SIOUX CITY -- When one of Dr. Michael Piplani's classmates was inserting a needle into an acupuncture point on his foot during acupuncture training for physicians, it was so painful, Piplani said he began yelling.

Painful spots, according to Piplani, are usually related to organ dysfunction in other parts of the body. After five years of experiencing gallbladder problems, to Piplani's surprise, the aching finally stopped.

"That amazes me that a point down here is telling you about something in another spot," Piplani said pointing to his foot in a cozy, beige room tucked away from the hustle and bustle at Siouxland Community Health Center (SCHC), where the chief medical officer will now be offering acupuncture to patients.

The traditional Chinese medicine treatment involves inserting thin needles into the skin at specific points of the human body to alleviate pain and treat various medical conditions. SCHC had to get special permission from the Health Resources and Services Administration (HRSA) to add acupuncture to its list of services.

Piplani is aware of just two other health centers in the country, in North Carolina and Massachusetts, that provide the alternative treatment to patients. 

At SCHC, Piplani said he will primarily use acupuncture on patients who are withdrawing from opioids in conjunction with Suboxone -- medication-assisted treatment. Acupuncture needles are placed in various spots on the ear, where Piplani said there's believed to be a connection into the brain. 

"The idea is (acupuncture) quells liver fire -- that kind of agitation that you have as you're withdrawing. It can really lower that and then allow you to be more compliant with your abstinence or whatever program you're going to go on," he explained. "You actually have to be going through some withdrawal in order for it to be effective. Bringing people in routinely over a course of a few weeks, will kind of help them adapt and just increase their likelihood of success."

Piplani, who was first exposed to acupuncture in 1995 as an intern at an alcohol detoxification center in Albany, New York, attended a medical acupuncture for physicians program in Tempe, Arizona, completing 300 hours of training from December 2017 to May 2018. The training was offered through Helms Medical Institute and paid for by a HRSA grant. Dr. Joseph Helms, the institute's president, is regarded as the father of medical acupuncture in the United States and has taught physicians since 1978 through the continuing medical education program.

Piplani said acupuncture can also be used to relieve digestive problems and headaches and aid in weight loss and smoking cessation. He expects that a number of patients will request the therapy to treat musculoskeletal problems, such as arthritis and fibromyalgia.

"Since I'll be offering pain treatments, maybe people don't have to go down that road getting addicted in the first place," said Piplani, who said SCHC is "ready to go" with acupuncture in combination with Suboxone therapy. He said acupuncture for other medical conditions will be available by April 1.

Medicare and Medicaid don't cover acupuncture treatments, which will cost $50-$80 at SCHC. About half of private insurance companies do pay from them, according to Piplani.

"If our patients want to try it, because they think it could help, they can apply for our sliding fee. If they qualify, the prices would be reduced," he said.

Piplani said a single acupuncture treatment averages 15 minutes and involves inserting needles that are much different than those used to deliver vaccines. Acupuncture needles consist of solid shafts of stainless steel with rounded tips that push tissue fibers apart rather than cut them. Piplani said patients should only feel a finger or a small plastic tube pushing on their skin.

"When the needle goes in, you look for something called de qi, that's a grabbing of the needle. You're right at the exact point that you want to be," he said. "We ask people, 'Do you feel that grab?' It's kind of a little tug, or a soreness. They shouldn't feel anything after the needle is in if it's done properly. We're not in a nerve, but right next to it."

After a series of treatments, Piplani said patients may find relief and not return unless they experience a flare-up of symptoms several months later. 

"Sometimes, the condition persists and then you need Western medicine. That's kind of what I offer that is unique from seeing an acupuncturist," he said.

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