Addiction is a cunning and deadly disease, and it’s killing more of us than ever before. In the last half-century, the United States has endured three major drug epidemics.
The first began in the 1970s with returning Vietnam war vets addicted to heroin. The death rate due to overdoses was about 1 per 100,000 people. America’s second drug epidemic occurred in the 1980s due to crack cocaine. The overdose death rate doubled to nearly 2 per 100,000. Now, with America’s third major drug epidemic, fatal overdoses attributed to opioids alone claim about 47,000 American lives a year — a rate of 14 per 100,000.
Many of these deaths resulted from a medical professional legitimately prescribing an opioid for pain management. All too often, however, the patient becomes addicted or misuses the drug and overdoses. Sometimes the patient sadly decides that suicide is the only way to escape the mental health nightmares that accompany severe opioid addiction. Unfortunately for veterans, opioid addiction is more prevalent than for nonveterans because pain is more often an issue.
A recent analysis of data from a national survey by the National Center for Complementary and Integrative Health found that veterans were more likely than nonveterans to have a range of painful health conditions—such as back pain and joint pain—and to classify their pain as severe. These findings provide the first national estimates of numbers of veterans with severe pain. The findings show that more veterans (65.5%) than nonveterans (56.4%) reported having pain in the previous three months and a higher proportion of veterans (9.1%) reported having severe pain than nonveterans (6.3%).
“More than 100 million Americans suffer from some form of chronic pain, and the overuse and misuse of opioids for pain management in our country is taking too many lives,” Department of Veterans Affairs Secretary Robert Wilkie stated in an April 24 VA blog post. “Veterans who have served our nation are particularly challenged by chronic pain. VA has demonstrated success in reducing opioid use, while addressing the challenge of living well with chronic pain.” Yes, we are making progress, but much more can and must be done.
Over the past six years, the VA’s Opioid Safety Initiative (OSI) has reduced opioid dispensing more than 50%. Most of this reduction is attributable to not starting new, long-term opioid therapy in veterans with chronic pain. Specifically, VA is not starting veterans with chronic, non-cancer pain on long-term opioid therapy, but is instead offering them complementary pain management strategies. These treatments include the use of complementary therapies, such as acupuncture, yoga, chiropractic medicine, tai chi and biofeedback, and have proven to be more effective for veterans long term.
The Boulder region provides a unique set of pain management therapies that may prove successful in reducing pain and opioid use among vets and non-vets alike. These therapies include hot springs, radon health mines and outdoor recreation such as equine therapy and mindfulness exercises. Along with more traditional pain management strategies, the combination can provide a holistic approach to long-term pain management without dependence on opioids.
At a recent meeting at the VA Medical Center’s Behavioral Health Unit at Fort Harrison in Helena, MSU Extension Agent Tom Harrington, Jefferson County Commissioner Leonard Wortman and I spoke with Unit Director Paul Harman, who stated that the single most important issue facing veterans’ mental health care today is the lack of effective pain management services. This issue is even more problematic for Montana veterans since the closest VA pain management center is in Seattle and has a limited number of beds. In fact, according to Todd Lester with the VA Medical Center in Bozeman, some Montana vets in need of pain management care are shipped off as far as Florida. This can be troublesome enough for single, unemployed veterans, but for those with families and jobs, this is just another major struggle for the veteran to overcome.
Part of the former MDC campus may be an excellent location for a holistic pain management center for veterans. Discussions are underway to develop relationships with third-party health care providers to assist in getting such a program off the ground in Jefferson County. Such a program could bring much needed jobs to the area while providing a long-term positive community impact by reducing the high rate of opioid dependency among veterans.
To learn about the OSI or for more information on VA pain management, visit www.va.gov/painmanagement.
Kristian Richardson is president of Acceler8 Consulting and a veteran who served in the U.S. Army. He can be reached at Kristian.Richardson@gmail.com.
If you are a veteran in crisis or having thoughts of suicide, or if you know a veteran in crisis, call the Veterans Crisis Line for confidential support at 800-273-8255 and press 1.
