Many mainstream health care organizations have been reluctant to embrace such complementary therapies as massage.

As the opioid crisis has raged out of control across the U.S., more of these organizations are turning to nonpharmacological alternatives to opioids.

Among them is University Hospitals, a health care system of 18 hospitals, more than 50 outpatient health centers, and hundreds of physicians’ offices throughout northern Ohio.

According to the National Institutes of Health’s National Institute on Drug Abuse, Ohio is among the top five states with the highest rates of opioid-related overdose deaths.

The state has taken an aggressive, multipronged approach to its opioid crisis. Among its strategies is the Ohio Opioid Technology Challenge, a state-sponsored program to spur technology-based solutions to address the state’s opioid epidemic.

UH, as it is colloquially known, won a $200,000 award from the Ohio Opioid Technology Challenge last fall for its new discharge planning process, called UH Care Continues. As the UH Care Continues program is launched across the hospital system, it will link to the Connor network to more efficiently connect patients with opioid alternatives, including nonpharmacologic treatments such as massage therapy, which is an in-demand service.

Opioid Alternatives

The UH Care Continues program, which the health system just began rolling out, aims to use technology tools to support patients prescribed opioids following hospital discharge. It also aids clinicians, helping them determine potential opioid alternatives for their patients and identify which patients may be at risk for addiction before discharging them from the hospital.

“Routine opioid prescriptions are no longer an acceptable approach at the time of hospital discharge. Accordingly, UH is thoughtfully using technology to be more intentional, supporting physicians and other clinicians in considering each patient’s needs, risks, preferences and alternatives as part of our new discharge planning process,” said Eric Beck, DO, MPH, in a press release.

Beck is an emergency medicine physician at UH and also serves as president of the hospital system’s business innovation arm, which designed the UH Care Continues technology.

UH has been ahead of the trend of using complementary modalities in patient treatment. In 2011, it opened the Connor Integrative Health Network, a system-wide program that combines Western medical treatments with complementary modalities, such as massage therapy, acupuncture, meditation and yoga.

“We’re fully integrated in the hospital system,” said Christine Kaiser, LaC, a licensed acupuncturist and Chinese herbalist who serves as the clinical manager of acupuncture and massage therapy at the Connor Integrative Health Network.

Christine Kaiser, LaC

Like physicians and other clinicians in the health system, Connor network practitioners use the health system’s electronic health record. This enables everyone to see each other’s notes for their patients and allows direct communication for collaborative teamwork.

A Growing Initiative

In the years since opening, the Connor Integrative Health Network has experienced a lot of growth, she said. In-system physician and clinician referrals continue to climb, and in 2017, UH received a $6.5 million grant to increase hiring, training and research. The Connor network recently opened a second fully staffed office and will open a third office later this year.

Massage therapy is one of the biggest service lines UH’s Connor network offers, Kaiser said. The Connor network has a “pretty big team” of eight massage therapists who are employees rather than independent contractors. Massage therapy is a big component of nonpharmacological treatment partly because it is the complementary therapy people – patients and clinicians – are most familiar with, she said, and there is a lot of research supporting its benefits, which makes it easier for physicians to recommend.

Connor network practitioners also do a lot of in-health system education, she said. They go on grand rounds with physicians, which allows them to present the research that has been done demonstrating the benefits of complementary therapies and educate doctors on what opioid alternatives are available; furnish an integrative medicine physician assistant who works as a complementary medicine consultant for clinicians who may not be sure what modality is the best fit for a patient; and offer services, such as massage therapy and acupuncture, to physicians and other clinicians so that they can experience these services firsthand.

While educating mainstream physicians and clinicians about what integrative medicine has to offer is certainly a big part of why the Connor Network program is growing, the opioid crisis, she said, “opened people’s eyes” to the reality that pain medications weren’t working and that opioid alternatives are needed.

Drug-free Interventions

Respected health care facilities across the country, such as Mayo Clinic, Intermountain Healthcare and Duke University Health System, among others, have launched major integrative medicine programs, and organizations that set health care practice standards have also been updating practice guidelines in response to the opioid crisis to support the use of nonpharmacologic pain-management treatments.

Among those organizations, the American College of Physicians, a national member organization of internal medicine physicians, updated its low back pain guidelines in 2017, recommending that non-drug therapies, including massage, be offered as the first line of treatment.

And The Joint Commission, a nonprofit that accredits hospitals and other health care organizations and sets performance and quality standards for the health care industry, is requiring, since last year, hospitals to provide nonpharmacologic pain treatment modalities, such as massage therapy, to avoid or reduce the use of opioids.

The updated practice standards, the staggering statistics associated with opioid abuse, and consumers themselves, are all driving the trend of mainstream health care organizations turning to complementary therapy modalities such as massage therapy, said Francoise Adan, MD, the medical director of UH’s Connor Integrative Health Network.

Francoise Adan, MD,

That trend, she said, is only going to accelerate. “I really believe that within the next few years, we are going to see a change in policies and insurance coverage because the momentum now is virtually unstoppable,” she said. “The evidence in research, consumer requesting, the response to the opiate crisis — everything is in alignment.”

About the Author:

Stephanie Bouchard is a freelance writer and editor based on the coast of Maine. She frequently reports news and features for MASSAGE Magazine; her articles include “Licensure for Ayurvedic Practitioners May be Coming Soon” and “Utah’s Intermountain Health Care System Values Massage Therapy for Patients.”