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Combatting the opioid epidemic: One student’s innovative approach in Idaho

A shared medical appointment pilot program might be the answer for farmers struggling with chronic pain and opioid dependency.

Editor’s note: This essay was originally published by Pacific Northwest University of Health Sciences College of Osteopathic Medicine News and has been edited for The DO. It has been reposted here with permission.

According to the National Institute of Health, pain affects more Americans than diabetes, heart disease and cancer combined, and stands as the most commonly cited reason for people accessing the health care system each year. It is the most common cause of long-term disability, and treatment with opioids is often viewed as one of the major contributing factors to our nation’s ongoing opioid epidemic.

The devastating effects of chronic pain are visible across the United States, and especially apparent in rural communities. Despite its size—approximately equivalent to the entire state of Rhode Island—the expansive landscape of Lincoln County, Idaho, is home to only around 5,300 people, most of whom work in the farm industry. The labor-intensive and often dangerous demands of farming are complicated by our nation’s overwhelming need for health professionals in rural communities.

Six generations of Jacob Thatcher's family have farmed in Idaho.

Jacob Thatcher, OMS III, has witnessed the devastation first-hand. Six generations of Thatcher’s family have farmed the fertile lands of Idaho, and he has seen the price they’ve often paid for their hard work and dedication.

“Over 60 years of hard work have taken a toll on my grandpa,” says the Pacific Northwest University of Health Sciences College of Osteopathic Medicine student. “Initially, the opioids controlled my grandpa’s pain enough to continue farming, but soon, it was his dependency on them that would prevent him from continuing our family tradition.”

Thatcher’s family took his grandfather to countless medical appointments, including those for osteopathic manipulative treatment, to combat his pain, but it soon became apparent that his inability to control the pain, coupled with his hesitancy to talk about his opioid abuse, were a problem facing not only the Thatchers, but also countless farmers throughout the region.

Determined to do something for his family and his community, Thatcher applied for and was chosen to be a scholar at the Paul Ambrose Scholars Program, which prepares students in health professional programs to be leaders in addressing population health struggles.

Scholars arrange and complete projects which aim to achieve the goals of Healthy People 2020, the federal government’s prevention agenda for building a healthier nation. Thatcher set his project’s crosshairs on substance abuse.

In conjunction with the Shoshone Family Medical Center and the Hazelden Betty Ford Foundation, and a grant from the Health Resources and Services Administration, the program has provided scholars with tools to begin exploring options to improve the lives of the people in rural communities like Lincoln County. A micro-research RuralPREP grant through the University of Washington and Ohio University Heritage College of Osteopathic Medicine is helping to provide the funds necessary for the program to be successful.

Thatcher has started hosting bi-monthly shared-medical appointments to evaluate the effectiveness of treating patients with chronic pain. The appointments, which offer an innovative, interactive model of health care by bringing patients with common needs together with one or more health care providers, have been largely untapped in regards to treating chronic pain, Thatcher says.

According to a meta-analysis published in The Journal of the American Osteopathic Association, SMAs have been shown to be more effective than the traditional office visit at not only motivating patients, but also reducing hospital admissions and emergency department visits, which is particularly crucial in rural health care settings where resources are limited, practitioners are overburdened and more health care professionals are desperately needed.

Today, Thatcher’s grandpa is improving. Though his pain is still debilitating, he has discovered alternative ways to control it.

This month he will drill wheat for the 70th time.

“I believe his principal method of recovery has been connecting with another farmer with similar issues,” Thatcher says. “If all goes well, my grandpa will be farming the soil of Idaho for many years to come.”

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