The Role of Acupuncture in Treating Opioid Addiction: Outcomes of a Community Acupuncture Program

Transcription

1 The Role of Acupuncture in Treating Opioid Addiction: Outcomes of a Community Acupuncture Program Guinevere Crescenzi, LAc., MOM, NCAAOM, Dipl., NADA Spec. WellSpan Center for Mind/Body Health

2 Financial Disclosures In accordance with ACCME Standard 6: Disclosures Relevant to Potential Commercial Bias An individual must disclose to learners any relevant financial relationship(s). The following in control of content has no relevant financial relationships to disclose. Guinevere Crescenzi, LAc., MOM, NCAAOM, Dipl., NADA Spec. 2

3 Primary Learning Objectives Overview of acupuncture & conditions treated Description of NADA protocol Effectiveness of NADA protocol in treating opioid addiction How we set up a Community Acupuncture program Outcomes of the recent grant project with WellSpan Center for Mind/Body Health Demonstration & Questions 3

4 What is Acupuncture? Acupuncture is a technique in which practitioners stimulate specific points on the body most often by inserting thin needles through the skin. It is one of the practices used in traditional Chinese medicine (TCM). It is often used in conjunction with other TCM techniques such as moxibustion (heat stimulation), acupressure (finger pressure), massage & lifestyle counseling. 4

5 Some Conditions That Acupuncture Can Treat Vomiting & nausea after surgery Chemotherapy side effects Dental aches Headaches & migraines Addiction Body aches & pains Asthma Stroke 5

6 What is the NADA Protocol? The National Acupuncture Detoxification Association (NADA)- standardized 3 to 5 point ear acupuncture protocol, born of a community-minded response to turbulent times not unlike today, has evolved into the most widely implemented acupuncture-assisted protocol, not only for substance abuse, but also for broad behavioral health applications. (Stuyt & Volyes, 2016). 6

7 Points on the Ear for NADA Protocol 7

8 NADA Protocol the use of acupuncture in the treatment of addiction is a relatively recent phenomenon. A mid-twentieth-century French neurologist, Nogier, created a systemized map correlating the ear to the rest of the body. This makes it theoretically possible for practitioners to stimulate ear points and effect change in the area of the body which is represented on the ear (Stuyt & Volyes, 2016). 8

9 Opioid Epidemic in the USA Acupuncture could play a significant role in combating the opioid epidemic that is raging in the USA, according to a white paper by authors from acupuncture organizations including the American Society of Acupuncturists, the Acupuncture Now Foundation and the Joint Acupuncture Opioid Task Force. Official figures show that opioid overdose kills 91 Americans every day and more than half of these deaths involve prescription opioids. The 21-page white paper was published a week after the US National Association of Attorneys General (NAAG) wrote to health insurance companies asking them to review their payment policies in order to promote alternatives to opioids including physical therapy, acupuncture, massage and chiropractic. Acupuncture is recommended as a powerful, evidence-based modality that can be employed as a first-line, non-pharmacologic method for pain relief and management. The authors explain how acupuncture can safely, easily and cost-effectively be incorporated into diverse medical settings, resulting in dramatically decreased healthcare expenditure, both by treating acute pain and avoiding addiction to opioids that requires costly care, destroys quality of life and can lead to fatal overdose (Herman, 2018). 9

10 Background of the Program WellSpan Center for Mind/Body Health (CMBH) has been in existence since 1999 operating 2 locations (Gettysburg & York). Team of 35 Licensed Massage Therapists, Licensed Acupuncturists, support staff & leadership. CMBH supports initiatives across the health care organization including programs which support employee wellness, addressing health issues such as pain, headaches, cancer (to name a few) & vulnerable populations in the communities that we serve. In October 2017, WellSpan Health received 1 of 4 Pennsylvania Coordinated Medication Assisted Treatment (PacMAT) grants from the Pennsylvania Department of Health. CMBH was engaged to offer Community Acupuncture to patients receiving MAT in conjunction with other supportive therapies. 10

11 Setting Up the Program Liaised with leadership from Family First Community Health to utilize space in their S. George Street location that was convenient for patients & easy to get to via public transportation, car or walking. Flyers were created & there were weekly calls with stakeholders of the PacMAT grant project. Patients were referred through a variety of methods including providers, treatment facilities & themselves. Billing components were set up on the back end to ensure patients did not receive a bill for these services. This involved several departments within the organization working together. Supplies were ordered including zero gravity chairs, acupuncture needles, etc. Patients were given reminder calls about their appointments for their sessions. The first session of PacMAT Community Acupuncture was held from February 7, 2018 through March 14, Patients completed Outcomes Assessments at each session. 11

12 Assessment of Pain at Start/Conclusion Pain Assessment Sum of Pain Assessment Start Sum of Pain Assessment End 12

13 Overall Pain Reduction Percentage of Pain Reduction Results 45% 55% Yes No 13

14 30 Assessment of Stress at Start/Conclusion Stress Assessment Sum of Stress Start Sum of Stress End 14

15 Overall Stress Reduction Percentage of Stress Assessment 19% No Yes 81% 15

16 Anecdotal Remarks from Outcomes Assessments Made me extremely relaxed and lowered anxiety. Very relaxing; I enjoyed it. I'm very relaxed. Thank you very much. I feel very relaxed and calm. My pain in my neck feels better. I can really tell a difference. It was a great new experience. This was exciting to feel. :-) I m very relaxed right now :-) It worked a lot. I feel wonderful - thank you so much. I had such a beautiful experience today. I felt out of body and so relaxed. I enjoyed this session so very much. Thank you :-) I feel so relaxed and hardly have any pain at all. It's so amazing how much different I feel after having a session. Thank you! :-) I love the acupuncture class and the women who run it. They are very nice and informational. I was semi stressed before the session today and felt more relaxed and less stressed after. I always feel relaxed and less stress after I come. I am happy with the results in the area of my neck/shoulder pain. It seemed to help a lot and the instructor was very informative and nice. Thank you for all of this. My stress is from having/raising an autistic /ADHD daughter and it's been very hard but since coming here, I feel so amazing so thank you. Since coming here a lot has changed for me. I am on the suboxone program and was having issues lowering my dose but since coming here I knocked off 2 mg and I feel amazing. Thank you so much. These sessions really help! I was skeptical but very glad I decided to come! 16

17 Summary of the Program 55% of patients experienced a reduction in their pain. 81% of patients experienced a reduction in their stress levels. Patients benefit from incorporating acupuncture into their regimen of care for their recovery program, both physically and emotionally. 17

18 The NADA protocol is a very straightforward and low-cost tool that is not a stand-alone procedure, but aids in behavioral health treatment and recovery (Stuyt & Volyes, 2016). 18

19 Demonstration & Questions 19

20 Thank you. Anika Jackson, Director, Substance Use Services at Family First Health All the staff at CMBH Dr. Sonia Del Tredici, WellSpan Health Family First providers & Staff Patients who graciously took part in the PacMAT program White Deer Run Treatment Facility 20