YOUNGSTOWN, Ohio – For decades, there’s been a stigma that patients treated for behavioral or mental health issues were distinct from those who suffer physical pain.
No longer.
At Meridian Healthcare Inc., the operating philosophy is that addiction, behavioral and mental health, and the physical condition of a patient are all connected. More important is the realization that addressing all of these facets is vital to successful treatments that could have life-saving outcomes.
“The biggest change that’s happening in our industry is this concept of recognizing that mental health, behavioral health and physical health all have to be addressed together,” says Larry Moliterno, president and CEO of Meridian Healthcare, Youngstown. “You can no longer separate someone’s physical wellness with their behavior health wellness.”
Meridian Healthcare opened its doors in 1974. Over the last six years or so, Meridian has worked to integrate general practice and chiropractic medicine into its behavioral, mental health and addiction recovery care services, Moliterno says.
“We started having this new perspective of looking at things collectively and looking at integrated
care,” he says. “It means you change the whole culture of your organization.”
As an example, Moliterno points to clients who seek treatment for opiate addiction. Often, these patients were prescribed opiates because of chronic pain and the use of these drugs led to dependence.
In the past, the patient was treated for addiction, not the underlying physical causes that initially drove the patient to be prescribed these painkillers.
“You treat them for the addiction and send them on their way,” Moliterno says. “But they still have chronic pain. Everyday when they wake up in pain is another opportunity or trigger for a potential relapse.”
Thus, treating addiction alone doesn’t solve the problem, Moliterno says.
As such, Meridian has added services such as chiropractic care, acupuncture and primary practice medicine to treat potential root causes for a patient’s addiction or depression.
Dr. Luis Villaplana, chief medical officer at Meridian, says that recent studies in neurobiology have found that pain receptors in the human body are not far afield from receptors that deal with emotion and fulfillment.
“The biggest challenge that I see right now is the evolution of the addiction problem,” Villaplana says. “These substances are becoming more potent, more lethal.”
The arrival of synthetic drugs such as fentanyl – a narcotic that is 80 to 100 times more powerful than morphine – has led to a consistent battle in the medical community against the dangerous effects of the drug.
Meridian has also moved to treat pain through measures that stop short of prescription medications, Moliterno says.
“We have found tremendous results in providing chiropractic care for people with chronic pain as an alternative for medications,” he says.
The organization today employs three full-time and one part-time chiropractor on staff. Acupuncture has also proven effective in treating pain, according to Moliterno.
“I feel that it goes hand-in-hand,” says Dr. Jeremy Dotson, a chiropractor at Meridian.
The programs have proven successful in treating addiction from opiates. For example, Meridian’s chiropractic practice has helped those in recovery deal with pain.
“They could still have residual pain that we as chiropractors can co-manage with the medical route,” Dotson says.
Villaplana adds that the chiropractic team has had a significant effect on patients, particularly those with stimulant-use disorders.
An article he happened to read several years ago showed that certain pressure points around the ear decreased cravings for cocaine and other stimulants.
“That grew into trying to integrate acupuncture into our stimulant-use disorder patients,” he says. “There’s truly not a treatment for cocaine use disorder.”
Acupuncture treatment has also proven successful in other respects, Dotson says. Chemotherapy patients have found that acupuncture helps to lessen the aches and pains associated with the effects of the treatment.
Moliterno says that treating conditions such as anxiety and depression with medicine is most effective when combined with sustained counseling. Still, 75% of those treated for these conditions fail to follow up with counseling sessions.
Meridian has the advantage of providing both medical treatment and counseling services, Moliterno says.
“When someone is diagnosed with anxiety or depression, and the physician prescribes medication, we’re also able to have a counselor go right into the exam room and talk to that person,” he says.
This presents the patient on-site with the option to pursue counseling that can explore stressors or underlying factors that could trigger these conditions, Moliterno says.
“If we don’t connect behavioral health with physical health, then we’re going to keep spinning our wheels,” he says.
The ultimate result is a healthier patient, Moliterno says, which in turn lowers medical, hospital and insurance costs.
“We’re able to have long-term relationships with our patients,” he says.
This relationship is critical, since the medical staff can monitor a patient’s progress and respond quickly should he suffer a relapse.
“The concept of integrated health care is a win for everybody,” Moliterno says.
Villaplana, a physician more than three decades, says the concept of integrating primary care medicine into counseling and other therapies makes perfect sense.
“I’d be willing to say that over 32 years, everybody at some point and time could have used some counseling and some behavioral health help,” he says.
More patients today suffer from co-occurring conditions, Moliterno says, noting that those who experience behavioral or mental health issues are also prone to substance abuse. The pandemic, he continues, exposed this to a great extent.
“For a long time, people were stressing every day,” he says. He points to the higher sales of alcohol over the last two years as an indicator of how many responded to cope with the COVID-19 crisis.
Meridian employs approximately 270 in its operations in Youngstown, Howland and Warren. Future growth includes establishing dental services, Moliterno says.
Meridian is also reaching out to the medical community so it can introduce a counseling presence in some local practices, Moliterno notes.
“The patient wants to go where they feel safe, where they feel comfortable, where they’ve built trust with their physician. They know they could go to that same office and see their counselor – that’s a good partnership to have and that’s what we see as the future,” Moliterno says.
“I think in the next decade, integrated care is the biggest change we’re going to see in the health care system,” he says. “We’re trying to be on the forefront of this as much as we can.”
Pictured: Dr. Jeremy Dotson is a chiropractor who practices at Meridian Healthcare. Dr. Luis Villaplana is the chief medical officer and Larry Moliterno is the president and CEO. The nonprofit agency employs 270 at three sites in the Mahoning Valley.