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 past 20 years witnessed the expansion of a new type of institution in academic health care – and specifically in integrative health and medicine: multidisciplinary universities with professional degrees in multiple natural health fields. Variously denominated as universities of “natural health sciences” or “health sciences” or “integrative health” or merely as “university,” these 7 institutions were each founded as single purpose colleges to educate chiropractors, naturopathic doctors or acupuncturists. They expanded to include other disciplines, degrees and certifications. Many have played important roles in the integrative health movement. All sit at the intersection of two fields in turmoil: health care and higher education. I interviewed the presidents of each to access their vantage points. This overview is a first in a two-part series.