As trusted providers on the frontlines, Community Health Centers are uniquely positioned to respond to complex and challenging public health problems. Right now one of those problems is the national epidemic of opioid abuse. Every day in the U.S. over 40 people die from overdosing on prescription painkillers, and many more are becoming addicted, according to the Centers for Disease Control and Prevention (CDC). The widespread addiction to painkillers is also spurring the sales of a much cheaper alternative on the street — heroin.
Family Care Health Center in St. Louis, MO, is among the hundreds of health centers diligently working to counter the opioid epidemic with innovative collaborations and approaches. The health center has been working with Logan University since November to provide chiropractic care to patients in an effort to reduce dependency on painkillers, along with Myrtle Hilliard Davis Comprehensive Health Centers. (see article, St. Louis Post-Dispatch)
“This is one avenue of helping with pain problems,” explained Mattie White, MD, a family medicine doctor at Family Health Care Center. “Our goal is to keep acute problems from becoming chronic problems.”
According to Dr. White, up until the program launched, there were few treatment options beyond exercise or over-the-counter pain medicines for patients, who are largely low-income and uninsured. Many patients struggle with back problems or injuries and were highly medicated. Now patients who take part in the program, which is housed in the Logan Chiropractic Community Outreach Clinic, receive an initial evaluation with assessment tools that include measuring pain levels and depression. Patients get up to 6 to 12 follow up visits and a treatment plan that may include alternate therapy options. ”
The challenge is to reduce the addiction to painkillers while managing a patient’s pain level. While it is still too early to measure success, Dr. White says the results are encouraging and the staff Family Care, which has an impressive integrative focus on behavioral health, is learning a lot about the link between opioid addiction and depression.
“There recently was a great study published at St. Louis University looking at chronic opioid use as an independent risk factor for depression,” she said. “Once on chronic pain medications what happens is that we’re treating the tolerance. People develop a level of tolerance with the pain medication; the patient hurts worse when the pain medication wears off so it doesn’t do the job anymore, and from then on we’re feeding that tolerance. After a while, one gets into a trap of pain and there is no way out.”
Family Care has received a high volume of referrals and appointments for the program, enough to begin the discussion about widening the availability of services. “I think this is making a big difference,” said Dr. White. “We are already talking about starting a pain focus group so that we can look at avenues to improve function among our patients with chronic pain.”
According to the CDC, the amount of painkillers prescribed and sold in the U.S. has nearly quadrupled. Health and Human Services (HHS) Secretary Sylvia M. Burwell announced $94 million in funding to 271 health centers in 45 states, the District of Columbia, and Puerto Rico to improve and expand the delivery of substance abuse services in health centers, with a specific focus on treatment of opioid use disorders in underserved populations [see press release].