MATTERS OF NOTE

Acupuncture in the Emergency Room Abbot Northwestern Hospital in Minneapolis, Minnesota, is conducting a pilot study in their Emergency Department to determine if acupuncture can help reduce pain, anxiety, and nausea in emergency room patients. It is already proving so successful that Allina is planning on deploying acupuncture in the emergency room at its new WestHealth clinic site. The program began when Research Director Jeff Dusek, PhD, received a philanthropic donation to look at the provision of acupuncture in the emergency room. Dusek worked with acupuncturist Adam Reinstein, LAc, and Chris Kapsner, MD, the medical director of the Abbott Northwestern Emergency Department, to design the study. “The emergency room physicians had told us that they wanted options other than medications to help control pain, anxiety, and nausea,” Dusek explained.

Healing. “And when these patients start to get medicalized, that stress and anxiety can increase even more.”

Courtney Baechler, MD

Jeffrey Dusek, PhD “There was also a real recognition that many people who go to the emergency room have conditions with a stress and anxiety component,” explained Courtney Baechler, MD, Vice President of the Penny George Institute for Health and

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Before starting the pilot study, Reinstein shadowed in the department for several months, educating both the clinical and administrative staff on what acupuncture was and the conditions for which it could be used. “That helped develop cultural awareness that Adam was going to be part of the Emergency Department team and what kind of patients would be appropriate for an acupuncture intervention,” explained Dr. Kapsner. Many of the staff even received treatments themselves during this training period. The pilot study was designed so that Reinstein works in the emergency room for a variable period of time (e.g., one or two weeks) and is then off for variable period of time (e.g., one or two weeks). This schedule enables the researchers to collect comparison data and to begin to answer questions such as, “Can pain be managed with non-pharmacologic treatments? Are less pain medications used?

Does the Emergency Department function better when some patients receive acupuncture? One of Dr. Baechler's patients, whom she was seeing at the Penny George Institute for Health and Healing, was experiencing paroxysmal atrial fibrillation, or short episodes of increased heart rate. Even though the patient was not comfortable in conventional medicine settings and preferred a more natural approach, Dr. Baechler sent her to a conventional cardiologist for an electrocardiogram. “I really felt that we should look at the test data and she agreed,” explained Dr. Baechler. But while getting the cardiology tests, the patient started to become increasingly anxious and went into atrial fibrillation. The cardiologist immediately sent her to the Abbott Emergency Room. Even though it was a week when the Reinstein was not providing services in the emergency room, the culture had changed so much that the attending physician called Reinstein to see if he would be able to treat this patient. The emergency room physician put the patient in a room and turned on some relaxing music for her. Then Reinstein came to the emergency room and gave her a 20-minute acupuncture session. At the end of the treatment, the patient's heart rate had normalized. “This was a person who traditionally would be admitted into the hospital and given medications to slow their heart rate,” explained Dr. Baechler. “But after 20 minutes of treatment she was released and she walked home.” Dr. Baechler added that, “My patient was so thankful to have that experience to heal the way she wanted to heal, but she was also thankful to be in a setting where if things got worse and she needed conventional treatment, it would be available. I think this is really the type of care we should be offering everyone.”

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Integrative Healthcare Reducing Opioid Use at VA

Adam Reinstein, LAc Reinstein has treated more than 200 patients since the pilot study began in November 2013. “It is exciting to have this opportunity to integrate acupuncture into the Emergency Department. I am encouraged by the overwhelmingly positive acceptance of acupuncture by both the patients and staff,” says Reinstein. While the original philanthropic funding for the pilot study will eventually run out, Dusek has just been awarded an administrative supplement to his NCCAM grant. “It's a CAM practitioner award for individuals who are trained in different CAM modalities to have an opportunity to learn about research,” Dusek explained. “This award will allow Adam to discern whether he wants to continue his research education and also allow him to move from a pilot study into a formal research study over the next year.” The challenge, according to Dusek, will be sustainability after the research support ends. His plan is to gather enough data to show that acupuncture is clinically relevant and cost-effective through the reduced use of pain medications, improved patient satisfaction, and perhaps averting some hospital admissions, which could then incent administrations to pay for the position. “We are very encouraged at this point,” said Dusek. “The project has been extremely well received by the emergency physicians because it gives them another tool by which to treat pain and anxiety.”

Matters of Note

There is some good news coming out of the Department of Veterans Affairs (VA) these days. Launched in October 2013 in Minneapolis, Minnesota, the Opioid Safety Initiative (OSI) is a multi-faceted approach to reduce the use of opioids among America’s Veterans using VA healthcare. OSI incorporates the team approach with the goal of reducing opioid use by alleviating a Veterans’ pain using nonprescription methods, with an emphasis on patient education, close patient monitoring and integrative practices like acupuncture and behavior therapy. OSI is already demonstrating success in lowering dependency on opioids. At eight sites of care in Minnesota, OSI practices have decreased high-dose opioid use by more than 50%.

for the State of Washington (1997–1999); three Integrative Medicine Industry Leadership Summits which involved leaders of all healthcare stakeholders (2000–2002); the National Policy Dialogue to Advance Integrated Care: Creating Common Ground (2001); the Integrated Healthcare Policy Consortium, for which he served on the steering committee (2002–2008); Collaboration for Healthcare Renewal Foundation (2001–2004); and organizing and directing the National Education Dialogue (NED) to Advance Integrated Healthcare: Creating Common Ground (2004–2006).

“The Opioid Safety Initiative is an example of VHA’s personalized, proactive and patient-centered approach to healthcare,” said Dr. Robert Petzel, VA’s Under Secretary for Health. “We are delivering healthcare with the patient’s long-term personal health goals at the forefront.” For further information, Veterans should contact their primary care health team. To learn more about VA health care, visit www.va.gov.

Weeks Receives Lifetime Achievement Award John Weeks was recently honored for his three decades of work in advancing integrative healthcare at the 2014 International Research Congress of Integrative Medicine and Health with a Lifetime Achievement Living Tribute. Weeks co-founded the Academic Consortium for Complementary and Alternative Health Care (www.accahc. org) and currently serves as its executive director. Over the last three decades, he helped organize many multidisciplinary collaborative forums among disciplines and stakeholders, including the Clinician Work Group on the Integration of CAM for the Office of the Insurance Commissioner

John Weeks Perhaps best known for his work as publisher and editor of The Integrator Blog News & Reports, he also regularly writes for IntegrativePractitioner.com, The Pain Practitioner, Integrative Medicine: A Clinician’s Journal and the Huffington Post. Weeks has consulted and presented widely on integration strategies for numerous hospitals, complementary healthcare educational institutions and professional associations, managed care firms and conventional academic health centers. He served as a consultant to the World Health Organization's 2014–2023 Traditional Medicine/CAM strategic plan. Spearheaded by FON Therapeutics, tribute sponsors included the Consortium of Academic Health Centers for Integrative Medicine, the Integrative Healthcare Policy Consortium, the Academic Consortium for Complementary

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and Alternative Health Care, the Foundations of Naturopathic Medicine Project, Integrative Health and Wellness Strategies and others. The e-book is available for free download at: http://fontherapeutics.com/resour ces/fon-presents-a-living-tribute-to-integrati ve-medicine-pioneer-john-weeks/

To become licensed in Maryland, a naturopathic doctor must attend a fouryear naturopathic medical school that is accredited through the U.S. Department of Education. For more information: www.naturopathic.org.

Schwartz Recieves Faculty Appointment More States Granting Licensure for Naturopathic Doctors Maryland recently became the newest state to grant licensure to naturopathic doctors, bringing the total to 18 states. Maryland Governor Martin O'Malley signed the bill that enables naturopathic doctors in Maryland to become licensed to practice naturopathic medicine after it received strong bipartisan support. According to Dr. Emily Telfair, president of the Maryland Association of Naturopathic Physicians, “The law will lead to greater access to doctors who emphasize disease prevention, healthy lifestyles, and natural therapies. It will also enable consumers to distinguish between licensed doctors who meet extensive education and training requirements and others who call themselves naturopaths but do not meet the state's rigorous licensing standards.”

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EXPLORE columnist Stephan Schwartz (The SchwartzReport) has recently been appointed as a Distinguished Consulting Faculty at Saybrook University. The appointment is in the Consciousness, Spirituality, and Integrative Healthcare department of their school of Psychology and Interdisciplinary Inquiry. Located in San Francisco, Saybrook University is a leading educational institution for humanistic studies. Stephan A. Schwartz is the editor of the daily web publication The SchwartzReport (http://www.schwartzreport.net), which concentrates on trends that will shape the future, an area of research he has been working in since the mid-1960s. Previously, he was the Senior Samueli Fellow in Brain, Mind and Healing at the Samueli Institute. For over 35 years, Schwartz has also been an active experimentalist, doing research on the nature of consciousness, particularly Remote Viewing, healing, creativity, religious ecstasy,

and meditation. He is the author of several books and numerous papers, technical reports, and general audience articles on these topics.

Naturopathic Archives Release Online Library Naturopathic Doctor News and Review (NDNR) recently announced the release of its Library, a free online directory of nine years of published issues in an eversion format. NDNR covers the practice of naturopathic medicine. Every issue covers varying clinical themes with pertinent case studies, clinical research, and discussions on the usage of nutraceuticals, botanicals, IVs, injection therapies, homeopathy, and countless other naturopathic modalities. All content is free in an effort to provide education to all those interested in naturopathic medicine. To access the Library, visit www.ndnr.com/library.

Matters of Note is compiled and written by Bonnie J. Horrigan, editorial director for EXPLORE: The Journal of Science and Healing and author of Voices of Integrative Medicine: Conversations and Encounters.

EXPLORE September/October 2014, Vol. 10, No. 5

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