Tag Archives: Veterans

Improving Opiate Prescribing Practices Among Veterans

Successfully treating physical pain while still protecting patients from becoming addicted to the drugs has been something that medical professionals have struggled with for quite some time now. It is often up to the prescriber to assess whether or not the patient is being truthful about their symptoms, and if there are any viable alternatives to opioids. This has proven to be difficult, as there is very little in the way of screening and decisions are often based on what the patient is reporting.

Although addition does not discriminate, and anyone can become dependent on a substance, certain populations tend to be more prone to dependency due to their exposure. Our nation’s veterans tend to be especially at risk of developing a dependence on prescription painkillers. Veterans often present to VA hospitals with physical and emotional trauma, requiring medication for bodily pain while also being at risk of self-medication for PTSD, depression or anxiety. Because of this high risk population, a concerted effort was taken to reduce the number of painkillers prescribed to veterans while still providing them with the care they need.

The Opioid Safety Initiative was a program that started in 2013 with the aim of improving prescribing practices and creating a safer medical environment for veterans. As part of the initiative, a monitoring tool was developed that connects VA physicians and VA clinic heads of departments, allowing people to view the different prescribing practices throughout the country. Viewers can see various alternatives and step-down methods used by VA doctors to help avoid dependency.

According to the research, the tool is effective at helping to change prescribing practices. After the development and implementation of the monitoring tool in 2013, heavy painkiller prescriptions have reduced by 16%. The study appears in the journal Pain and was conducted by researchers from the University of Michigan Medical School and Institute for Healthcare Policy and Innovation, the VA Ann Arbor Healthcare System, and Yale University.

“These results highlight the importance of addressing provider behaviors in our efforts to address the opioid epidemic, and the need for large health systems to develop and implement systematic approaches that are flexible enough to allow clinicians to make individual decisions while still reducing the overall prevalence of potentially risky prescribing,” explained Mark Ilgen, Ph.D. and senior author of the study.

Researchers are also hopeful that this VA experiment can translate into the broader population, further reducing large and heavy doses for prescription painkillers and their subsequent effects.

Study of Veterans Documents Transition from Painkillers to Heroin Abuse

veterans painkillersAddicts who abuse prescription painkillers often turn to heroin as well. This phenomenon has plagued society for the last several years. Some people insist that in order to reduce heroin addiction in the country, the prescription painkiller epidemic must be solved first. Others caution that by making prescription painkillers harder to obtain, that policy makers will drive users to toward heroin. In order to develop the best plan of attack for reducing heroin and prescription painkiller abuse, ongoing studies are being conducted and analyzed on different demographics that abuse these types of drugs.

One recent study shows that veterans are more likely to use heroin if they have misused prescription painkillers in the past. Veteran healthcare, including mental health, has been an ongoing concern of late, as they deserve the best care our nation can provide. Veterans and other people who present with suspicious behavior regarding their prescription painkillers should be more closely monitored by medical professionals for potential heroin abuse in the future. The results of this study appear in the journal Addiction.

“Our findings demonstrate a pattern of transitioning from non-medical use of prescription opioids to heroin use that has only been demonstrated in select populations. Our findings are unique in that our sample of individuals consisted of patients who were receiving routine medical care for common medical conditions,” explained David Fiellin, the co-author of the study.

This specific information and method of study can now also be applied to other groups to better document the link of painkillers and heroin addiction. As more information is gathered about the transition into heroin abuse, the more specialized prevention programs can be.

For people who do become dependent on opiates, including veterans and other populations, should seek out effective addiction treatment programs such as Desert Cove Recovery.

U.S. Pledges More Than $20 Million to Study Ways to Ease Soldiers’ Pain

The United States Government recently announced that it will launch research efforts focused on finding alternative ways for members of the military to manage their chronic pain. Thirteen projects will explore alternative therapy options for pain-related conditions as well as post-traumatic stress disorder, drug abuse and sleep problems, to hopefully lessen the use of narcotic painkillers.

In a government news release, Dr. Josephine Briggs, Director of the United States National Center for Complementary and Alternative Medicine, said that pain is the most common reason for Americans to turn to complementary and integrative health practices. She added, “We believe this research will provide much-needed information that will help our military and their family members, and ultimately anyone suffering from chronic pain and related conditions.”

The 13 research projects will be conducted at the Veterans Affairs medical centers and academic institutions across the country, and will cost close to $22 million over the next five years.

Nearly 100 million adult Americans have chronic pain, and the problem disproportionately affects members of our military, both current and former, according to a 2011 Institute of Medicine study. In the June issue of the journal JAMA Internal Medicine, a report said the rate of chronic pain is 44 percent among members of the U.S. military after combat deployment, compared with just 26 percent in the general population. The report said the rate of use of powerful and potentially addictive narcotic painkillers is 15 percent among U.S. military members after deployment, compared with only 4 percent in the general population.

National Institute on Drug Abuse Director Dr. Nora Volkow said prescription opioids are a key tool in managing pain, but doctors prescribing the narcotics more and the increased availability of the drugs may be contributing to the growing misuse of the drugs. “This body of research will add to the growing arsenal of pain management options to give relief while minimizing the potential for abuse, especially for those bravely serving our nation in the armed forces,” Volkow said.

Treating Chronic Pain and Addiction Among Veterans

housevaA recent article from the American Psychiatric Association (APA) urges better cooperation between states and Veterans Affairs (VA) health centers regarding prescription drug monitoring among Veterans, especially for opioids and benzodiazepines. It cites the necessity to ensure quality treatment and alleviation of pain while being more aware of addiction problems for the purpose of prevention and rehabilitation.

Last Fall, a statement was provided to the House Veterans Affairs’ Subcommittee on Health hearing, “Between Peril and Promise: Facing the Dangers of VA’s Skyrocketing Use of Prescription Painkiller’s to Treat Veterans” by APA CEO and Medical Director Saul Levin, M.D., M.P.A. Dr. Levin recommended more specialty training for physicians within the VA system for the diagnosis and treatment of co-occurring disorders as well as opioid addiction.

The APA produced a series of webinars focused on the use of treatments for opioid dependence and on the safe use of opioids in the treatment of chronic pain. The free webinars were available for psychiatrists, physicians of other specialties, other prescribers, residents, and other interested clinicians. Example webinar topics included:

– The Use of Buprenorphine to Treat Co-occurring Pain and Opioid Dependence in a Primary Care Setting

– Learning the Evidence Behind Alternative/Complementary Chronic Pain Management – Emphasis on Chronic Low Back Pain

– Patterns of Opioid Use, Misuse, and Abuse in the Military, VA, and US Population

– Enhancing Access to PDMPs [Prescription Drug Monitoring Programs] Through Health Information Technology

– Identifying and Intervening With Problematic Medication Use Behaviors

– Assessing and Screening for Addiction in Chronic Pain Patients

– Psychological Management and Pharmacotherapy of Patients with Chronic Pain and Depression, Schizophrenia, and Post Traumatic Stress Disorder (PTSD)

The number of Veterans dealing with anxiety, PTSD, depression or any other disorder in conjunction with substance abuse is higher than ever. A large portion of the addiction problems are connected to prescription drugs, especially for those who are also combating chronic pain symptoms. A greater awareness and higher level of education and training on how to deal with the multi-layered problems will help to ensure better outcomes for the health of our Veterans.