An estimated 140 people die from drug overdoses every day in the U.S. with about two-thirds of deaths linked to opioids. To address what is now considered the worst drug crisis in American history, a group of ACTCM students brought together TCM, western medicine and mental health experts to discuss how health practitioners can create a better model for patient care.
On October 7, 2018, Dr. Steven Tierney, Emeritus Professor, Dr. David E. Smith, MD, renowned addiction specialist and Robyn (Ra) Adcock LAc., UCSF acupuncturist and CSOMA executive director, discussed the path for integrated pain and addiction treatment, and the role of acupuncture and TCM in patient care. It befittingly opened with Dr. David E. Smith sharing a moment from his younger years when, on an LSD trip, he had the spiritual revelation that healthcare is a right. This idea later came to life in his famous Haight Ashbury Clinic and, more recently, his involvement with Healthright 360.
Top 5 Takeaways of the Opioid Panel Discussion
1. People Use Substances for Healing, Soothing and Pleasure
We will never medicate or treat ourselves out of the drug crisis in America. Instead, we must look at why people are using and abusing substances. Steven Tierney believes one reason is because people are confused about pleasure and desire. He leads Meditation & Recovery at the Zen Center in San Francisco and in his private practice he helps people feel good about pleasure without shame. Much of his work is grounded in the belief made famous by Johann Hari; that the opposite of addiction is not recovery; the opposite of addiction is connection.
2. The Connection Between Addiction and Acupuncture Lies in Grey Matter
Dr. Smith, who studies the brain, says there is a biological basis to addiction. Taking high doses of opioids or potent forms of marijuana is like putting a deep electrical probe into the grey matter of the brain and altering its neurochemistry. Similarly, acupuncture works by stimulating the receptors outside of the body to permeate the grey matter and possibly, reach as far into the brain as the dark matter. He notes that there are more receptors outside of the brain and body than inside the brain, and this teaches us why acupuncture works. It is Dr. Smith’s hypothesis that acupuncture even influences epigenetics (the study of biological mechanisms switching genes on and off).
3. Integration Requires Assimilation
Dr. Smith suggested that the future is bright for acupuncturists to integrate into Western medicine, but we have to be aware of how the current medical system operates and demonstrate we are well-equipped to effectively respond to the opioid epidemic. Because Dr. Smith has seen the power of Chinese medicine, he is highly motivated to support the integration of acupuncture with Western medicine and ensure we are compensated.
Ra Adcock added that in order to widely integrate acupuncture into the Western medical model, we all have to be pioneers and carve out a path for ourselves and future generations of acupuncturists. She believes it is our responsibility as acupuncturists to fully integrate our medicine into this country and create a new brand of “American acupuncture medicine.” We must learn enough biomedical language to communicate across the table without losing the poetic nature of our medicine that is inherent to the efficacy of it. If we want to see a more integrated system, we can’t just be clinicians. We have to do political work and fully understand the system.
4. Research Is the Language of Medicine
In order to make acupuncture available on a much wider scale in the treatment of opioid addiction and beyond, acupuncturists have to participate at the research level to prove our efficacy and to make a case for incorporating TCM into the Western medical system. We need more comparative studies that look at a Western standard of care vs. an integrative approach with acupuncture. One organization to have on the radar is PCORI (Patient-Centered Outcomes Research Institute), which cares about subjective data and comparative studies. By focusing on research, we can bring our medicine and its integrity to the table in a Western setting.
5. Kick Down the Wall like Mr. Kool-Aid
Ra Adcock has been a leading clinician for a number of integrative and non-pharmacological pain studies and she is currently onboarding as the first acupuncturist on the Integrated Pediatric Pain & Palliative Care team at UCSF. When asked about the state of integration at hospitals in addressing pain and how she got her foot in the door at UCSF she likened it to kicking down the wall like Mr. Kool-Aid — don’t hold back! Ra has inserted herself into the Western system largely by educating doctors, nurses, and Western providers by offering acupuncture to them through weekly treatments to demonstrate the power of the medicine. As she says, nothing sells the medicine like experiencing the needle itself. By tonifying the doctors and staff, we can support every patient that the staff sees. It’s clear that Ra is bringing a new energy to our profession and helping to create incredibly important changes in the Western setting.
The purpose of this event was to educate both practitioners and the general public on the holes and opportunities in the healthcare system, with the opioid crisis as a lens, as well as establish a dialogue between both CIIS and ACTCM communities. After an enlightening conversation it was clear that we have only just begun and there is an appetite for deeper and more specialized education on this important topic of our time. We are exploring the possibility of future events on the opioid topic.