In a publicly available draft of their Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain, the US Food and Drug Administration says “A number of nonpharmacologic therapies are available that can play an important role in managing pain, particularly musculoskeletal pain and chronic pain … e.g., acupuncture, chiropracty (sic).”  The document is meant as a guideline for doctors and other health professionals who prescribe extended-release and long-acting opioids.

Talk about an unlikely source. An earlier version of the Blueprint did not mention chiropractic care or acupuncture. Historically, the mainstream medical community has been resistant to endorsing complementary medicine because of the lack of scientific evidence vouching for its effectiveness. Another concern is that seriously ill patients might go to naturopaths and other complementary health care providers instead of, rather than in addition to, traditional doctors.

Even if there is little to no proof that acupuncture and other forms of complementary therapies work, they generally pose no threat to the health of patients, since acupuncturists and chiropractors do not prescribe medicine. In the midst of a nationwide opioid epidemic, complementary medicine providers are in an ideal negotiating position, so it’s not surprising that they’re aggressively lobbying Congress and state governments. It’s far less risky to allow a patient to see an acupuncturist or a masseuse than it is to prescribe OxyContin for pain relief. The inclusion of both in the current version of the Blueprint suggests that complementary medicine advocates are influencing legislators successfully.

The draft of the FDA Blueprint is a list of proposed changes, not a finalized document. Between now and July 10th, members of the public were able to comment on these and other revisions to the Blueprint.  It will be interesting to see if there’s enough of a consensus in support of complementary medicine to include it in the published version.