In an age where Americans use and misuse pain prescriptions, Faith Community Health in Branson remains committed to the no narcotic prescriptions policy of its dispensary. According to the clinic’s physician assistant Stephen Berkstresser, provider for Faith Community Health, pain medications such as opioids are over-prescribed. “It is sometimes easier to write a prescription than to otherwise make a patient comfortable. As they become addicted, patients begin doctor-hopping and pharmacy-hopping to find more pills,” Berkstresser said.
Indeed, the number of Americans who use and misuse prescriptions, especially pain medicines such as opioids, continues to rise. The 2015 National Survey on Drug Use and Health found an estimated 97.5 million Americans aged 12 and older using pain relievers, including 12.5 million people aged 12 and older misusing pain medications. Misuse is defined as not using medications as directed by the patient’s provider.
“Pain has become the fifth vital sign,” Dr. Heather Lyons-Burney said. Burney is the dispensary pharmacist for Faith Community Health and a clinical assistant professor of pharmacy practice at Missouri State University, Springfield. “When you see a medical provider, you will be asked about your level of pain. Later you may receive a survey, asking how well your pain was managed by your provider,” Burney said. “Providers who receive government funding are rated through the patient surveys.”
Burney said, “The problem is pain is not something we can measure with a blood pressure cuff.”
Burney is a co-founder of Faith Community Health, which opened March 2010 in the former Branson Elementary School. “We formed Faith Community Health with a faith-based emphasis on whole-person care, including the spirit, mind and body. For that reason we included a dispensary from the start. However, from the beginning, we also decided not to carry controlled substances or narcotics.”
The dispensary is one of several affordable healthcare services Faith Community Health offers to medically underserved residents and workers in Stone and Taney counties. Its whole-patient care involves primary care providers, pharmacists, mental health providers, optometrists, dentists, wellness and disease prevention education. Patients pay on a sliding scale depending on their income. Financially, most of them fall into the healthcare gap, ineligible for Medicaid, and earning too little to qualify for marketplace insurance (Obamacare) subsidies.
Last year the dispensary filled 14,264 prescriptions for its patients and expects to provide even more prescriptions in 2017. For a monthly administrative fee of $10, patients have access to medications at no cost, including those for hepatitis C and chronic conditions such as diabetes, high blood pressure and COPD. FCH partners with Dispensary of Hope, a medication distributor for charitable clinics, supplying generic medications, and with Cox Medical Center Branson for many generic medications and injectables. The City of Branson contracts for services to assist with the cost of care for Branson residents.
About the clinic’s policy on not using narcotics, Burney said, “Not all pain is the same and not all pain is relieved by narcotics. We decided early on not to bandage pain with narcotics.” Berkstresser said chronic pain management issues are often caused by a patient being out of good physical condition. He said, “We get injured more easily when we are out of shape. When the injured part of the body causes pain, you don’t want to use it. It becomes a spiral.
“I found some of my patients don’t know about wellness and caring for themselves. Instead of taking a pill for pain, they should exercise and recondition their muscles.” Berkstresser said. “Ninety percent of these people have deconditioning, that is, muscle weakness and a weakened core.”
According to Berkstresser, the clinic staff looks for a variety of ways to attack chronic pain. “We want to find the root problem and encourage other methods first: stretching, ice, heat, physical therapy and anti-inflammatories, as well as help them manage other components of health such as depression.” If the pain does not respond, he refers the patient to a pain specialist.
“Our goal at Faith Community Heath has always been to get the patient back to work and stay healthy,” Burney said. “We serve hundreds of patients with chronic illnesses and provide more than $3 million in medications annually to help keep patients healthy and avoid expensive hospital care.”
Editor’s note: Burney also serves as the co-chair of the Taney County Alcohol and Drug Abuse Prevention Team (ADAPT). The organization focuses on preventing alcohol and drug abuse in the county especially among youth and families.