https://www.surveymonkey.com/r/BRFG8KW
The Silver Star Families of America, the SSFOA, is well aware of the dangers of opioids in all their various forms and, for the most part, agrees with the new federal and state guidelines that are tightening up the distribution of the drugs as long as it does not adversely affect the veteran population. https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
There was a time when V.A. doctors were trusted to use good judgment in the prescribing of opioids. While a few may have over prescribed most others were thoughtful and cautioned patients about abuse and prescribed opioids judiciously.
The DEA changed the rules in October, 2014 when they moved hydrocodone combination pain relievers (HCPs) like Norco and Vicodin from Schedule III to Schedule II. That meant no more electronic prescriptions to pharmacies and doctors could not call in a prescription. Each prescription was good for only one month. That meant it was much harder for veterans suffering from severe chronic pain to access opioids.
What exactly is an opioid? “Opioids are a powerful class of painkillers derived from opium that come from the poppy plant. These drugs, which come in pill or liquid form, are available by prescription.” These drugs include:
Hydrocodone (Vicodin)
Oxycodone (OxyContin, Percocet)
Morphine (Kadian, Avinza)
Codeine and related drugs
Heroin
http://www.lifescript.com/health/briefs/l/list_of_opioids.aspx
In this new “war on drugs” it must be remembered that veterans are a distinct group that does not necessarily reflect the same demographic as civilians. Many veterans suffer from horrendous injuries, both seen and unseen. We must proceed with the utmost caution before we succumb to “opioid paranoia” and withdrawn pain medication from those that need it.
The V.A. has reported that approximately 60 percent of military personnel returning from deployments in the Middle East and 50 percent of older veterans suffer from chronic pain. These rates exceed the reported 30 percent national average of chronic pain within the general American population.
https://www.addictionhope.com/blog/veterans-ptsd-addiction/
What we need to do is actually ask the people affected by the new guidelines what they think. And who are the people affected most----chronic pain sufferers. (See links at the end of this article)
https://www.merriam-webster.com/dictionary/chronic
Many doctors, including V.A. physicians are becoming more and more reluctant to prescribe any opioids, and/or are reducing the amount of the pain killers even as they more closely monitor patients. Monitoring can include giving urine tests, more frequent trips to the doctor and counselling. Problematic for some veterans if they must drive long distances for their primary care. And I’m not at all sure how well the “urine drug” tests will go over. Veterans are not children.
So how about the alternatives to opioids? The Veterans Administrations List of alternatives include things like biofeedback, acupuncture, cognitive behavioral therapy, alternative physical therapies including yoga.
https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/Academic_Detailing_Educational_Material_Catalog/Pain_ChronicPainProviderEducationalGuide_IB101000.pdf
And here is another situation where the government has not done its homework. Many Christians do not believe that yoga is acceptable:
“What does the term “yoga” actually means. “According to tradition, ‘yoga’ means ‘union,’ the union…of the finite ‘jiva’ (transitory self) with the infinite’…Brahman’ (eternal Self).” “Brahman” is a term often used for the Hindu concept of “God,” or Ultimate Reality. It is an impersonal, divine substance that “pervades, envelops, and underlies everything.” Courtesy: Michael Gleghorn https://probe.org/yoga-and-christianity-are-they-compatible/
“Yoga has demonic roots and it can’t be separated from Hinduism. You can’t put a Christian name tag on it and call it Christian.” http://biblereasons.com/yoga/
Ok. Let’s try acupuncture:
“Acupuncture is said to work because needles stimulate acupuncture points, releasing a flow of energy called qi, or chi. Acupuncture is a complementary medical practice that entails stimulating certain points on the body, most often with a needle penetrating the skin, to alleviate pain or to help treat various health conditions.” https://www.livescience.com/29494-acupuncture.html
Not sure you want your “qi” or “chi” releasing a flow of energy? Read on:
“In early 2009, the British Medical Journal published a new analysis of acupuncture for pain … with discouraging results. More recently and dramatically, the journal Pain did it again — one of the top ten journals for pain and injury science. In early 2011, Pain published a thorough and rather harsh scientific smack down of acupuncture, concluding that there is “little truly convincing evidence that acupuncture is effective in reducing pain, “or anything else. In 2016, acupuncture was officially scorned in the NICE guidelines for back pain, with the recommendation “do not offer.”
https://www.painscience.com/articles/acupuncture-for-pain.php
https://osteofm.com/2016/12/06/new-nice-guidelines-november-2016/
How about cognitive behavioral therapy?
The diagram depicts how emotions, thoughts, and behaviors all influence each other. The triangle in the middle represents CBT's tenet that all humans' core beliefs can be summed up in three categories: self, others, future
CBT focuses on the development of personal coping strategies that target solving current problems and changing unhelpful patterns in cognitions (e.g. thoughts, beliefs, and attitudes), behaviors, and emotional regulation. (How does this reduce pain?)
https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy
So let’s review:
The Veterans Administration is now asking veterans who are in severe pain, to give up/reduce pain medications and as an alternative, try yoga which may violate Christian principles, or to release our “chi,” or treat the pain by changing “thoughts-behavior- and emotion or whatever the new/old fad might be. Poor choices for someone in real pain.
Should we just tell a veteran to rub some dirt on it and take a lap?
We give the V.A. credit because even with its short comings, we believe they are still ahead of the curve in research and development of pain management. https://www.research.va.gov/topics/pain.cfm
However there are many examples of the V.A. studies that show even they are not sure of their findings. Note below:
Veteran’s Opioid doses and risk of suicide
In a 2016 study, researchers with the VA Ann Arbor Healthcare System and University of Michigan found that Veterans receiving the highest doses of opioid painkillers were more than twice as likely to die by suicide, compared with those receiving the lowest doses.
The research team looked at nearly 124,000 Veterans who received VA care in 2004 and 2005. All had non-cancer chronic pain and received prescriptions for opioids. Using the National Death Index, the researchers identified 2,601 patients who died by suicide before the end of 2009.
They found that the suicide risk rose as dose increased. The researchers could not tell, however, whether there was a direct causal link between the pain medications and suicide risk. Instead, the high doses may be a marker for other factors that drive suicide, including unresolved severe chronic pain.
In other words a veteran suicide might be because he is in constant severe pain.
Conclusions
Again the Silver Star Families of America is aware of the dangers in opioid use. However it is strongly suggested that before someone is refused pain medication or that pain medication is reduced or eliminated, that careful consideration of the patient’s pain levels be taken into consideration.
The VA can’t afford to launch these well-intended but clumsy attempts at reducing pain medications at veteran expense. The nature of military service can lead to a lifetime of physical and mental pain for veterans.
It is always wise to consider very carefully the effects of the decisions we make concerning the lives of others. Sometimes the ramifications are not foreseen.
Respectfully submitted by: Steve Newton CEO The Silver Star Families of America
http://taskandpurpose.com/the-vas-attempt-to-fight-opioid-dependence-leaves-pain-patients-cut-off/
https://www.theguardian.com/us-news/2016/jul/12/prescription-drugs-what-if-you-depend-on-opioids-chronic-pain
https://www.peoplespharmacy.com/2017/03/13/war-on-opioids-punishes-desperate-pain-patients/
https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm
https://www.pbm.va.gov/PBM/AcademicDetailingService/Documents/Academic_Detailing_Educational_Material_Catalog/Pain_ChronicPainProviderEducationalGuide_IB101000.pdf
Credits:
The Department of Veterans Affairs Wikipedia Pain Science NICE Probe.org Webster Addiction Hope CDC Lifescript
Folks we can really use your help. If your a veteran suffering with pain and have had the V.A. reduce or deny medication please go and take the quick survey. We must do something to stop this “war” on pain medication.
https://www.surveymonkey.com/r/BRFG8KW
“There was a time when V.A. doctors were trusted to use good judgment in the prescribing of opioids.”
They proved themselves not up to the task.
Still, not entirely their fault. Some of the fault resides with the veteran.
There’s a reason for PT and innumerable other pain management techniques. They often work over the long term, or work well enough.
And opioids only work over the long term at great personal cost and ever increasing dosage.
Sure, there are a very few who will require opioid therapy for the rest of their lives.
But it’s damn few. And I give my sympathy to them.
But to no other.
I blame the the opiod epidemic on the 8 years of Obama. I personally believe the Obama administration medical solution to health care was to just take drugs to dull the pain. Don’t worry about fixing the medical problem, just escape from reality with highly addictive medicines.
I wonder how much those opiod manufacturers plowed back into the campaign coffers of Rats around America.
The new VA pain drug is turmeric. It helps arthritis and some other pain. They will not provide it you have to find it yourself. I buy one pound at a time. Get the 5% cur cumin variety.
Opioids work better to control pain than anything else.
Chronic pain requires chronic opioid treatment.
Do you know what the worst side effect of well-controlled chronic opioid use for chronic pain is? Constipation.
Drill down in all of these reports of opioid overdose deaths and you will find that most of them are due to street drugs - heroin and fentanyl - in spite of what Tucker Carlson states.
I’ve treated lots of vets who suffered terrible injuries during military service. They were stable on set doses of opioids, never asked for dose increases, never asked for early refills. They are targeted just like everyone else.
The guidelines should be exactly the same, 100% perfect, for both veterans and civilians.
No state’s guidelines should significantly differ from any other state’s.
Guidelines based on uncertain information should clearly specify their knowledge base deficits.
First thing, i start reading the descriptions of altwrnatives to opioids, as though they were taken from The 700 Club Pat Robertson’ dictionary.
Demonic?? You do realize that not everry American GI/veteran is judeo-christian, or do I have to remind you that the V
A. was sued in 2007, for crapping on veterans about their headstone symbols?
Bttt.
5.56mm
I am really happy to see that someone else is concerned about this.
I know this is bound to be a hot button topic but I fully support any veteran or any person getting pain medication needed to make daily life better than bearable. A qualified doctor, or team of doctors, can and should determine the needs to give every one of our vets the best quality of life.
I am not a vet but 2 of my dear sons-in-law are. Both retired after 20 years, one in great health, the other dealing with wounds from Iraq. Different circumstance but if opiates were the medication he needed then by gosh that is what he should have.
I understand the need to balance physical therapy, OTC meds and opiates. I deal with spinal injury myself thanks to a texting driver. Docs have done what they can surgically, I am fit (more fit than the average 60-something woman), I eat a far healthier diet than the average American. I use some natural supplements that I’ve discovered help me. Yet I still require opiates some days. It’s been a long uphill battle trying to live an active life, enjoy my family, participate in life as I want.
Every one of our Vets is wholly entitled to every help to live in the best health possible. Yes, being physically active helps most. For me, I’ve found that diet is critical also. As a Christian I was averse to yoga but went to a weekly session geared toward handicapped for about a month. I’m in rural Texas so when I announced that I wasn’t going for their eastern crap I was greeted by like-minded church ladies. We chose to meditate on scriptures. I now set aside time in the mornings to put on some worship music and do my physical therapy exercises. I think it amounts to the same thing.
I can go for days or weeks now without an opiate. But come winter weather or stormy weather, there are days I can’t breathe without agonizing pain. For that I feel blessed to have found a pain management specialist who prescribes what helps.
Final thought. I do know that drug abuse is rampant in our nation. I know a lot of people who start down a prescription opiate path get trapped in addiction also. I think it’s an individual’s choice and responsibilty to care for themselves but as a nation, we owe extra courtesy to our vets in getting them the help they need. I can say from personal experience that when pain is agonizing for days on end suicide starts looking “not as bad.” I kept those thoughts at bay by knowing I could not leave my husband or kids with that thought of me. But for chronic pain sufferers I think the daily pain weighs a lot heavier than opioid influence.
That’s my $.02. Won’t buy nothin’ but anyone needing help with chronic pain gets my prayers and support.
Once again the VA goes through another pain med crisis. It only took them about 20 years to do it. Back in the late 90s and early 2000, doctor’s would not prescribe narcotics, as they were called back then, like acetaminophen with codeine. No they prescribed Ibuprofen or Naproxen. No matter the pain level an individual had doctors were reluctant to prescribe narcotics due to its addictive nature. If you went to the emergency room you had to go see your PCP in order to be prescribed anything stronger than 800 mg of Ibuprofen. Slowly the VA eventually backed off of this policy and it took 10 to 15 years in order to do so. Even still ER docs at the VA will prescribe Ibuprofen or Naproxen over a narcotic like aspirin with codeine. How do I know this, I personally experienced it at at least three different VA hospitals in three different states. In one of those states the doctor almost killed me by sending me home with a bottle of Ibuprofen. If it weren’t for my spidey senses going off I would be dead. I did go to a private care hospital and was in emergency surgery a few hours after being discharged from the Vet Admin ER. This is just another crisis that the VA has named something different. It’s the SOS YoY.
I am a 75 year old female, not a veteran, who has peripheral neuropathy due to treatment for stage 4 cancer - luckily stable at this point. My cancer doc after prescribing about 2 Percosets a day for a year said she would no longer give me the prescription and sent me to pain management where I had to give a urine test prior to any prescriptions. They are giving me a 15 day supply which would normally be fine, but then I got shingles down the back of one leg from hip to the bottom of my foot. When I called for a refill, explaining I had shingles which caused me to use more pain med than usual, I was treated as if this was “drug seeking behavior” and told the doc could not give me extra meds for shingles. I have since written to the pain med doc to see how this is supposed to work. Do I have to see her after I go to my pcp for shingles or something else that causes a lot of pain??? This is ridiculous not to mention cruel.
Most of the problems with “opiods” are due to the influx of illegal drugs across the border. Punishing veterans and others for the actions of criminals and drug addicts is cruel and pointless.
To many “trained” Indian doctors let into the US to practice. They don’t know American care standards. And the VA hires tons of them.
Do not know a lot. Have made, in the past, an essential oil mixture which contained wintergreen, ginger, black pepper and something else - would have to search - to apply for ongoing arthritis pain for a friend. Worked for some, not for others.
In addition, here is an alternative medicine website which contains many different chronic pain relief items to try when needed pain medication is not forthcoming.
https://www.earthclinic.com/cures/pain5.html#coldshowers
Suggest as always to do own research.
Note: There exists research demonstrating the use of very large doses of Vitamin C to reduce opiod withdrawal symptoms.
Carlin was right, “I bet ya, if we still called it ‘Shell Shock’, Veterans would get the help they needed.”