White River Junction part of statewide pilot program.
White River Junction acupuncturist Britton Mann is one of 12 Vermont clinicians participating in a pilot study on the impact of acupuncture on chronic pain patients who are also on Medicaid. The Vermont legislature appropriated $200,000 to fund the study as part of its effort to combat the opioid crisis.
The idea of the study isn’t so much to measure the efficacy of acupuncture on pain, but to see what happens if the Medicaid population is given access to the therapy. Fifty people will be recruited and offered treated from a dozen practitioners in Chittenden County, Montpelier and White River Junction. Questionnaires will collect information about intensity of pain, physical and social functionality, depression, sleep, fatigue and use of medication. The study ends on June 30 and a report will be submitted to the legislature in September.
The Observer spoke with Mann about acupuncture and chronic pain and how treatment can help everyone, not just those on Medicaid.
Let's start by talking about you. Have you had acupuncture treatment for pain?
As a young man, before I knew anything about Chinese medicine, I injured my neck while rock climbing. On a recommendation from a friend I got acupuncture and medicinal tea from a Taiwanese doctor in Boulder, Colorado. The relief was instantaneous after the acupuncture and sustained by the herbs. Since then I've had acupuncture for pain from my feet (plantar fasciitis) to headache, and just about everything in between.
What's been your professional experience treating people in pain with acupuncture?
Treating patients with pain is about a third of any given day in my clinic. I haven't come across a pain condition that isn't helped to some degree by acupuncture. Sometimes it is a little helpful, sometimes a lot... but if a patient is in chronic and debilitating pain, even a 20 percent reduction in pain can mean they are functional and able to engage in work and society again. Excellent research published in the most highly regarded biomedical journals has described the effectiveness of acupuncture for chronic lower back pain, osteoarthritis, headache, and various other conditions. This is one of the reason that states like Vermont, the National Institutes for Health, the military, and most teaching hospitals in this country have thrown a lot of resources into exploring application of acupuncture for pain.
Every person is different, but for the purposes of the test subjects being recruited for the grant, how frequently will they have come in for treatments?
On rare occasions acupuncture is a one-shot-wonder. For longstanding or stubborn pain, weekly visits are sometimes needed. There's a rule of thumb: one month of treatment for every year the patient has been suffering from the condition to gain resolution. I'm not fond of rules of thumb, but it speaks to the incremental nature of acupuncture and herbal medicine. The process of healing can be accelerated if the patient is motivated to change lifestyle habits. For treatment of pain this can and often includes diet change, weight loss, mindful exercise, and perhaps most importantly, cognitive and emotional changes. Healing from pain can induce profound and positive changes across a patient's life, from increased work productivity, better family relationships, and so on.
What if someone is in pain and is addicted to opioids, will acupuncture help with the pain and the addiction issues or just the pain?
In 2011-2012 I worked at the city-funded Hooper Detox center in Portland, Oregon. Inpatients with addictions to opioids, alcohol, meth, and just about every other drug were treated with acupuncture the very morning they were being admitted for treatment, and twice daily during their stay. Pain management aside, there's a good track record for acupuncture dealing directly with addiction. One proposed mechanism explaining this is that during acupuncture, the patient's body produces and releases its own natural opioids, so there is less craving for that lift from the outside. During my time at that detox center, and at the other two city-funded health clinics where I worked, I saw people in very bad shape become calm during and after acupuncture. I can't give exact numbers for recidivism, but it certainly seemed that for a short period of time, those patients gained some perspective on their situation.
Acupuncture has good track record as a treatment for pain and addiction says Britton Mann.
If you, or know someone who, may be interested in joining the study, here's the skinny. Participants will be eligible for the study if they meet all of the following inclusion criteria:
At least 18 years of age
Qualifying Pain score for at least 15 out of the past 30 days and for at least the past 3 months.
Enrolled for Vermont Medicaid services
Able to read and understand English
Able to understand and sign a consent form.
Participants will be ineligible for the study if they meet any of the following exclusion criteria
• Start of a new treatment for pain or any acupuncture treatment within the 4 weeks prior to the onset of
treatment in this trial
Concurrent participation in any other clinical trial
Conditions that make treatment difficult: paralysis, psychosis, schizophrenia.
Possible contraindications for acupuncture: pregnancy, untreated coagulation disorders, untreated seizure disorders.