Dr. John Watson from Smithfield, Utah is currently retired but remembers the conversations he had with his patients. "I asked directly what drugs were being used. I instructed my patients that pharmacology was not the area of my training but that I had become knowledgeable in dealing with health issues. I shared the concept that there are no 'side effects,' only direct wanted effects and direct unwanted effects. I shared the contra indications from the PDR and the Pill Book and attempted to get patients to think. I never interfered with medications but tried to educate my patients and get them to make good choices."

Dr. Robert Gear from Phoenix has found that "my patients automatically stop taking medication as I correct their spinal subluxations. Correction allows proper blood flow to the spinal nerves which then allows normalization of blood flow in the gastrointestinal and endocrine organs. This then allows the chemistry of the body to function in proper biochemical harmony. Most medication is necessary due to disharmony of biochemical function."

Patient Education

Educating patients was a recurring theme with chiropractors across the nation. Dr. Denise Primavera from Telford, Penn. says that she "often discovers in the course of an exam that a patient is taking a great many prescription drugs, some of which may be causing some of their presenting complaints, for example dizziness, fatigue or weakness. I never advise a patient to discontinue a drug on their own but I do share information about the drug's actions and side effects and I discuss possible less harsh alternatives. I then suggest they discuss my recommendations with their provider who prescribed the drug and often the regime can be modified or a different drug prescribed."

Dr. Arno Sullivan from Pine Grove, Calif. believes "the treating physician should be alerted to contra indications that may be due to medications they are taking, either prescription or over-the-counter. And depending on the doctor's level of education and experience they might contact the patient's MD suggesting a review of their medications and consider alternatives or discontinuation altogether. If the DC has prescribing privileges they can remove the patient from the medications in question and/or provide an alternative medication or homeopathic substitute in conjunction with their adjustive procedures."

Dr. Kelli Pearson of Spokane, Wash. believes "the number of drugs a person is on is diagnostic of how hard it will be to reduce their pain and see improved function. The more drugs, the longer the treatment time needed. I begin on day one discussing food is medicine and let them know that I will be adjusting their spine and their diet or we will get nowhere quickly. It is a trend over the 30 years that I have been practicing that folks are harder to treat, in part to the toxicity of the environment but more so related to what they put in their mouth, what they choose to do (or not do) with their body and how much courage they have to move beyond the pain and not take pain killers for a short term fix."

Many chiropractors believe it is first important to establish a respectful relationship with patients before the education can really begin. Dr. Paul Marston of New Jersey says "the outcome is usually an agreement for the patient to reduce or change the medication they are taking with the blessing of the MD, if the medication was not necessary. Advising the patient to discuss the over-the-counter use of medication and nutritional supplements with their primary care physician is also recommended. This concern for the patient's health and wellbeing aids in the establishment of a sincere doctor-patient relationship with the DC and the patient, as well as the MD."

Dr. Jared Leath from Tennessee believes "many of our patients come to us because they are looking for a way to take less medication. Others who are obviously being over-medicated or taking too many over-the-counter drugs, we simply try to educate." He continues, "Our education consists of taking the information directly from the drug manufacturers web site or WebMD if appropriate, printing out the information and going over the potential side effects. We are constantly amazed that many of our patients complaints resolve by simply taking that information back to their MD and asking for a change. Side effects from medication is a possible cause for our patient complaints and should not be overlooked in treatment."

One thing to consider is the population you are treating. For example, according the National Institute of Drug Abuse (part of the National Institutes of Health) persons aged 65 years and older comprise only 13 percent of the population, yet account for more than one-third of total outpatient spending on prescription medications in the United States. If you serve an aging population, you should consider this statistic as you educate your patients.

The bottom line seems to be that chiropractors will inevitably deal with patients using unnecessary prescription or over-the-counter medications. Opening the doors of communication with primary care physicians and establishing good relationships with them and with patients appears to be the most successful route in dealing with this unfortunately growing trend.