• Gliedt JA
• Reynolds M
• Moonaz S
• Long CR
• Russell R
• Schneider MJ

• Affiliation / Medical College of Wisconsin. Department of Neurosurgery
• Affiliation / Southern California University of Health Sciences
• Affiliation / University of Pittsburgh
• Affiliation / University of Pittsburgh. Clinical and Translational Science Institute
• Affiliation / University of Pittsburgh. School of Health and Rehabilitation Sciences. Department of Physical Therapy
• Alcohol Drinking
• Chiropractic
• Cross-Sectional Studies
• Drug Misuse
• Open Access Document
• Surveys and Questionnaires

Background: Chiropractors commonly encounter patients who present for spine pain with parallel substance use. There is currently no widespread training within the chiropractic profession to prepare chiropractors to recognize and address substance use in clinical practice. The purpose of this study was to examine chiropractors’ confidence, self-perceptions, and interest in education associated with identifying and addressing patient substance use.

Methods: A 10-item survey was developed by the authors. The survey addressed chiropractors’ assessment of their training, experiences, and educational interest/needs regarding identifying and addressing patient substance use. The survey instrument was uploaded to Qualtrics and was electronically distributed to chiropractic clinicians at active and accredited English-speaking Doctor of Chiropractic degree programs (DCPs) in the United States.

Results: A total of 175 individual survey responses were returned from a total of 276 eligible participants (63.4% response rate) from 16 out of 18 active and accredited English-speaking DCPs (88.8% of DCPs) in the United States. Nearly half of respondents strongly disagreed or disagreed (n = 77, 44.0%) that they were confident in their ability to identify patients who misuse prescription medication. The majority of respondents (n = 122, 69.7%) indicated that they did not have an established referral relationship with local clinical providers who provide treatment for individuals who use drugs or misuse alcohol or prescription medications. Most respondents strongly agreed or agreed (n = 157, 89.7%) that they would benefit from participating in a continuing education course on topics related to patients who use drugs or misuse alcohol or prescription medications.

Conclusions: Chiropractors indicated a need for training to help them identify and address patient substance use. There is a demand among chiropractors to develop clinical care pathways for chiropractic referrals and collaboration with health care professionals who provide treatment for individuals who use drugs or misuse alcohol or prescription medications.

Author keywords: Chiropractic - Alcohol use - Substance use - Opioid use - Prescription drug misuse - Surveys - Cross-sectional studies

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