YOUNGSTOWN, Ohio – For decades there has been a stigma that patients treated for behavioral or mental health problems are different from those suffering from physical pain.
Meridian Healthcare Inc.’s operating philosophy is that addiction, behavior and a patient’s mental health and physical condition are interconnected. More important is the recognition that addressing all of these facets is critical to successful treatments that could have life-saving outcomes.
“The biggest shift happening in our industry is this concept of recognizing that mental health, behavioral health and physical health all need to be addressed together,” said Larry Moliterno, President and CEO of Meridian Healthcare, Youngstown. “You can no longer separate a person’s physical wellbeing from their health wellbeing.”
Meridian Healthcare opened its doors in 1974. For the past six years, Meridian has worked to integrate general medicine and chiropractic care into its behavioral, mental health and addiction treatment services, says Moliterno.
“We started with this new perspective of looking at things collectively and in an integrated way
care,” he says. “It means you’re changing the entire culture of your organization.”
As an example, Moliterno points to clients who are being treated for opiate addiction. Often these patients were prescribed opiates for chronic pain, and taking these drugs led to addiction.
In the past, the patient was being treated for addiction, not the underlying physical causes that originally led the patient to prescribe these pain medications.
“They treat them for addiction and send them on their way,” says Moliterno. “But they still have chronic pain. Every day they wake up in pain is another opportunity or trigger for a possible relapse.”
Addiction treatment alone does not solve the problem, says Moliterno.
As such, Meridian has added services such as chiropractic, acupuncture and family medicine to address possible causes of a patient’s addiction or depression.
dr Luis Villaplana, Meridian’s chief medical officer, says recent studies in neurobiology have found that pain receptors in the human body are not far removed from receptors that deal with emotion and fulfillment.
“The biggest challenge I see right now is the development of the addiction problem,” says Villaplana. “These substances are getting stronger, more deadly.”
The advent of synthetic drugs like fentanyl — a narcotic 80 to 100 times more potent than morphine — has led to an ongoing battle in the medical community against the drug’s dangerous effects.
Meridian has also moved to treating pain through measures that come before prescription drugs, says Moliterno.
“We have had tremendous results in bringing chiropractic care to people with chronic pain as an alternative to medication,” he says.
The organization now employs three full-time and one part-time chiropractors. Acupuncture has also been shown to be effective in treating pain, according to Moliterno.
“I feel like it goes hand in hand,” says Dr. Jeremy Dotson, Chiropractor at Meridian.
The programs have proven successful in treating opiate addiction. For example, Meridian’s chiropractic practice has helped people in recovery manage pain.
“You might still have residual pain that we as chiropractors can treat along the medical route,” says Dotson.
Villaplana adds that the chiropractic team had a significant impact on patients, particularly those with stimulant use disorders.
An article he happened to read a few years ago showed that certain pressure points around the ear reduced cravings for cocaine and other stimulants.
“That evolved into trying to integrate acupuncture into our patients with stimulant use disorders,” he says. “There really is no treatment for cocaine use disorder.”
Acupuncture treatment has also proven to be successful in other ways, says Dotson. Chemotherapy patients have found that acupuncture helps reduce pain associated with the effects of the treatment.
Moliterno says treating conditions like anxiety and depression with medication is most effective when combined with sustained counseling. Yet, 75% of patients treated for these conditions fail to attend counseling sessions.
Meridian has the advantage of offering both medical treatment and counseling services, says Moliterno.
“If someone is diagnosed with anxiety or depression and the doctor prescribes medication, we can also have a counselor walk right into the exam room and talk to that person,” he says.
This provides the patient with an on-site opportunity to seek counseling that can examine stressors or underlying factors that could trigger these conditions, Moliterno says.
“If we don’t connect behavioral health to physical health, we keep turning our wheels,” he says.
The end result is a healthier patient, Moliterno says, which in turn reduces medical, hospital, and insurance costs.
“We’re able to build long-term relationships with our patients,” he says.
This relationship is critical as it allows medical staff to monitor a patient’s progress and respond quickly should they relapse.
“The concept of integrated healthcare is a win for everyone,” says Moliterno.
Villaplana, a physician for more than three decades, says the concept of integrating family medicine with counseling and other therapies makes perfect sense.
“I would be willing to say that anyone over the course of their 32 years could have used some behavioral health counseling and help at some point,” he says.
More patients are now suffering from co-occurring medical conditions, says Moliterno, noting that those who suffer from behavioral or mental health problems are also vulnerable to substance abuse. The pandemic, he continues, has exposed this to a large extent.
“For a long time, people have been stressed every day,” he says. He points to higher alcohol sales over the past two years as an indicator of how many people have responded to deal with the COVID-19 crisis.
Meridian employs approximately 270 people at its Youngstown, Howland and Warren facilities. Future growth includes establishing dental services, says Moliterno.
Meridian is also reaching out to the medical community to introduce a consulting presence at some local practices, Moliterno notes.
“The patient wants to go where they feel safe, where they feel comfortable, where they have built trust in their doctor. They know they could go to the same office and see their advisor – that’s a good partnership and we see that as the future,” says Moliterno.
“I think integrated care is going to be the biggest change we’ll see in healthcare over the next 10 years,” he says. “We try to be at the top as much as possible.”
Pictured: Dr. Jeremy Dotson is a chiropractor practicing at Meridian Healthcare. dr Luis Villaplana is Chief Medical Officer and Larry Moliterno is President and CEO. The non-profit organization employs 270 people at three locations in the Mahoning Valley.