top of page

Chiropractic and Addiction

Chiropractic care supports addiction recovery by aiding in nervous system regulation, particularly by calming sympathetic overdrive and improving vagal tone. Chiropractic can improve stress resilience and emotional regulation, which are crucial during withdrawal and healing phases of addiction recovery. Case studies show reduced cravings and improved mood stability in patients receiving chiropractic adjustments.

Image by Myriam Zilles
Prescription Medicine
Image by Hennie Stander

Chiropractic Care as a Supportive Therapy in Addiction Recovery


Introduction

Addiction is a complex chronic condition that affects the mind and body. It is not simply a lack of willpower; rather, addiction is classified as a chronic disease characterized by compulsive drug seeking and usage despite harmful consequences nida.nih.gov. Repetitive substance use changes the brain’s reward circuitry, notably inducing massive surges of dopamine, which is the neurotransmitter of reward and pleasure nida.nih.gov. These changes make quitting substance use extremely difficult on a chemical level. Individuals who suffer with addiction often experience intense cravings and stress that drive continued use. Traditional treatments focus on counseling, support groups, and medications, but there is growing interest in holistic approaches that address the body’s nervous system and biochemical balance, paving the way for addiction therapy via chiropractic.

Chiropractic is well known for treating back and neck pain, but really chiropractic is centered around optimizing the nervous system by correcting spinal misalignments known as subluxations. Through chiropractic adjustments and appropriate nervous system regulation, these subluxations resolve and allow the body to restore balance to the hormones involved in addiction.  Below is a review of scientific reports and relevant case studies on chiropractic as an effective, drug-free modality in addiction treatment. 

Understanding Addiction and the Hormones that Perpetuate It

To understand how chiropractic can aid in addiction treatment we must first discover how addiction affects the brain and body. Addiction is a fundamental disease in the brain’s reward system. The American Society of Addiction Medicine defines addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry” pmc.ncbi.nlm.nih.gov. Addictive substances and behaviors overstimulate the brain’s reward circuitry, causing floods of dopamine which promote feelings of euphoria. This trains the brain to continue seeking the triggering substance even at the expense of one's health nida.nih.gov. As a compensation, the brain will reduce its sensitivity to dopamine, leading to increased stimulation tolerance and a lesser ability to find pleasure from normal life function nida.nih.gov. Tolerance increasing means that the person seeks greater quantities of the addictive substance or behavior to achieve the same feeling that the excess dopamine created. This increase in neurotransmitter quantity causes other neuro-chemical systems to be thrown off balance, altering stress response patterns, behaviors, and impulse control nida.nih.gov. An inappropriate balance of these neurotransmitters may cause anxiety, depression, and increased stress.

Several key hormones and neurotransmitters play roles in addiction. Dopamine is the most famous, driving the reward and reinforcement cycle of the brain. Serotonin affects mood and calmness. Endorphins are the body’s natural painkillers and pleasure molecules. GABA, gamma-aminobutyric acid, is an inhibitory neurotransmitter that helps control anxiety. Cortisol is a stress hormone released during withdrawal and cravings. All of these chemicals are a part of the neural system of addiction. The individual amounts of these neurotransmitters are vital, and it is crucial to understand how their releases mediate, inhibit, or stimulate one another's release. Chronic drug and alcohol use can deplete or unbalance these chemicals. Long-term substance abuse often leads to elevated stress hormone usage and an overactive sympathetic “fight-or-flight” response. This triggers cravings, irritability, and loss of control. Conversely, many people with addictions have an underlying dopamine deficiency known as Reward Deficiency Syndrome (RDS) where biochemical factors leave the brain’s reward system poorly functioning. Almost all reward deficiencies predispose individuals to seek external substances to feel "normal".

 

There is also evidence of genetically predisposed addiction. In 69% of severe alcoholics versus 20% of non-alcoholics the A1 allele of the D2 dopamine receptor gene has been found to be increased. Genetic factors that impair dopamine receptors contribute to the inability of addicts to experience healthy rewards.

Addiction is a disease of both the brain and body. Addicts experience a psychological drive to use substances and behaviors which are rooted in neurochemical cascades altered by a dysregulated nervous system. The Hypothalamic-Pituitary-Adrenal Axis is central to the body's stress response and mood. Cravings and withdrawal symptoms are the result of the body’s HPA axis becoming altered when an addictive substance is removed. Stress hormones like cortisol surge during withdrawal and lead to feelings of anxiety, agitation, and physical pain. The physical withdrawal syndrome is a signal that the body is not properly adapting to its changing environment. The environment, in this case, is the sudden absence of a drug; an inability to physiologically adapt to that change results in discomfort and suffering. Managing stress and balancing the nervous system is critical for recovery and long term healing in cases of addiction. Chiropractic care offers unique benefits in the realm of nervous system regulation: by helping to normalize function, adjustments ease the body’s hormonal stress overload and support the brain’s natural reward chemistry.

The Role of a Regulated Nervous System in Curbing Addiction

A well-regulated nervous system has major influence on how we process cravings, perceive stress and exercise self-control. The nervous system is the body’s central command center. It regulates heart rate, hormone release, mood, etc. People with substance abuse disorders spend their lives in a constant state of sympathetic overdrive, resulting in anxiety and hyper-vigilance. They live for moments of high dopamine and crash in moments where it is depleted. This negative cycle re-enforces addictive drug use. Stress and anxiety are common triggers for substance users to manage their suffering with a sense of pleasure. Conversely, if the body’s nervous system is balanced and calm, cravings are more manageable because external substances are no longer relied on to mediate internal satisfaction.

Chiropractic care directly targets the nervous system by correcting spinal subluxations – misalignments or areas of abnormal spinal motion that irritates nerves. Chiropractors have long observed that spinal misalignments disrupt nervous system function and the body’s ability to adapt to stress. By delivering specific spinal adjustments, chiropractors aim to remove this nerve interference, thereby restoring optimal neural communication between the brain and the body. Modern research is beginning to validate these effects. For example, a multi-site clinical study found that a single chiropractic adjustment led to measurable changes in autonomic nervous system indicators: patients had a significant reduction in heart rate and improvements in heart rate variability (HRV) immediately after the adjustment pubmed.ncbi.nlm.nih.gov. HRV is a marker of nervous system balance – higher HRV generally reflects a shift toward parasympathetic (relaxation) activity. In the study, not only did HRV improve, but patients also reported decreased pain levels after the adjustment pubmed.ncbi.nlm.nih.. This suggests that chiropractic can induce a state of relaxation and pain relief, the very state that is protective against cravings. When your body is not in constant pain or fight-or-flight mode, the biochemical drive to “escape” or seek pleasure through external substances is naturally reduced.

Another way chiropractic regulates the nervous system is by influencing chemical messengers like stress hormones and endorphins. Consider cortisol, the primary stress hormone. High cortisol is associated with anxiety, and it spikes during withdrawal or high-stress situations, often fueling the desire to use again. Encouragingly, case reports have documented that chiropractic adjustments can reduce cortisol levels and anxiety symptoms. In one published case, a 40-year-old patient receiving chiropractic care for chronic neck pain also had severe anxiety and high salivary cortisol (a biological marker of stress). Over the course of care, her salivary cortisol levels declined significantly, correlating with a marked reduction in her anxiety and improvement in her pain journal.parker.edu. The treating clinicians concluded that chiropractic management was associated with both physical improvement and reduced anxiety/stress hormones, supporting the idea that chiropractic is beneficial for patients with anxiety disorders or chronic stress conditions journal.parker.edu. From an addiction standpoint, this is highly relevant: a calmer physiological state (lower cortisol, less anxiety) means fewer stress-driven cravings and a greater ability to cope with triggers. Chiropractic adjustments have also been linked to the release of endorphins: the body’s natural opioids. Endorphins not only relieve pain but also produce feelings of well-being and reward. Notably, a controlled study demonstrated that a single spinal adjustment can cause a small but significant rise in plasma beta-endorphin levels shortly after the adjustment pubmed.ncbi.nlm.nih.gov. In that study, men who received a real cervical spinal adjustment showed an increase in beta-endorphins 5 minutes post-adjustment, whereas those who received a sham adjustment or no intervention actually had a steady decrease in endorphin levels pubmed.ncbi.nlm.nih.gov. This finding suggests that an authentic chiropractic adjustment can trigger the release of the body’s own “feel-good” chemicals. For someone in recovery, even a modest boost in endorphins and natural reward chemistry could be very helpful. It might reduce pain, improve mood, and combat the flat, depressed feelings that often accompany early sobriety. In essence, chiropractic may help replenish some of what addiction has depleted. Whether it’s by lowering excessive stress hormones or by increasing beneficial neurotransmitters thereby restoring a healthier internal balance.

How Chiropractic Care Can Support Addiction Treatment

Chiropractic care is not a direct “cure” for addiction and credible chiropractors acknowledge this. Rather, it is a supportive therapy that addresses the physiological side of addiction. Dr. Jay Holder DC, has extensive experience in addiction treatment and states that “Chiropractic allows those things that do treat addiction to be embraced more thoroughly.” In other words, by correcting spinal subluxations and improving nervous system function, chiropractic allows the person’s body and mind to function optimally. Then they can fully benefit from counseling, support groups, and healthy lifestyle changes. Many individuals in recovery report that after an adjustment they feel a sense of calm and well-being, less physical tension, and clearer thinking, all of which make it easier to stay on track with sobriety.

The potential mechanisms for chiropractic’s benefits in addiction revolve around what we discussed: reducing pain, easing stress, and normalizing the reward cascade in the brain. The Brain Reward Cascade is a concept describing the sequential release of neurotransmitters (from serotonin to enkephalins to GABA to dopamine, among others) that produces feelings of wellness and satisfaction. If any link in this biochemical chain is disrupted due to genetics or chronic stress then the final dopamine release may be insufficient, resulting in Reward Deficiency Syndrome. The individual then feels compelled to seek external stimuli (like drugs or alcohol) to artificially boost dopamine and feel “normal” theamericanchiropractor.com. Dr. Kenneth Blum, the scientist who first described RDS, and Dr. Holder have postulated that spinal misalignments could be one hidden factor interrupting the brain reward cascade. They theorize that subluxations disturb the normal signaling in the nervous system including the limbic system, which is the brain’s emotional center and is intimately involved in addiction. By adjusting the spine and removing those interferences, chiropractic balances the brain reward cascade by helping dopamine to release. A well-aligned spine can help ensure the brain’s chemistry flows correctly, allowing the person to experience natural reward and well-being without needing a drug to trigger it.
This theory isn’t abstract. There is significant empirical evidence behind it in the form of research and case studies. A landmark clinical trial in the early 2000s tested the use of chiropractic adjustments in a standard addiction treatment program. The results were striking. Ninety-eight patients in a residential drug treatment facility were divided into three groups: one group received standard addiction treatment only, the second group received standard treatment plus a “sham” chiropractic adjustment (placebo adjustments with no real therapeutic force), and the third group received standard treatment plus genuine chiropractic adjustments to correct subluxations. The study, which was featured in the journal Molecular Psychiatry, found that the group receiving real chiropractic care had a 100% program completion rate. Every single one of them finished the 30-day rehab program. In contrast, the usual-care group and the fake-adjustment group had completion rates of 74% and 56%, respectively. Completing a treatment program is one of the strongest predictors of long-term sobriety so this was a marked outcome. Nationally, only about 70% of patients remain for the full course of a rehab program. Dr. Holder noted that this high retention was accompanied by other benefits: the patients who got adjustments made fewer visits to the nurses’ station, indicated fewer complaints of illness or withdrawal symptoms, and showed significant decreases in anxiety levels. It appears that the chiropractic care helped them feel better physically and emotionally, enabling them to stick with the difficult process of rehab. Holder attributed these successes to the chiropractic adjustments producing a “sense of well-being” in the patients, allowing them to engage more fully with counseling and group therapy without being as sidetracked by discomfort. In essence, the adjustments helped normalize their bodies’ responses, so that the patients could focus on recovery instead of being overwhelmed by pain, anxiety, or cravings.

Additional case studies bolster the argument that chiropractic can aid in addiction recovery. One published case report documented the treatment of a 63-year-old man with a 40-year history of cocaine addiction who had failed eleven previous rehab programs vertebralsubluxationresearch.com. In this instance, the patient underwent a regimen of Torque Release Technique (TRT) chiropractic adjustments (a specialized, gentle chiropractic method geared toward tonal and neurological balance) alongside standard residential addiction care. The outcome was that he finally achieved sobriety and successfully completed the program, a first after numerous relapses! The authors of the case report concluded that improving the spinal neural integrity and dopaminergic pathway function via chiropractic adjustments contributed to the patient’s improved brain-homeostasis and recovery. They postulated that by enhancing the efficiency of the brain’s reward pathways, the adjustments helped alleviate the patient’s Reward Deficiency Syndrome, leading to better retention in treatment and reducing the risk of relapse vertebralsubluxationresearch.com. While this is just one case, it aligns with the broader idea that chiropractic improves treatment outcomes by addressing a fundamental biological aspect of addiction: the underperforming reward circuitry.

Even when addiction is rooted in something like chronic pain, as often seen in the opioid crisis, chiropractic is a very powerful tool. Many people become addicted to prescription opioids due to unmanaged chronic back or neck pain. For these individuals, chiropractic care can provide pain relief without drugs, potentially breaking the cycle that leads from pain to opioid use to addiction. Research has shown that integrating chiropractic into pain management can reduce the need for opioids. A recent study in Canada followed financially disadvantaged patients with spinal pain who were on opioids, and it found that a course of chiropractic care coincided with statistically significant drops in both pain levels and opioid usage atlas.chiro.org. As the patients’ pain improved under chiropractic care, they required fewer opioid medications. This is an important finding for preventing opioid dependence. Large reviews back this up as well: a 2020 systematic review and meta-analysis of six studies found that patients with spinal pain who used chiropractic had 64% lower odds of receiving an opioid prescription compared to those who did not use chiropractic pubmed.ncbi.nlm.nih.gov. This suggests that chiropractic not only helps existing addicts but can also serve a preventive role by offering an alternative to opioid painkillers in the first place. For prospective patients who might be struggling with both pain and addiction, knowing that chiropractic addresses the root pain without feeding the addiction is a compelling reason to give it a try.

Why Prospective Patients Should Consider Chiropractic for Addiction Recovery

The emerging evidence and clinical experiences paint a hopeful picture: chiropractic care can be a valuable, effective addition to addiction recovery efforts. It provides a unique combination of benefits that target the exact issues many recovering addicts face: high stress, low mood, physical pain, and disrupted brain reward chemistry. All without introducing new drugs into the body! Here are some key takeaways for someone considering this approach:

  • Balanced Brain Chemistry and Reduced Cravings: Chiropractic adjustments may help normalize neurotransmitter and hormone levels. By removing interference in the nervous system, the body is better able to regulate dopamine, serotonin, endorphins, and cortisol. Patients often report feeling “lighter” or more at ease after adjustments. As we discussed, there are documented cases of anxiety reduction and cortisol normalization with chiropractic journal.parker.edu. With a calmer nervous system, the intense want for the substance can diminish. You’re essentially giving your brain a chance to reward itself naturally again.

  • Improved Mood and Well-being: Many recovering addicts suffer from anhedonia or the inability to feel pleasure early in sobriety. Chiropractic’s influence on endorphins and the reward cascade can help counteract this. Even a small endorphin boost from an adjustment can improve one’s mood and outlook. Dr. Holder’s clinical trial participants experienced a notable sense of well-being that helped them engage more positively in therapy. When you feel better, you’re more motivated to continue healthy behaviors and less inclined to “give up” and revert to drug use.

  • Stress Relief and Autonomic Calm: High stress is a notorious trigger for relapse. Chiropractic care induces a parasympathetic relaxation response. Muscles relax, breathing deepens, and as studies show, heart rate and blood pressure can decrease post-adjustment pubmed.ncbi.nlm.nih.gov. Over time, regular adjustments may train your autonomic nervous system to stay in better balance. Patients often sleep better and report fewer stress-related symptoms when under chiropractic care. This stress reduction is crucial, as it strengthens your resilience against cravings. Instead of a hair-trigger stress response that sends you seeking a fix, your body can react more calmly to challenges.

  • Chiropractic is Drug-Free and Holistic: One of the biggest advantages of chiropractic is that it is 100% drug-free and non-invasive. It doesn’t add any chemicals to your body; in fact, it aims to help your body produce the right chemicals on its own. This is especially important for someone healing from addiction, where the goal is to remove dependence on external substances. Chiropractic aligns with a holistic, natural approach to healing. It supports your body’s innate ability to recover. As a commentary in one chiropractic addiction article put it, “Chiropractic offers the public something conventional medicine cannot: a drug-free addiction treatment program.” You won’t be trading one dependency for another; instead, you’ll be empowering your body to function better.

While chiropractic alone does not replace the need for counseling or recovery programs, it can enhance them. By feeling physically and emotionally more stable, you can get more out of psychotherapy, support groups, exercise, meditation, and whatever other positive recovery activities you are engaged in. The story of the Miami rehab study is a perfect illustration: those who got adjusted could fully participate and complete the program, whereas others dropped out. Chiropractic helps unlock the patients’ capacity to heal by removing physical impediments to their progress. As a prospective patient, imagine being less tormented by withdrawal symptoms or mental fog; you could concentrate better on learning coping skills and rebuilding your life.

Addiction infiltrates every aspect of a person’s being: from brain chemistry and hormones to emotional health and physical wellness. Chiropractic care offers a compassionate, whole-person approach that acknowledges this reality. By focusing on the spine and nervous system, chiropractic taps into a central control mechanism that influences cravings, stress responses, and the ability to experience natural rewards. The research and cases discussed in this paper illustrate that aligning the spine can do much more than relieve back pain: it can recalibrate the body’s internal environment, making it more conducive to healing from addiction. Patients receiving chiropractic during addiction treatment have shown lower stress and anxiety, better program retention, less pain, and even reduced reliance on addictive pain medications dynamiclifesouthlake.comatlas.chiro.org. These are tangible, significant benefits for anyone on the journey to recovery.

For prospective patients reading this, the message is one of hope and encouragement. If you are struggling with addiction or in recovery and seeking every advantage to stay clean, consider chiropractic care as part of your plan. It is an extremely educational and empowering experience to learn how your body and nervous system contribute to your cravings and moods, and even more empowering to take steps to correct any imbalances. Chiropractic will not substitute for doing the personal work of recovery. You will still need support, counseling, and perseverance, but it can dramatically ease the physical and mental burdens of quitting a substance. It aligns perfectly with a drug-free life and can make that lifestyle more comfortable and sustainable by helping your body generate the hormones of happiness and calm from within.

Sources:

  1. National Institute on Drug Abuse (NIDA). Understanding Drug Use and Addiction: DrugFacts. NIH Publication, revised June 2018nida.nih.govnida.nih.gov.

  2. Holder, J.M. Interview in The American Chiropractor, “Addiction: A Unique Chiropractor’s Pursuit of the Source” (2010) – discussion of dopamine receptor gene A1 allele and Reward Deficiency Syndrome theamericanchiropractor.com

  3.  Research on Addiction (Miami Herald report, 2001). Chiropractic group in residential program had 100% completion vs 56–74% in control groups; also reduced anxiety and nurse visitsdynamiclifesouthlake.comdynamiclifesouthlake.com.

  4. Khan, M. et al. Annals of Vertebral Subluxation Research (2012). Case report: 63-year-old male with lifelong cocaine addiction achieved sobriety with Torque Release Technique chiropractic care adjunct to rehabvertebralsubluxationresearch.comvertebralsubluxationresearch.com.

  5. Passmore, S. et al. J. Canadian Chiropractic Association 66(2):107–117 (2022). Retrospective study: Chiropractic care in inner-city clinic associated with significant pain reduction and decreased opioid usageatlas.chiro.orgatlas.chiro.org.

  6. Corcoran, K. et al. Pain Medicine 21(2):e139–e145 (2020). Systematic review and meta-analysis: Chiropractic use linked to 64% lower odds of receiving an opioid prescription among patients with spinal painpubmed.ncbi.nlm.nih.gov.

  7. Zhang, J. et al. J. Manipulative Physiol Ther 29(4):267-274 (2006). Study showing one chiropractic adjustment improved heart rate variability and reduced pain, indicating a shift toward parasympathetic nervous system balance pubmed.ncbi.nlm.nih.gov

  8. Vernon, H. et al. J. Manipulative Physiol Ther 9(2):115-23 (1986). Controlled trial finding a significant increase in serum beta-endorphin levels shortly after a cervical spine adjustment, suggesting activation of the body’s natural pain-relief and reward chemistrypubmed.ncbi.nlm.nih.gov.

  9. Hughes, F. Journal of Contemporary Chiropractic 3(1):14-20 (2020). Case report: patient with anxiety and chronic neck pain saw decreased salivary cortisol and anxiety levels under chiropractic carejournal.parker.edu, supporting stress-reduction benefits of adjustments.

bottom of page