Integrative solutions for worsening opioid crisis, rising impact of healthcare disparities

The integrative healthcare community knows our nation is suffering from a serious infectious disease. Like a human body with pre-existing chronic illness, the novel coronavirus (COVID-19) has laid bare the underlying conditions afflicting our country’s health system.

Healthcare disparities, inequities, and racial biases have long blocked access to care for the nation’s communities of color and vulnerable populations. Nowhere is this more evident than in the link between the already raging opioid crisis and existing barriers to treatments for acute and chronic pain which affects more than 50 million people nationwide.

Pain is one of the most common symptoms seen and treated by primary care providers. America’s largest primary care safety net, caring for more than 30 million people, are the Federally Qualified Health Centers (FQHC’s), otherwise known as Community Health Centers. FQHC’s receive funds from the Health Services & Resources Administration (HRSA) Health Center Program to provide primary care services in underserved areas. FQHC’s are one of the crucial front-line battle grounds for pain management services.

In 2019, a landmark federal report, impacting practitioners and pain sufferers alike, was published by the Department of Health and Human Services 29-member, interagency Best Practices in Pain Management Task Force report. The report endorsed five broad pain treatment categories using a multidisciplinary approach across various disciplines, including a range of complementary and integrative health treatments like acupuncture, chiropractic, and mindfulness meditation, to be used either as a first line therapy, in conjunction with, or in place of prescription drugs. 

Before the pandemic hit, FQHC’s frequently struggled to make ends meet even with HRSA funds. FQHC’s, driven by passionate and forward-looking practitioners and administrators, found creative ways to fund and pilot innovative integrative programs including collaborative, integrative pain management.

A feature that makes FQHCs suited to integrative programs is that the care is already integrated. Most FQHCs are Patient Centered Medical Homes (PCMHs) which use a collaborative model that combines primary care, behavioral health, dental, and other supporting services that also address social needs and upstream determinants of health. It is a straightforward step to add integrative treatments to this infrastructure. For example, the People’s Community Clinic in Austin, Texas offers an Integrative Pain Management Program that has comprehensive pain care consisting of trauma-informed behavioral health services, nutrition, acupuncture, substance use services, a medical-legal partnership, group visits, and more. 

More of these multidisciplinary programs are needed in our nation’s Community Health Centers as well as private and academic centers. That means greater awareness of the report data and greater funding. To that end, on July 24, the Congressional Integrative Health and Wellness Caucus and the Integrative Health Policy Consortium (IHPC) will hold a virtual Capitol Hill briefing, which will be free and open to the public.

The briefing will feature presentations from Vanila Singh, MD, the immediate past Chief Medical Officer in the US Department of Health and Human Services and was Chairperson of the highly regarded HHS Task Force, and Sharad Kohli, MD, a family physician at the People’s Community Clinic. More information can be found here.

Editor’s note: David Fogel, MD is the chief executive officer and co-founder of CHI Health Care and at-large board of director and co-chair of the Policy Committee for the IHPC. This article is sponsored by the IHPC.