Corrections_Today_January_February_2020_Vol.82_No.1

Correctional Health Perspectives

managing pain and reducing the need for prescription drugs in the elderly like acupuncture, massage, cryotherapy, and thermotherapy (Bruckenthal, Marino, & Snelling, 2016). These options may not be fea- sible in a correctional environment. However, there are still a number of options that the elderly can utilize by themselves that can reduce costs to correctional agencies. Guided imagery, yoga, mindfulness medita- tion, tai chi and even music therapy have proven benefits to decrease reported pain levels in the elderly population. These can all be taught in a group setting to increase savings and decrease the number of profes- sional visits. Minority and medically under- served oncology patients report high levels of interest in CAM as a way to have better control of treatment, re- duce their stress levels, and increase overall quality of life (Jones et al., 2018). This provides an opportunity for providers to engage their patients and present a range of alternatives aside from just pharmaceutical inter- ventions. A therapeutic relationship should be built on trust, and it is up to a professional to help patients if they are interested in CAM so that safe and effective options are pro- vided (Jones et al., 2018). Some barriers to access using CAMs still exist. Most often, the pa- tient is not aware that a CAM option is out there (Brems, Barnett, Parret, Metzger, & Johnson, 2013). This is largely due to a provider not giving

back pain, surgical intervention is only considered after having tried other treatments first (Yilmaz & Cav- dar, 2017). A study of 92 individuals hospitalized for disc hernias in their spinal column revealed that 62.5% reportedly benefited from CAM prior to surgery (Yilmaz & Cavdar, 2017). Other data related to chronic lower back pain (CLBP) shows that Mindfulness-Based Stress Reduction (MBSR) can lower reported pain lev- els and objectively increase quality of life based on an increase of body functioning (Ardito et al., 2017). These results are also more signifi- cant over an extended period of time. Improvement in coping skills and usefulness in pain management with a cohort of patients that required long-term daily opioid therapy for CLBP is also associated with posi- tive benefits from CAM (Zgierska et al., 2016). This group participated in a mindfulness meditation study. Beneficial effects for mental health Mental health is an essential component to the overall health of an individual. This is very true in a high-stress environment such as a correctional facility. The prevalence of mental health problems within local, state, and federal correctional facilities ranges from around 45 to 64% (Substance Abuse and Men- tal Health Services Administration [SAMHSA], 2013). The benefits of CAM on mental health in this popu- lation should be explored further.

patients a menu of CAM options that are available or not being educated enough on CAM in the first place. This requires administrative staff or treatment professionals to put added importance on educating themselves on pain management alternatives for stronger bodies and minds. Prisons and jails provide a unique opportunity to access large populations of adults from lower socio-economic status and edu- cational levels that may not have access to CAMs in the community. There are many sociodemographic barriers (e.g., access, monetary, loca- tion) associated with accessing some forms of CAM. Lower education levels and minority status also corre- lates to lower levels of participation in mindfulness practices (Olano et al., 2015). The unfortunate predictor is that education and race/ethnic- ity are also associated with poorer health outcomes in general terms of health disparities. Examples of these disparities are socioeconomic status, behavior, and health care quality (Katzen, 2011). Correctional systems provide an opportunity to access minority populations, which can improve lives inside and outside of the system. Benefits of CAM Medical benefits of CAM It is important to assess the level of benefit that CAM provides. When considering all treatment options for

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