Increasing Equity in Pain Management, Substance Use Disorder Treatment, and Linkages to CARE

❚ Interventional approaches: Image-guided and minimally invasive procedures, such as trigger point injections, neuromodulation, and sympathetic nerve blocks ❚ Behavioral approaches: Counseling to address the psychological, behavioral, and social aspects of pain, such as cognitive behavioral therapy, and acceptance and commitment therapy ❚ Complementary and integrative health : Mind-body behavioral interventions, osteopathic and chiropractic manipulation, acupuncture, massage, movement (e.g., yoga, tai chi), and spirituality Support groups and shared medical appointments Support groups and shared medical appointments are another important component of integrative pain management that may work well for health centers. 20 These facilitated groups meet weekly or biweekly, in person or online, to deliver education and teach skills on a variety of pain self management methods, such as mindfulness and acupressure, and they also provide a space for patients to feel heard and not alone. Integrative pain management program The Integrative Pain Management Program (IPMP) at the People’s Community Clinic, a health center in Austin, Texas, is a model program adapted from evidence-based best practices. IPMP offers an array of non-pharmacological strategies to help patients reduce chronic pain and improve quality of life (e.g., nutrition, yoga, acupuncture, therapy, and support groups), as well as onsite access to SUD treatment and a medical legal partnership. When working with each individual patient, IPMP providers: consider all possible biopsychosocial causes of the patient’s pain; talk with the patient about what tools can address those root causes; and ask the patient to choose which tools to try first. If a patient is not ready to engage in pain treatment due to other unmet needs, such as housing, immigration status, or an SUD, the IPMP team supports the patient in accessing those services.

Sharad Kohli explains the biopsychosocial model of care at IPMP.

20 California Health Care Foundation Pain management on a new track: Complementary therapies in the safety net ; 2016.

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