches. Her body pain was made worse when she would sit for more than 45 minutes. She rated her headaches as a 6 out of 10, with 10 being the worst.
A chiropractic examination was performed which showed multiple areas of tenderness on palpation of her spine. The girl also had reductions in a number of her spinal ranges of motion, and her posture showed a forward projection of her head. Spinal x-rays were taken and a measurement of her scoliosis was made. Her curvature measured 27.3° using a standard measuring system for scoliosis known as the "Cobb angle." Stress film x-rays were also taken to view how the girl's spine reacted to being in certain positions.
As a result of the examination, specific forms of chiropractic care were started along with structural rehabilitation, traction, and home traction. After 15 weeks of care consisting of 24 in-office visits and her home traction, follow-up x-rays were taken to compare with the originals. The new films showed that her spine had improved a full 19° from an original 27.3° Cobb angle down to only an 8° Cobb angle curvature. The girl also saw significant improvement in her back pains and headaches rating them at 0 out of 10.
The study authors note that most cases of AIS will progress and worsen if left untreated. In this case, not only was the progression stopped, but the curvature and the girl's association symptoms was improved.
Multiple Sclerosis Patient Improved Under Chiropractic
On November 9, 2017, the Annals of Vertebral Subluxation Research journal published the results of a case study of a woman suffering with long-term multiple sclerosis (MS) being helped by chiropractic. Although rarely fatal, MS is an unpredictable disease of the central nervous system (CNS) that can range from a mild course of symptoms to steadily worsening or even disabling condition.
The study authors report that “Multiple Sclerosis (MS) is the most common disabling neurological disease of young adults.” Although there is no way to know what course this disease will take with any given individual, most patients seem to experience short periods of exacerbation of their symptoms followed by long periods of relief.
According to the study authors, there is a wide variety of possible symptoms associated with MS. These include numbness or weakness in one or more limbs that typically occur on one side of the body at a time, tingling or pain in parts of the body, electric-shock sensations that occur with certain neck movements especially bending the neck forward, tremors, lack of coordination or unsteady gait, slurred speech, fatigue, dizziness, partial or complete loss of vision often with pain during eye movement, prolonged double vision, and problems with bowel and bladder function.
In this case, a 39-year-old woman presented herself to a chiropractic office accompanied by her parents and an aide. Her first symptoms of MS began at age 19, when she first became partially blind in one eye. She was partially blind for several months and nearly lost her ability to see. She was then diagnosed with MS by a neurologist and confirmed by an MRI which showed active plaque formation. The woman was given prednisone which seemed to help for a while. One year later, the woman began to lose her ability to walk. Her legs continued to feel weak and she started feeling fewer sensations in the legs, upper body, hands and arms.
The woman’s condition continued to deteriorate to where she was in her apartment and her legs just gave way. She fell down and was stranded in her apartment for a couple of days until someone found her. From that point, forward she never regained the ability to walk, leaving her wheelchair bound without the ability to move her legs. Her condition continued to worsen, as she became unable to sit up in her wheelchair without assistance or hold her head up for more than a short period of time.
Chiropractic x-rays were taken specifically of her neck. Significant subluxations were noted and specific forms of chiropractic care were started multiple times per day along with physical rehabilitation. Over the course of a year of chiropractic care, the woman steadily showed improvement. Another MRI was performed that now showed no active plaques in the woman’s brain. The study also reports that her neurological signs also were improving.
Over the course of a year, the woman continued to show improvement and she began to regain sensations to her legs, which was followed with improvements in the movement of her toes and feet. Additionally she started to have control of her upper body where she was able to hold herself upright in her wheelchair, feed herself, comb her hair, put on make-up and put her own clothes on. She eventually improved to the point to where she was able to leave her wheelchair and walk using a walker.
Many of the woman’s other symptoms also improved including her partial blindness in one eye. Additionally, her abnormal skin sensations improved, she had no more migraine headaches, and she regained full function of her bladder and bowels.
In their conclusion, the authors summed up the success of this case by saying, “In this case study of a 39-year old female patient with a 20-year history of MS, subluxation-based chiropractic care decreased the neurological interference, which resulted in reduction of MS symptomatology and resolution of the active plaques and mass lesion in the post-MRI of the brain. Overall, the patient’s quality of life was improved based on the patient’s functional goals that were reached.”