By Katherine Shagoury

The 2019 Institute for Functional Medicine (IFM) Annual International Conference was held May 30 through June 1 at the JW Marriott San Antonio Hill Country Resort & Spa in Texas. Leaders in functional and integrative medicine gathered to discuss stress, pain, and addiction, and the transformative treatments and innovative solutions taking place in the integrative healthcare community.

Integrative Practitioner reported live from the session rooms and the show floor, bringing you the breaking news and insights from some of the top speakers and exhibitors.

Explore our complete live coverage.

Navigating stress, pain, and addiction with functional medicine

The current “gold standard” for treatment of opiate addiction, said David Haase, MD, is “medication-assisted treatment combined with psychosocial therapies and community-based recovery supports.” The functional medicine approach to the triple epidemics of pain, stress, and addiction focuses on the intersection of these diseases and understands that they are linked in not only occurrences and causes, but in solutions.

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Physician’s journey through addiction

Addiction is not a moral failure, said Stephen Loyd, MD, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

As a young physician, Loyd was teaching students and treating patients in the hospital. He was experiencing pain and stress and turned to opioid medications as a solution to his anxiety and depression. But he was able to get help through a functional medicine, mind-body-soul approach, which shaped the way he treats patients suffering from addiction.

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Facilitating recovery from substance use disorder

In the last 50 years, laws passed have moved from more punitive to public health-oriented, said John Kelly, PhD, increasing availability, accessibility, and affordability of treatment. The “war on drugs” was part of a national concerted effort to reduce supply but also demand that created treatment and public health-oriented federal agencies, such as the National Institute on Drug Abuse.

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Breaking News: Michael Stone, MD, MS, ABFM, named recipient of Linus Pauling Award

The Institute of Functional Medicine (IFM) announced the recipient of its Linus Pauling Award at the Annual International Conference in San Antonio, Texas on Thursday afternoon. The winner of this year’s award is Michael Stone, MD, MS, ABFM.

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Defining evidence-based functional medicine

Heath is personal, and medicine is evolving to become more individualized through advances in medicine and in technology. While this concept of precision medicine aims to incorporate individual variability in genes, environment, and lifestyle, the emphasis is currently on profiling risk, according to a 2017 article in the Journal of the American Medical Association. The future of evidence-based precision medicine in the age of genomic diversity, said Jeffrey Bland, PhD, said, moves beyond population risk to understanding individual functional uniqueness. There is less emphasis on risk, and more emphasis on opportunity, he said.

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Rethinking chronic pain

There are many different ways to approach chronic pain, said Heather Tick, MD, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

In the U.S., $560-635 billion is spent annually on pain care, said Tick. This exceeds the annual expenditures for heart disease, cancer, and diabetes combined.

“There are huge costs to how we treat pain case now,” said Tick. “We have an epidemic of chronic disease and, as those figures grow, we’re going to have more pain.”

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Stress and addiction in young minds

Chronically ills kids seem to be the new normal, said Elizabeth Mumper, MD, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

Pediatric medicine has shifted from acute to chronic care, with conditions like asthma, allergies, diabetes, autism, seizures, obesity, anxiety and depression, pain, opioid misuse, and alcohol abuse becoming more common. Instances of child abuse and gun violence are also on the rise.

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Mindfulness-oriented recovery enhancement for stress, pain, and addiction

The opioid crisis is the greatest threat to public health faced by this generation, said Eric Garland, PhD, LCSW, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

Opioid addiction and chronic pain have been empirically linked to the rise of morbidity and mortality observed among white U.S. adults, Garland said. The U.S. is the only wealthy country that has seen increases in the mortality rate in the past two decades. Addiction is a disease of despair, he said.

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How healing works

How do we get from healthcare to health and wellbeing, asked Wayne Jonas, MD, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas?

Opioid prescriptions have increased by 60 percent from 2000 to 2010, Jonas said. Opioid-related deaths topped 60,000 in 2017, and 11.8 Americans misused opioids.

“We need to start asking, where is the value in health,” said Jonas. “We are not facing an opioid problem. We are facing a chronic pain mismanagement problem.”

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Cannabinoids for stress and pain management

The endocannabinoid system has a significant role to play in regulating stress and pain, said Cecilia Hillard, PhD, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

Cannabis is an annual herb. The botanical family includes hemp, cannabis indica, and cannabis sativa. There are over 100 unique chemicals and a family of terpenephenols found in cannabis. Strains have differing amounts of tetrahydrocannabinol (THC) and cannabidiol (CBD), thus aggregated data regarding effects of cannabis on humans are difficult to interpret, Hillard said.

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Using psilocybin for anxiety, depression, addiction 

There is therapeutic potential in psilocybin, said Roland Griffiths, PhD, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

Psilocybin is the principal psychoactive component the Psilocybegenus of mushrooms. The classic psychedelics are a structurally diverse group of compounds that bind at 5-HT2 Aserotonin receptors and produce a unique profile of changes in thoughts, perceptions, and emotions. Examples include the tryptamines and phenethylamines, Griffiths said.

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Nutrition supplementation for pain management

All pain management should be a functional medicine approach, said Nancy Cotter, MD, CNS, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

“We would all have much better outcomes if we used functional medicine,” said Cotter. “If we look at pain management in a broad concept, nutraceuticals are a small but important part and we need to look at how we can use them as part of a complete program.”

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A strengths-based approach to eating disorder recovery

There are very few practitioners outside of the eating disorder specialty who can effectively identify patients who need help and treatment, said Amy Pershing, LMSW, ACSW, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

An eating disorder is a relationship with food, weight, or exercise that is used to meet needs other than the needs these things can truly fulfill. It is a serious mental illness, Pershing said.

People never choose an eating disorder. Eating disorders cause extreme distress. They rob sufferers of most of their energy, attention, and focus. No one with an eating disorder can simply stop the behaviors. Willpower has nothing to do with it. No matter how difficult, people are terrified to let go of the eating disorder. For those with eating disorders and trauma, the eating disorder allowed them to survive.

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Evaluating and treating traumatic brain injury

There is no cure for traumatic brain injury (TBI), said Michael Lewis, MD, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas. But there is a way to effectively evaluate, treat, and manage TBI.

Evaluating and treating TBI should emphasize the importance of diet and exercise, targeted nutritional therapy, and correcting pituitary dysfunction.

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Keys to provider stress reduction and thriving practice

Providers in functional and integrative medicine are in a unique position, said Georgia Tetlow, MD, ABOIM, ABPMR, CWSP, at the 2019 Institute for Functional Medicine Annual International Conference in San Antonio, Texas.

Burnout is increasingly common in healthcare, and though functional medicine addresses burnout, in many ways it creates its own, Tetlow said. Struggles with identity, financials, logistics, and starting something new can leave a functional or integrative provider feeling overwhelmed.

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