Calling the U.S. Department of Veterans Affairs a recognized leader in pain management and opioid safety, VA Secretary Robert Wilkie today underscored the department’s innovative approaches to chronic pain management.

Wilkie’s response followed President Trump’s speech April 24 at the annual Rx Drug Abuse & Heroin Summit in Atlanta, where stakeholders gathered to discuss prevention, treatment and actions to curtail the opioid crisis.

“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,” Wilkie said. “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.”

Over the past six years, 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, noncancer pain on long-term opioid therapy, but is instead offering them complementary pain management strategies. These treatments include use of complementary therapies, such as acupuncture, yoga, chiropractic medicine, tai chi and bio-feedback, among other modalities, and have proven to be more effective for Veterans long term. Veterans are 40 percent more likely to have severe, chronic pain than non-Veterans.

VA has employed four broad strategies to address the opioid epidemic: education, pain management, risk mitigation and addiction treatment. VA addressed the problem of clinically inappropriate high-dose prescribing of opioids, while developing an effective system of interdisciplinary, patient-aligned pain management to provide safe and effective pain control. In the process, VA trained hundreds of clinicians on this approach to pain management.

VA’s approach is Veteran-centric and whole health. By understanding the Veteran’s goals and lifestyle and incorporating a variety of therapeutic treatments, Veterans are now achieving success in managing chronic pain.

VA continues to offer full transparency of its efforts to reduce opioid prescribing. To learn about the VA Opioid Safety Initiative or for more information on VA pain management, go to www.va.gov/painmanagement.

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14 Comments

  1. David May 24, 2019 at 07:41

    See how the anti-opiate rhetoric MUST be derived from one superficial motive by some? That is why it always sounds the same, deceptive, non-committal, vague, WRONG. They have no REAL proof everyone who needs an opiates dies or addicts and so the selling point doesn’t lend itself to ad-libs but a dogma repeated over and over. While sufferer’s opinions, from those who speak or write well and not as well, are offered in a multitude of ways all arriving at the truth. Opiates ARE very safe and effective as MEDICINE.

  2. David May 24, 2019 at 06:50

    The very truest view of Opiates is that they are effective for severe pain and safe as a MEDICINE and the potential for an exaggerated, hyper-active response in the 1 of 250 persons exposed to opiates for medical reasons or by accident or by illicit use must not be ignored at any level from the start. And that opiates ARE the very worst choice for a ‘PARTY DRUG’ as withdrawal is just as bad as it looks, however this is never the concern of those with severe chronic or acute pain who must never be started and stopped and started again or under-treated.

    How do we treat true reductive (self-harmful) opiate addiction?

    With a doctor prescribed and controlled dose of an opiate of course. It is a genetic status, …a condition if you will, a disease if you must (not recommended). We can see the potential for hyper-response, slow metabolisms or normal metabolisms at CYP-450 or by the patients true history (not the one someone has written to ‘justify’ cut-off). Once triggered, if the sufferer of true biological addiction does not have enough fortitude to avoid them, then they must be dosed without stigma or condemnation. It’s just one of the things in life we must allow for. We CAN’T however leave them to seek street substances of unknown strengths or possibly toxic properties.

  3. Tracey R May 23, 2019 at 19:32

    “In two sets of fiscal years — 2010-2011 and 2013-2014 — opioid discontinuation was not associated with overdose mortality but was associated with increased suicide mortality.”

    https://www.wjhl.com/news/va-reps-to-discuss-impact-of-opioid-reduction-on-suicides-during-summit_20180123093420242/934066782

    Written by a practicing psychiatrist who specializes in addiction:
    https://www.politico.com/magazine/story/2018/02/21/the-myth-of-the-roots-of-the-opioid-crisis-217034

    More info:
    https://www.bloomberg.com/opinion/articles/2019-03-21/prescription-drugs-aren-t-to-blame-for-rise-in-addiction-deaths

  4. Tracey R May 23, 2019 at 19:25

    Are you serious?? The “Opioid Safety Initiative” has done nothing but destroy lives. This is despicable to read. Within the past few years, suicide rates have skyrocketed and are now at an all-time high in this country while the overdose death rates (most due to heroin and illicitly-produced fentanyl analogs) have increased by over 500% (yes, FIVE HUNDRED PERCENT). This “Safety” Initiative is forcing people in severe constant pain to choose between UNREGULATED, dangerous street substances that possess strong pain relieving properties and suicide. Look. At. The. Numbers. (This is NOT a politically motivated post, as both sides – democrats and republicans – have the blood of many people in pain who had such a sh*tty quality of life due to suffering ungodly, never ending physical pain they were forced to the unregulated crap on our streets or to ending their own lives). But keep patting yourselves on the back.

  5. David McPeak May 14, 2019 at 18:20

    I have been trying for almost a year (Jul 2018) to get chiropractic care. Fayetteville VA Medical Center tell me I have to go to pain management first. I did in Oct and now they are saying I have to go again. Yesterday, my primary care provider (who is wonderful and trying to get me approved) to say they cancelled the consult again and wanted me to have a drug screen and back x-rays. Don’t mind went yesterday to do drug screen and tomorrow for x-rays (which I have to drive 50 miles for). Funny thing is, one of my service connected disabilities is….. wait for it…diffuse lumbar spondylosis with developing degenerative disc disease L4-L5 and L5-S1. Almost a year to receive a non-drug, non-invasive, low cost to the government working solution.

  6. Jesse Jones May 9, 2019 at 12:08

    My experience with service connected pain started in 1986 looking down at the Patriot Missiles Computers, no ergo and over the last 25+ years I suffer pain every day I wake up, the VA continues to push back on my compensation, even though I went to the Troop clinic and reported joint pains in neck and shoulders both in and on my Initial claim. So the only reason I can function each day is with opiods ! They want to fuse my neck and cant guarantee the pain will go away so I am stuck with the pain medications until Science develops Spinal Cartilage for my neck and back that has degenerated over these years. Every time the DEA and the news focuses on an epidemic I suffer trying to get my medication they add more paperwork, Urine tests and now require Narcan RX just in case I Overdose as if the last 20 years I needed this additional cost RX. The VA is still setup to force veterans into suffering and until they actually accept that we served our country with our Youth and Health and should be treated accordingly we will struggle. God Bless those who Served, and are still serving.

  7. Hiram Meyer May 9, 2019 at 10:07

    And they wonder why so many vets are committing suicide.

  8. Herbert A. Davis April 28, 2019 at 20:50

    I agree that there may be a better solution, however limiting or not prescribing pain meds to a veteran in need is the absolute worst response to a national abuse epidemic. I know first hand what it feels like to live with daily pain, what the cost is if I can’t get out of bed and worse yet the bills I can’t pay if I can’t work. I have had the full gambit of pain management therapy as well as the so called “Living with pain” therapy. All said an done, I am still in pain everyday, still to poor to pay al my bills and have no hope of being able to work as no one wants to take on the responsibility of hiring a veteran that is only partially functional. Not to mention giving a veteran a little latitude if he may not be able to work one or two days in a row because he/she has a spike in pain levels. You folks catch yourselves talking a good game. I challenge you to walk in my shoes for a couple weeks and see the real shame that you are putting on us veterans.

  9. Lee Rice April 28, 2019 at 03:45

    Told by the VA physician that my chances of treatment of my chronic pain from service connected injuries is best outside of the VA because they aren’t allowed to prescribe opioids anymore. But they can have lidocaine injected into my veins! Wha! More vets suffer and who knows how many kill themselves due to this forced zero tolerance opioid policy on the population stricken with higher percentage of sever chronic pain. Stop this.

  10. Shelley Baldwin April 27, 2019 at 14:06

    CDC issues new guidelines for opioids while VA refuses to prescribe them and believes anyone needing them to treat their pain is an addict. Believe me, if, after 54 years of migraines, there was an alternative I would have found it. You fake public servants are ignorant of the issues and do an injustice to our Veterans with this same old governmental, knee-jerk, one-size-fits-all “solution”.
    Shame! We already have 22 veterans committing suicide a day! You apparently think more need to die as a result of perfectly treatable conditions?
    There are words for your ignorance and cruelty as you blindly follow bad policy issued by stupid people.

  11. Pam Molnar April 26, 2019 at 23:05

    This is an OUTRAGE! The VA’S motto is “Deny til dead” So many of our heroes being ABANDONED by their drs, being cut off LIFESAVING PAIN MEDICATION, LEFT IN AGONY! THAT’S THE REASON FOR THE MANY SUICIDES DAILY. !! YOUR #FALSIFIEDOPIOIDEPIDEMIC HAS TAKEN THE LIVES OF THOUSANDS OF PAIN PTS

  12. Charles D Knopf April 26, 2019 at 07:30

    The real truth is , I walk in for my physical , told WE VETERANS ARE THE REASON FOR ALL THE DRUG ABUSE . Stopped MY prescription cold , with no options . Appointment done Dr. left . VA still a joke .

  13. Jennifer Meyer April 25, 2019 at 20:30

    This suvh a load of crap. Veterans are killing themselves rather than live in agonizing pain. I am a victim of the VA. I have done ALL of their so called modalities. Majority of the doctors wiill not even discuss opiod meds. We are suffering and our quality of life is down to zero because of some fake crisis!

  14. William M. Green April 25, 2019 at 19:26

    This is news to me. All I’ve been told is the VA can no longer manage chronic pain. Someone needs to get their stories straight.

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