title: Cross-Sectional Analysis of Per Capita Supply of Doctors of Chiropractic and Opioid Use in Younger Medicare Beneficiaries.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Professor, The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH. Electronic address: wbw@dartmouth.edu.
authors.forename: William B
authors.initials: WB
authors.lastname: Weeks
authors.affiliation: Professor, Palmer College of Chiropractic, Palmer Center for Chiropractic Research, Davenport, IA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Goertz
mesh_terms: D000367:Age Factors; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001416:Back Pain / Q000628:therapy*; D002684:Chiropractic / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D018588:Fee-for-Service Plans / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D026882:Manipulation, Chiropractic / Q000191:economics* / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data*; D019547:Neck Pain / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D000078329:Workforce
chemical_list: D000701:Analgesics, Opioid
keywords: Chiropractic; Key Indexing Terms; Medicare; Opioids