Idaho bill would give chiropractors authority to prescribe "natural" remedies

Idaho bill would give chiropractors authority to prescribe "natural" remedies

House Bill 593 would give chiropractors the right to prescribe "natural" substances, some of them drugs, after obtaining a "Certificate in Specialized Clinical Nutrition." The bill would also expand the scope of practice for all Idaho chiropractors.

Currrently, under Idaho law, chiropractors can

"investigate, examine, and diagnose for any human disease, ailment, injury, infirmity, deformity, or other condition."

by applying principles or techniques of chiropractic practice. These include "adjustment" of the non-existent "subluxation" to eliminate "decrease in neural transmission" or to correct the "subluxation complex," all in accord with traditional chiropractic philosophy that "subluxations" exist, they interfere with the transmission of "nerve impulses" and they can be corrected by "adjustments." All of this is fiction and only chiropractors hold this uninformed view of human anatomy. The scope of practice also includes "clinical nutrition."

What this means is unclear, but it implies that chiropractic treatment is not limited to musculoskeletal issues and the scope of practice includes chiropractors diagnosing and treating any patient with any disease or condition as long as it is based on the concept that removing this mythical "decrease in neural transmission" or correcting the equally mythical "subluxation complex" is effective. How "clinical nutrition" might accomplish this is unclear because the whole concept is bogus.

Even more disturbing is an interpretation allowing chiropractors to diagnose and treat any disease or condition, whether it involves mythical nerve interferences or subluxation complexes or not.

Whatever the meaning, the bill would allow all chiropractors to prescribe and sell to patients

"vitamins, minerals, botanicals, herbals, homeopathic [sic], phytonutrients, antioxidants, enzymes and glandular extracts."

All chiropractors would also be allowed to administer these substances not only orally, but also via enteral, topical and transdermal routes. Whoever drafted this bill obviously has no clue what "enteral" means, as it includes tube feeding.

If a chiropractor obtains a "Certificate in Specialized Clinical Nutrition" he (or she) will be able to administer these same "natural" substances

"via intravenous, intramuscular, intra-articular, subcutaneous and subdermal routes."

This Certificate requires only 120 hours in classroom and clinical instruction, far less than any other health care provider who can prescribe. Only 32 of those hours are allotted to cover all of these subjects:

"chiropractic injectable nutrients, which must include sterile needle practices, phlebotomy, proper injection technique, intravenous safety practices, trigger point injections, intramuscular injections, intravenous therapy, lab testing and blood chemistry interpretation."

The balance consists of 44 hours in classroom instruction, and 44 hours of practicum, in nutrition or nutritional pharmacology. All of this instruction can take place at a chiropractic school.

Once a vitamin, mineral or other "natural" substance is injected, it becomes, by law, a drug. Substances that fall into this category could be administered only if they were on a chiropractic formulary. But guess who is in charge of that? The formulary would be drafted by a "nutritional substance formulary council" composed of 2 chiropractors,1 pharmacist, 1 medical doctor and a public member.The public member is chosen by the chiropractic board. One can easily imagine manipulation of this system to insure that chiropractor interests dominate by appointing a public member sympathetic to chiropractors but otherwise clueless about pharmacology.

The list of "natural" substances chiropractors can administer and prescribe are typical of those included in naturopathic practice acts, making it easy to imagine the quackery that will open up for chiropractic practice if this bill passes. Given the fact that chiropractors will be able to perform lab tests on their patients, opportunities for exploitation expand even more lucrative. There is no shortage of quack lab tests and invented diseases out there, all of which can be "treated" with vitamins, homeopathy, glandulars, and the like

I wonder if the legislators who introduced this bill have any idea what they've authorized? 

Anyone taking enzymes (other than for lactose intolerance) is wasting his money. Homeopathy cannot, and does not, work. Very few people need vitamin or mineral supplementation. Antioxidant supplements may do more harm than good. Herbal remedies can be contaminated and there is little evidence for their effectiveness for any disease or condition. We don't know if phytoestrogens (one of the phytonutrients) are helpful or harmful to human health. Even the venerable alt med guru Dr. Andrew Weil recommends against taking glandulars. None of these are tested for safety or efficacy prior to their being marketed.  And these deficiencies don't even touch on the risks associated with delivery methods like IVs.

These are only a few of the facts about the substances chiropractors would be allowed to prescribe and administer easily found from reliable sources on the internet with simple Google searches. Of course, ideally legislators would call in neutral experts to draft healthcare bills instead of blindly relying on the self-interest of chiropractors, who have so little understanding of pharmacology and evidence-based medicine that they support a bill chock full of pseudoscience. Unfortunately, some Idaho legislators are too uninformed to know better. 

Points of Interest 03/19/2016
My Metaphor Was Lacking