In an effort to battle Florida’s opioid epidemic, state policymakers have passed a new law that pushes doctors to provide patients with options for alternative pain management. In cases where opioids may be used, doctors must inform patients of other forms of treatment. These alternatives include treatments like acupuncture, chiropractic care and massage therapy.

Though HB 451 passed without much opposition, some health care professionals have doubts about these forms of alternative treatment. Particularly, these professionals do not see the alternatives as proven, science-based alternatives for pain relief.

Controversial Alternative Treatments

Opioids drugs work by activating opioid receptors in the nervous system, which helps to relieve severe and chronic pain. The problem is that these substances are extremely addictive, and people who take opioids as prescribed can still become dependent on or addicted to them.

Another issue is that Florida doctors are prescribing too many opioids. In 2017 alone, providers wrote 60.9 prescriptions for every 100 people, which is higher than the national average of 58.7. Laws such as HB 451 seek to lower this number by giving patients other options. Unfortunately, some of these options may not be entirely helpful as alternatives for pain relief. Each alternative is explained in detail in this document.


Acupuncture uses needles that are inserted into certain points of the body. It is used to relieve certain types of chronic pain, such as low-back, neck, knee and arthritis pain. However, it has been found that locating these points is an inaccurate science. Since accuracy varies widely from one acupuncture practitioner to another, effective pain relief is not guaranteed.

Chiropractic Care

Chiropractors treat issues in the skeletal system, typically focusing primarily on the spine. They treat skeletal problems manually or with tools, such as by pushing on a joint in the spine. However, many health professionals argue whether chiropractic is a pseudoscience or is based in fact. For example, the idea of “spinal subluxation” has little evidence to support it.

Massage Therapy

Massage therapy is similar to chiropractic care, but it focuses on the muscles and tendons within the body. Massage therapists manually manipulate painful areas in the body to relax them and relieve stress. Also similar to chiropractic, there is little evidence to back up the benefits of massage therapy. License requirements vary from state to state, and no studies have discerned how helpful massage therapy truly is for pain.

Details of the Law

HB 451 went into effect in Florida on July 1, 2019. It requires health care professionals to provide patients information about non-opioid alternatives for pain relief. Professionals must cover the pros and cons of medicines as well as therapeutic and behavioral approaches. Patients have the right to refuse opioids and choose other options instead. Patients must be given this information in print form, and the document provides an overview of the benefits and side effects of each option.

If you or a loved one is struggling with an opioid use disorder, The Orlando Recovery Center is here to help. Contact us today to learn more about treatment options that can work well for your situation.


The Florida Senate. “LEGISLATION FILED TO EMPOWER PATIENTS WI[…]IOID PAIN TREATMENT.” January 31, 2019. Accessed October 23, 2019.

Florida House of Representatives. “CS/CS/HB 451.” 2019. Accessed October 23, 2019.

Rosenblum, Andrew; et al. “Opioids and the Treatment of Chronic Pai[…]d Future Directions.” Experimental and Clinical Psychopharmacology, October 2008. Accessed October 23, 2019.

Florida Health. “Alternatives to Opioids.” September 20, 2019. Accessed October 23, 2019.

Godson, Debra; et al. “Accuracy and Precision in Acupuncture Po[…]l Systematic Review.” Journal of Acupuncture and Meridian Studies, April 2019. Accessed October 23, 2019. 

Sam Homola. “Chiropractic Subluxation Theory: Legal S[…]Spinal Manipulation.” Science-Based Medicine, June 9, 2017. Accessed October 23, 2019.

Shekelle, Paul; et al. “Massage for Pain: An Evidence Map.” Department of Veterans Affairs, September 2016. Accessed October 23, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.