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Opioid Prescriptions for Back Pain Linked to Higher Risks

Adults starting treatment for back pain may face increased addiction risks, making alternative therapies worth discussing.

Updated on Oct. 21, 2026 in Substance Abuse

Isometric editorial illustration of a resistance band on a flat surface, representing evidence-based back pain treatment choices.
A Medicaid claims analysis finds that starting back pain treatment with physical therapy is associated with lower long-term opioid addiction risks. AI Illustration. Upload story photo >

Live Poll

Would you choose non-drug options like physical therapy first for managing new back pain?

A large-scale analysis of Medicaid claims published October 19, 2026, links initial high-dose opioid prescriptions for back pain to significantly higher risks of opioid use disorder or overdose. These findings for U.S. patients highlight the importance of discussing non-pharmacological pain management options with a clinician.

Why it matters

Understanding the correlation between early treatment choices and long-term risks for substance use disorder helps patients advocate for safer, evidence-backed care paths for back pain. This research clarifies how initial prescriptions or therapies significantly impact the trajectory of long-term health outcomes.

A study of 399,500 adults with new back pain diagnoses tracked outcomes over a 13-month period. Researchers found that patients starting on high-dose opioids, defined as exceeding 50 milligrams of morphine equivalent per day, faced a 146.6% higher relative risk of opioid use disorder or overdose.

The players

JAMA Network Open

A peer-reviewed, open-access medical journal that publishes research on clinical and public health topics.

The details

Researchers reviewed Medicaid claims from 25 states to compare patient outcomes within a month of a new back pain diagnosis. The findings showed that starting treatment with high-dose opioids or even lower-dose opioids for over seven days was tied to increased risks. Conversely, initial non-pharmacological approaches, specifically chiropractic care and physical therapy, were associated with reduced risks of approximately 33% and 31% respectively.

Timeline

  1. 2014 was the reference year for Medicaid expansion in the states studied.

  2. The reviewed Medicaid insurance claims spanned from 2016 through 2019.

  3. The study was published in JAMA Network Open on October 19, 2026.

Health Landscape

This study sits within the broader evolution of pain management strategies aimed at reducing reliance on high-risk medications for chronic musculoskeletal issues. It follows a research trend of re-evaluating standard clinical protocols to prioritize non-pharmacological alternatives.

If you are experiencing new back pain, it is worth discussing non-pharmacological options like physical therapy or chiropractic care with your primary care physician. Understanding the potential risks associated with high-dose opioid treatments can help you make informed decisions about your long-term care.

The takeaway

Initial treatment decisions for back pain can significantly impact your long-term risk for opioid use disorder. Always discuss with your physician whether evidence-based, non-drug interventions like physical therapy or chiropractic care are appropriate for your specific situation.

Further reading

For more information on managing chronic pain safely, see the Substance Abuse section.

More information

For those seeking resources on treatment, visit the confidential opioid treatment locator.

Live Poll

Would you choose non-drug options like physical therapy first for managing new back pain?