Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108713

Shireesh Bhalerao, DC and Owen T. Lynch, DC. Clinical Sciences, Western States Chiropractic College, 2900 NE 132nd Avenue, Portland, OR 97230, 503-251-5714, sbhalerao@wschiro.edu

In 2003, Western States Chiropractic College initiated a community service project to provide chiropractic care to increase access to and utilization of chiropractic care for A&D patients from three local residential rehabilitation centers in Portland, OR, U.S.A. The project shed light on several facts important in the management of these patients: chiropractic patients commonly suffer from chronic pain syndromes; there is a strong association between chronic pain, psychiatric illness and substance abuse; and, unrecognized substance abuse disorders can complicate and impede recovery from musculoskeletal pain. Therefore, it became apparent that it is important for chiropractors to screen patients for chronic pain, psychiatric illness, and substance abuse. To help identify susceptible patients, a protocol is recommended. Such a protocol requires that the chiropractor first identify a history of chronic pain, psychiatric illness, and/or substance abuse. This can be accomplished through focused interview questions and through the use of reliable and valid questionnaires that screen for such conditions such as the short-form-36. After this initial screening, the chiropractor should then use a cognitive behavioral approach to manage the patient directly by promoting active care over passive care, indirectly by referral for substance abuse or mental health treatment, or both together. Implementation of such a protocol would help chiropractors: (1) increase their awareness of the relationship between chronic pain, psychiatric illness and substance abuse, (2) improve their management of these conditions and, (3) promote their inclusion in the therapeutic alliance required to help these patients manage their pain and overcome substance abuse.

Learning Objectives: "At the conclusion of the session, the participant (learner) will be able to

• understand the relationship between chronic pain, psychiatric illness, and substance abuse."
• recognize the importance of screening chiropractic patients for chronic pain, psychiatric illness, and substance abuse."
• apply a diagnostic and treatment protocol for chronic pain, psychiatric illness, and substance abuse in a clinical setting."

Keywords: Substance Abuse, Chiropractic

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.