As reported in “How should $1B in opioid funds be spent? Local officials weigh in,” [Gazette, March 26] Massachusetts is in the preliminary stages of implementing a $400 million settlement to
combat the state’s opioid epidemic. At a listening session held in Northampton last month,
Department of Health officials asked community members and public health providers how
to use opioid settlement funds to address existing needs.

As a retired local chiropractor with 30-plus years serving western Massachusetts, I am all too familiar with the challenges of managing pain. And while opioids are essential medications, they carry considerable potential risk. For many people in pain, there are alternative treatment options — both non-opioid and non-pharmaceutical — that are effective and safer.

To be clear: I believe funding for existing harm reduction efforts, Naloxone, and treatment
programs for opioid use disorder (OUD) should be continued. But the opioid epidemic
cannot be stopped without decreasing opioid initiation, which is often by prescription.
Opioid settlement funding should also support education about primary prevention.
Fortunately, a comprehensive new law called Chapter 285, unanimously supported by Massachusetts lawmakers, resolves this issue. In a historic milestone, the law requires insurance carriers to cover and provide access to a broad spectrum of alternative treatment options, including chiropractic.

Further, the law requires practitioners who prescribe opioids to complete, as a prerequisite to obtaining or renewing their professional licenses, an approved training program on safer alternatives for the treatment of pain.

There is substantial evidence to support the effectiveness of alternative treatment options.
In fact, the CDC 2022 Opioid Guideline states that non-opioids are at least as effective as opioids, noting that the American College of Physicians recommends non-pharmacologic care, including spinal manipulation, as a cornerstone of treatment.

Patients deserve the right to choose effective pain management care without facing the
risk of dangerously addictive pharmaceuticals. Treatment of those already addicted to opioids is imperative, but it is not enough. The missing piece of the opioid puzzle is prevention.

Howard Ewert DC

Amherst