Shortly after my recent post, “How the Backlash to Oregon’s Plan to Taper Opioids with Integrative Approaches Missed the Mark”, I received an e-note from national pain leader Sean Mackey, MD, PhD. The letterhead of the chief of the division of pain medicine at Stanford University and co-chair of the US HHS National Pain Strategy was the vehicle through which Mackey and 100 co-signers successfully campaigned for the Oregon Health Authority to prevent forced tapering “of certain patient populations.” Mackey wrote that he presumed we had shared interests in bettering care, yet he thought there was a harmful “negativity” in my article: “May I suggest rather than a ‘missed opportunity’ message, you could easily frame it as ‘forced opioid tapering defeated – here is what we need to do next …'”
When Oregon announced in 2016 that it would shift its back and neck care for Medicaid clients from opioids toward acupuncture, spinal manipulation, massage, yoga therapy and mind-body methods, it was heralded as a breakthrough for pain treatment nationally. Inside that policy was a mandate many now consider even bigger news. Doctors were required to totally taper patients off opioids. A backlash propelled by a letter signed by over 100 conventional pain academics nationwide – plus with one notable signer from the integrative pain community – stopped Oregon’s planned expansion of the model in its tracks. While there are good reasons for caution on mandatory tapering, the one-sided reactivity missed a chance for practitioners and patients alike to gain more experience with non pharmacologic tools to rein in the known abuses associated with opioids.
From the perspective of research contributions from academic institutions in integrative health, the 7 multidisciplinary universities have been key important contributors. These institutions, with one exception, are products of the last 20 years of advance of complementary, integrative and non-pharmacologic approaches in US health care. Each began as a professional school for chiropractic doctors, naturopathic doctors or acupuncturists then chose to expand its offerings for bird-of-a-feather programs, morphing into universities of integrative, natural health sciences. Part 1 of this series, “The Future of Integrative Health – Interviews with Presidents of 7 Multidisciplinary Universities”, examined the cornucopia of their present offerings. Part 2 offers an examination of the current place of research in these integrative health universities as the nation begins to call on their practices and practitioners in developing a new chronic pain strategy.
The recent global activity featured in the Integrator Blog News and Reports and re-posted by ISCMR, an international society of researchers in traditional, complementary, alternative and integrative medicine and health, has shown an unmistakable pattern: multiple governments are acting to remove recognition of homeopathy and certain of other complementary and integrative practice deemed “psuedo-scientific.” It’s not the only pattern. There hjave been recent positive governmental steps in Switzerland, India, the US and elsewhere. Still, the regulatory integrative ectomies in Spain, France, the UK, Australia, Canada – and here in the USA – are worth a collective heads up.