A Quality-of-Care Pilot Study in the Use of Psychological Counseling, Acupuncture and Ketamine in the Treatment of Pain, Depression and Anxiety
Torres, M.D., L. Strozdas, PhD. Psych, G. Subieta, M.D., F. Yurasek PhD. TCM
Statement of Purpose:
To initiate, for review and refinement among Stroger Hospital Pain Service Integrative Medicine Team Members, the use and results of a Collaborative Care model for a patient struggling with Chronic Pain and Depression and previously relying on a drug-only care model.
Background:
Individuals suffering from a chronic condition are three times more likely to complete suicide (Rosston, 2019). Almost a decade ago, before the Covid suicide spike, it was reported that an average of approximately 800,000 people were dying by suicide each year worldwide (World Health Organization, 2015).
“Depressed patients often present to the emergency department with complaints of suicidal thoughts, accounting for more than half-a-million admissions annually to the emergency departments in the United States.” 3 (Ting, Sullivan, Boudreaux, Miller & Camargo, 2012).
Discussion cont’d:
Treatment of PTSD with the 5-point NADA Protocol as documented in Joe C. Chang’s book THE TREATMENT OF PTSD WITH TRADITIONAL CHINESE MEDICINE provided an additional bonus therapy effect with this patient by addressing his latent PTSD symptoms.
Methodology & Outcome:
- Psychotherapy using Mindfulness-based Stress Reduction, Variability monitored Biofeedback and Cognitive-based Therapy participation over a period of 48 months
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- Auricular Acupuncture using the National Acupuncture Detox Association Auricular Protocol of Shen Men, Sympathetic, Kidney, Liver and Lung points (see com) utilized during the same time period
- Ketamine, infused or inhaled, during 7 sessions over the last 9 months of combined therapies
Following this series of treatments, transitioning from a conventional body- centered intervention to a more neuroplastic model, random Heart Rate Variability monitoring during Auricular Acupuncture Therapy indicated the patient was exhibiting a shift from the PTSD state of “Flight or Fight” to “Rest & Relax” mode (“Where Have All the Flowers Gone” Vishnu & Yurasek, Toronto WFAS 2016). He also self-reported in his journal assignments a calmer and more accepting attitude towards the physical limits that had been caused by his injury.
The Patient: A 32 y/o Caucasian male with right-sided Complex Regional Pain Syndrome suffered from a work injury had declined a Spinal Cord Stimulator Trial and was referred by Pain Services for Psych. Evaluation and Counseling, having scored 100% on items measuring rumination on the Pain Catastrophizing Scale, and 50 above the cutoff off 24 on the Nijmegen Questionnaire for hyperventilation syndrome risk, and reported frequent episodes of rage and depression at home.
Discussion:
Given the addictive nature of Ketamine, we paired its use with Acupuncture to regulate dependency and A.N.S. balancing, and regular Psych. Counseling Sessions as an ongoing feedback mechanism to document and share progress and problems with other team members.
Conclusion:
With extensive studies at Yale University (1-877-YALEMDS March 9, 2022, “How Ketamine Drug Helps with Depression by Jennifer Chen), and Birmingham Hospital, Alabama (Heersink School of Medicine News, “UAB studying ketamine as suicide prevention drug” by Bob Shepard, March 26, 2013), it appears the Hallucination Therapy train has clearly left the station.
Our addition in our Case Study of utilizing regular Psych. Counselling and shared Evaluation Reports as well as Auricular Acupuncture for proven ANS stabilization and regulation gives added insurance of safe passage from “dream state” back to the real world.
References
Ting SA, Sullivan AF, Boudreaux ED, Miller I, Camargo CA Jr. Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993-2008. Gen Hosp Psychiatry. 2012 Sep-Oct;34(5):557-65. doi: 10.1016/j.genhosppsych.2012.03.020. Epub 2012 May 2. PMID: 22554432; PMCID: PMC3428496.
Photo credit: https://lotusblossomwellness.ca/nada-protocol (Poster Design by ARH)