In a pilot study of Veterans with chronic pain engaged in Whole Health services across 18 “flagship” VA Medical Centers, more than 100,000 Veterans experienced a meaningful reduction of opioid pain medications.
The Whole Health approach to care features conventional clinical care (such as medicines or counseling) and complementary and integrative care (such as acupuncture or yoga) working together as part of an overall treatment plan.
Pictured above, a provider shows where acupuncture is performed on a model ear.
Data from the VA Center for the Evaluation of Patient Centered Care (EPCC): Whole Health Flagship Site Evaluation report demonstrated that, between January 2018 and October 2019, Veterans with chronic pain who used Whole Health services experienced a threefold reduction in prescribed opioid use compared to those who did not.
Opioid use among Veterans engaged in Whole Health decreased 38%. That compares with an 11% decrease among those with no Whole Health use. Additionally, Veterans who used Whole Health services to manage their chronic pain used opioid medications three times less compared to those who did not.
Veterans connected to Whole Health increased by 193%
Prior to the pilot study, 10.5% of Veterans with chronic pain were being connected to Whole Health services. By 2019, this figure increased by 193% with over 30.7% of Veterans with chronic pain connected to the Whole Health System across the 18 pilot flagship sites.
The integration of Whole Health into VA health care was advanced by the passage of the Comprehensive Addiction and Recovery Act (CARA) in 2016. CARA aims to address opioid addiction and chronic pain management among Veterans.
In response to the passage of CARA, VA formalized its cutting-edge Whole Health approach to care that supports Veterans’ health and well-being.
Improved Veteran experiences
Veterans who used Whole Health services reported being able to manage stress better and noted the care they received as being more patient centered. These results indicate improvements in Veterans’ overall well-being.
Improving Veterans’ experiences with care may in turn improve Veteran engagement and foster better self-management of chronic illnesses. Self-management is critical to better health and well-being over time.
Implementation of a Whole Health approach is complex and takes time.
Yet, early findings suggest that when Veterans engage in Whole Health services, improvements in perceptions of care, engagement in care, and well-being are possible.
Demand for Whole Health services is high
Over 97% of Veterans responded that they were either somewhat interested, very interested or already using at least one Whole Health service. During interviews for the report, Whole Health leads shared several stories of the impact of Whole Health approaches on Veterans. These included reductions in the use of opioids and other pain medications, weight loss, smoking cessation, and improvements in mental health.
Whole Health leaders attributed these changes, in part, to a radical shift in approach to health care. Care shifted from one that fosters dependence on medical professionals to one that empowers Veterans and promotes their active partnership with a medical team as they figure out what health and well-being looks like for them.
“These are early findings. Even so, the opioid outcomes are striking and we’re seeing this is good for employees and the system,” said Barbara Bokhour, the principal investigator for the study and director of VA’s Health Services Research & Development Center for Healthcare Organization and Implementation Research at the Bedford and Boston VA medical centers.
“This may take as many as 7-10 years to adopt a Whole Health approach across VA,” she added. “We have to ask, is this the way VA should go? Early findings are saying yes.”
For more information on Whole Health and access to Whole Health service, visit www.va.gov/WHOLEHEALTH/.
Malaika Karriem provides contract support for the VA Office of Patient Centered Care and Cultural Transformation.
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I read & read how alike veterans or citizens look for relief wo being considered an abuser. To who else reads this, let me say it’s all true. I have a family business & must work. I want relief to get to work. I want relief so I can read a book. The alternatives mentioned? I do or have done them all. Just like a drug, some work better than others but nothing perfect. And I don’t think there will be for awhile. Many vets get wounded & by no choice, need help. Thank The Lord I wasn’t wounded, just over did at 27. Now I wish I had relief at least 3 out of 7 days, but not yet.
The Vetern needs everything that will help wo having to wait or permission. They didn’t schedule getting hurt & neither did I. I hope someone reads these letters & realizes we all know there’s no such cure. But I do believe it should be easier to help those who want to function & not be told there’s nothing to help if restrictions weren’t limited by a company or policy.
VA Healthcare like Ann Arbor PM&R and the systems leadership have been falsifying patient records for years which then are used in the false and biased studies. In addition to that they also have been dumping thier undesirable patients through disruptive behavior reports, withholding treatment and intimidation.
I have chronic pain! In 2016 I was removed from all pain medications. I am a veteran. I was lucky as The VA Dr’s had alway’s given me too much medication for pain. I had enough saved that when I was no longer alowed to have them, I had a three year supply left. Neither over or under prescribing is an answer! I would suggest a class action lawsuit aiming at better care for all veterans!
Either work on inventing better safer pain control, dig deeper into the root cause(s) of the pain or put more effort into monitoring but don’t just think that you can chock up another success story by stopping the only thing (so far) that has provided any relief. Bad went to so much worse when this new version of “just say no” came into being.
I gave it a try, went through Yoga, physical therapy, pain medicine and high end, probably very expensive acupuncture where I felt like I was coming out of a spa, for about 10 minutes. I wish they worked, would do anything to find something that worked, there just isn’t anything out there that even comes close unfortunately.
I see I am not alone going through this new brute force “just say no” attitude, it is really a horrible thing to do and then to brag about a success story?
We had accupuncture but it was taken away. I have never seen chiropractor or massage available at the VA. I would like to see more “alternative medicine” (actually ancient and time honored medicine) at the VA.
MY WHITE COAT FOREVER DESTORIED ALL WHITES CREITABLITY AND THE VA IS WERE WE GO TO DIE.
Historically our Military Veterans have struggled with chronic pain and coexisting problems post discharge and were often only exposed to the traditional Bio-Medical Mode (Pills, shots, procedures and surgeries). As a country we need to better serve our Vets. This new pilot study seems to be a step in the right direction. It is much more humane that what has been a draconian approach of just taking people off all Opioids.
I love this pilot study of Veterans with chronic pain engaged in Whole Health services across 18 “flagship” VA Medical Centers, more than 100,000 Veterans experienced a meaningful reduction of opioid pain medications.
Dr. Stephen F. Grinstead
Ann Arbor has been cooking up false patient records and study results for years.
I’m not trying, I’m not arguing, I’m not calling my Senator, I’m not calling my PA. I’ve cancelled all of my appointments including my second COVID vaccination and closely monitored cardiac care. Even the veteran service organizations don’t want any part of the opioid stigma.
Just a question though, why doesn’t the VA release a propaganda film to be shared by the recruiting office showing the dangers of enlistment and the expected treatment available if in the event of an injury. I mean, where were you then and why are you taking the respect away that I’ve earned now?
What they DON’T say in this article…is that these vets who were receiving opioids for chronic, intractable pain were cut off from these meds COMPLETELY, with no recourse or anything/anyone to help them with withdrawal symptoms…and what about the chronic pain? Thats supposed to just disappear because we do acupuncture or one of the many BS treatments that don’t and never have worked? I am a vet, but I will not EVER pass thru the doors of a VA hospital or clinic. I have seen first hand how our vets are treated. The government want us dead…that is the end all game here. It is a very sad state of affairs when one has to turn to the streets to find pain relief…and if you don’t think its happening because you don’t see it, just stick your head back in the sand…you are part of the problem and will in no way offer or give any solutions. I guess the drug cartels need to step up their game. They are supposedy re-writing the 2016 guidelines…and I am hearing it is “much worse” than the 2016 guidelines. And BTW…if these are “guidelines”, why are they jailing doctors for doing their jobs? I thought they were “guidelines”…the gov’t. Has criminalized pain medicine plain and simple. All of you who are sick – dying – chronic illness…we have been fed to the wolves. This is a very SICK society when a person works 40 years paying into a “system” that just robbed you of your money and health…this is their endgame all along. I HATE these people with a vengeance that cannot be described in words. I hope there will be a special place in hell for the likes of Andrew Kolodny, who is making millions mios representing chronic pain patients as nothing more than “heroin users”…
It is disgusting the lies that are in this article. These brave men and women didn’t have a choice. Their opiate medication was forcibly taken from them. There is nothing wrong in using complimentary means to help you deal with chronic pain but don’t leave the only medication that works to relieve severe pain off the table opiate pain medication. The suicide rate in our veterans has gone up by 30 percent since they started this disaster of taking opiate medication away from our most severely injured soldiers. Just like with Covid-19 politics has no place in the decision making when it comes to doctors and their patients.
This is an absolute travesty that has made things worse, not better.
They brag that fewer vets take opioids, but ignore the fact that untreated pain has increased & pain-related suicides.
The wounded veteran that fought for American freedom is viewed as a drug addict in need of Rehab and a never-ending series of drug tests & marginally effective treatments that somehow cost 3 to 5 times more.
Experts who have never been within 1000 miles of conflicts teach “Life to pain, deal with it” while vets who complain they are still in pain are said to suffer from an array of mental disorders making them unstable and dangerous.
They don’t mention that terminating or tapering opioid therapy TRIPLES RISK OF DEATH.
Perhaps the worst effect of all is the destruction of trust between doctors and patients.
I recently twice suffered through wide-awake cataract surgery after admitting to opioid therapy a decade ago.
I was given minimal sedation and they refused my request to properly sedate me before starting surgery, telling me to stop moving because “I’m about to start cutting your eye.”
PLEASE, ALL VETERANS, contact your states’ senator regarding the disinformation in this VA article! Also, contact the media about the truth!!! I can’t believe the propaganda they are trying to feed the public! We need some really good investigative journalists to dive into this story! The main theme of their program discussed above, is to get veterans off of opioids which started when the 2016 CDC guidelines came out or before! They are bragging about the reduction of opioids and how everyone is so happy with the program and from my research, these are lies! Actually talk to a lot of veterans who suffer from chronic pain daily, mostly due to injuries received while deployed and see what they tell you! Research just a little bit & you’ll find articles about when the VA began forcing vets off of their pain medications. These veterans are having intractable pain but have been taken off of the medications that work for them and this has caused so many daily suicides!! Surely you’ve read about the increasing number of veteran suicides in the news? Funny how those reports stopped recently and I can tell you that it’s not because the suicides stopped! The VA is not being truthful and this truth story needs to be told! I urge not just vets but the public also, to contact the media and your senators, and tell them the truth! Someone also needs to investigate who’s responsible for putting out these lies! ENOUGH ALREADY WITH THE LIES! The CDC/FDA has admitted that their statistics on OD deaths are way, way wrong! The numbers are wrong and the reason for the OD’s are wrong! Illicit street drugs with illegally manufactured Fentanyl and poly-drug abuse are responsible for the skyrocketing OD rate, NOT Rx pain meds, yet no one in power is listening to those with the proof! So many laws, programs, insurance rules, etc., have been written – all using the 2016 guidelines as proof these changes need to be made, which are causing those with pain to suffer needlessly! Many chronic pain patients have been cut off of their meds and/or force tapered to non-therapeutic doses! Even those with acute pain (i.e. accidents, illnesses), surgical pain and even patients on hospice are suffering! For those still receiving even lose doses, they are constantly battling with their doctors, pharmacies (who refuse to fill the Rx’s), and insurance companies who are refusing to cover many of these pain medications or limit the number of pills each month to very few! Doctors are pushing addiction drugs onto pain patients and this is because of the lobbying from Physicians for Responsible Opioid Prescribing (PROP), and some other organizations made up of parents who lost “children” (adults), to OD. They claim their child OD’d after receiving a Rx for a pulled tooth or other minor cause of pain and this is just not true! If you research some of these “children”, you’ll find they were addicted and/or were heavily involved in illicit street drugs and that’s what caused their OD’s – not Rx pain medications prescribed by their doctor! The information that PROP is putting out there through many different avenues, which are massive, is so loaded with propaganda, I honestly don’t know how they continue to get by with it, especially Andrew Kolodny!! They have been feeding these lies to other countries too, and helping them write their prescribing guidelines! Canada bought into it but then found that patients were suffering and it was driving pain patients to the street for pain relief, causing an increase in their OD rates, so they stopped using their new guidelines! Then PROP started “helping” Europe with their opioid policies and it’s very bad for pain patients! THE TRUTH NEEDS TO BE TOLD! Some have put the truth out there but the media just ignored it. When will the truth be listened to and who is going to shut PROP down (research back to 2004 and you’ll see how Kolodny became a salesman for addiction drugs like Buprenorphine and Suboxone and you can figure out why PROP really cared so much all these years…… follow the money)!
Im 60 years old ive been shot in the lower back L4 it damaged my spine this was in the early 90’s I also have 3 other discs damaged since 2004 ive taken pain meds opioid im the soul provider for my 3 kids and wife of 34 they have made it impossible for me to get my meds the doctors tell me if they operate on my back ill be retired for sure I have 1/2 of a bullet resting against my L4 they say it can’t be removed with possibly crippling me. Right now as I write this its 2:31 am I have to be up for work at 5:30am thats 3 hours from now i its not addiction I haven’t had any pain meds in 6 months its just overwhelming pain. I’m so desperate im going to try any way possible to acquire pain meds I must work or lose my home. Ive already had to ex military friends die since this BACKWARDS ASS band on opioid both men had been permanently injured and over night there doctors refused to give them any real pain relief both had never drank alcohol but both started drinking trying in desperation for any relief everyone I know is now resorting to the streets both of my friends were decorated soldiers both died from street Fontenot. All these treatments described in this bullshit article are for people with out permanent spine injuries that have REAL EVERYDAY
PAIN.
All the alternative non opioid stuff is junk. It doesn’t relieve pain and most definitely doesn’t improve functionality. Treatment of people in pain in this country is abusive and inhumane. I discourage anyone to go into the military as they will be treated worse than a prisoner of war after having served. They will leave you to die a slow painful death due to untreated pain. You will be gaslight and abused saying your pain is in your head and you can control it with your mind or sone other psychological torture they use called ‘pain acceptance’. They will make you go through so much junk alternatives that will provide you no relief. You will feel like you are being experimented on by a bunch of callous aliens that don’t have any empathy for you or your pain. The torment will be constant and unrelenting and street drugs or suicide are the only way out. This horrific treatment of people in pain needs to stop. It is a human rights violation.
Veterans doing Yoga bull fodder !!!!
I am not a veteran however since I relocated to Florida the new pain management doctors have reduced my pain medication to the point that I am in the bed 20 out of 24 hrs. Before
I moved here I was working full time and now I use a walker just to be able to get around and even at that it is very difficult and painful. The war on opioids is a farce. It is a scam to get everyone to go on medical marijuana that is being regulated and taxed by the government. The people that get addicted to opioids are people who are using them illegally like kids getting into their parents or someone else’s medications that are not prescribed for them . It made me made to see the Congress woman and her son that got addicted to opioids when he was a teenager and now he has been clean for a few years and goes on to write a book and make a ton of money . WE ARE THE ONES SUFFERING BECAUSE THE GOVERNMENT AND INSURANCE COMPANIES ARE DICTATING WHAT IS SUPPOSEDLY GOOD FOR THE PATIENT. BUT OUT ! AND LET THE PAIN DOCTORS DO THEIR JOB!!!
Yes it is impossible to get pain medication practically speaking in the VA medical system. I am not sure the decline in vets taking pain meds was exactly voluntary
I LEFT THE VA SYSTEM.
I spent YEARS on high dose IBUPROFEN that led to intestinal and gastro issues. I got tramadol through my private care provider. It worked well. Then some dumbass decided it should be Schedule 2!
Tramadol has LOWER addictive properties than most sleep/anti anxiety meds. You do not get “high” on tramadol, so it is low risk for recreational abuse. Yes, you can develop tolerance and then need a higher dose. This is true of MANY MEDICATIONS when used over time…even OTCs.
I had surgery recently and I am INCREDIBLY GRATEFUL that my surgeon pushed back against the pharmacist and filled the 30 day supply of oxycodone. I needed a higher level pain med. It was more pain than I expected, and worse than the prior surgery in my neck. Location does matter!
I had strong enough meds, early enough, to allow me to remain still and heal. I was kept comfortable. I had enough meds for my entire recovery period…8 weeks. I did not use it all, but have a few left if severe pain returns. I think many doctors underestimate the level of acute pain after surgery or from spinal involved injury. Nerve pain is hard to control at times.
The VA left me swinging in the breeze for years. All of my service connected care for my back and neck has been paid for by me. When I cannot work this job anymore or lose my private insurance, I will have to stop working! I cannot work without the spine injections to control the back pain. The VA doesn’t seem to want to go there, either.
I am receiving pain meds through the VA. They are automatically delivered at the end of each month. Ask for a different Primary Care provider. I also get epidural injections that help.
Dave
Whole Health my A$$. I was happily living my life with chronic pain until the VA decided that true pain should be experienced by all by making the Opioids that I had been living with for over 10 years so difficult to obtain that I just quit. I was referred to a pain management civilian doctor for procedures to alleviate pain from spinal stenosis. Well after all the steroid injections and burned nerves, the Doctor put me back on opioids to kill the pain. I doubt that the :”Whole Health” doctors have ever experienced severe chronic pain. Opioids are designed to treat pain and they do it well when managed correctly. Why should we pain sufferers suffer because others can’t control their actions? The VA has failed me personally many times in the past. Their concept of pain management is just another failure for me. I have Medicare, thank God, and all my Doctors are hose of my choosing. During my 15yrs with the VA I have had 6 or maybe 7 PCP’s and at least 5 Psych docsl My current PCP is a PA, which is ok because I only use the VA for the rest of my medications. My wife has ChampVA because I’m at 100% disability. I wish I could get the same plan as she has which is basically Medicare with a supplement with no cost drug coverage. I personally think that we disabled veterans should have a non political group to express our concerns. Groups like the DAV and the other service groups are too closely tied to the government to get any real concerns passed along.
I will not be here if they continue to reduce my pain meds. They’ve already reduced me by 80% that’s a fact. I can’t live like this I’ve never abused my human right to have pain relief. Not once. I should not be punished for people who have or addicts who need help with addiction. You can sue a doctor that doesn’t treat your pain appropriately. It’s inhumane to let a patient suffer… always be respectful to your doctor and never lose your temper. But know you DO HAVE RIGHTS.
Very well said. There are too many people suffering because of the government thinking they know what’s better for us the patient than our doctors do. The CDC exaggerated their numbers of opioid deaths and overdoses and have even acknowledged so. And their writing of the 2016 CDC Guidelines were to be used as a guideline but too many have used it as law and have gone too far with it…Government Overreach. It has harmed millions by untreated or undertreated pain. Less than 2% will ever become addicted from pain medication and you have to have the gene to become addicted. It’s time for the public to realize that the narrative that’s being fed to them through the media is false and incorrect and they need to help to get the truth out before it affects your or a member of your family. Pain does not discriminate and everyone is only and injury or illness away from it and you will be left to suffer just like 30 million people are right now.
My cousin was a Vet. He was injured by an IED. He lost his leg and almost his arm,11 surgeries. He was cut off of meds and became suicidal and ODed on the street. I’m a pain patient for 38 years. 20 years with pain relief and a life. 5 years ago I was lowered and lost all function. I’ve done all alternatives but they don’t lower my pain levels or give me function. I’ve done PT exercise/stretches,electric stimulation, radio ablation,injections,Botox, meditation, acupuncture,biofeedback, hypnotherapy, mindfulness, yoga,chiropractic,osteopathic, yoga,guided imagery,individual therapy, group therapy, occupational therapy,TMS, Cognitive Behavioral Therapy,Reiki,myofascial release,massage,Ketamine infusions,all alternative meds,Kratom and MMJ. I’ve tried everything available, I may have left something out. The elderly, disabled and Vets are dying from untreated and under treated pain from heart attacks, strokes, endocrine and organ failure, suicide and OD from desperation. .03%-8% exposed to opiates developed addiction and those had a history of recreational drug use. 64% of drug users surveyed recently said their main reason for using was pain. You aren’t helping them by taking meds away. Multi modal pain management is the best for people when it includes the actual treatment of pain. Don’t kill all of these brave kids to look good on paper.
Try a roll your own for PAIN Medication alternative to Opioid’s
Complimentary medicine and nutrition is a fine idea. It does not, however, solve real chronic pain. Take the politics out of prescribing appropriate meds for patients with pain. Science and medical necessity, as we learned during the last 12 months of Covid19 cannot be left to the whims of politicians. Why not without insulin and force diabetics to practice deep breathing to control their condition. Same answer, seek to heal and respect your patients
I am not a vet but I AM a chronic pain patient. There IS an opioid epidemic but instead of addressing the problem they treat actual patients like criminals. I practice yoga, meditation etc AND I used oral opioid medicine. Then my doctor had to change my therapy and discontinue one medication because of the hysteria and I went downhill fast. He then retired because he couldn’t effectively help his patients anymore. I now have a pain pump (surgical implant for part of my pain) and that has saved my life. I was yelled at by a “care” provider for saying I understood why pain patients committed suicide. Yelled at for expressing my pain was so bad that I might prefer not to be around even though I love my grandchildren. The problem is the cartel… The illegal drug trade is doing fine but they focus on doctors and patients who are suffering.
Dependence is NOT addiction and pain patients properly cared for by qualified pain management doctors are not the problem or the ones overdosing.
Please offer whole health services (mind and body) AND proper treatment for pain including opioid medication.
What they don’t mention is that they’re taking opioids away from veterans against their wishes by the hundreds of thousands, which the CDC brags about doing, leaving these veterans to be tortured in unrelenting severe pain, giving them a second chance to die for their country, and profoundly lowering their quality of life and leading to an increased suicide rate among veterans. There are no better treatments for chronic severe pain than opioids, which have been safely used for countless thousands of years. They are very safe and effective when used as directed. The problem does not exist due to exposure to opioids; nothing can cause addiction. So-called addiction is nothing more than the desire to use and abuse a substance over and above its intended purpose and regardless of the negative consequences to one’s life because you enjoy the feeling you get from said substance. It is a 100% choice to abuse any substance, including opioids. Addiction can’t be given to someone, as it’s not an objective side effect, and addiction is never about the tool and is always about the person. And the physiological aspect of opioid use that occurs that people equate with addiction is just the physical dependence that happens, just like it does in many drugs, including those for heart disease, diabetes, depression, anxiety, etc. A body does not know the difference between use and abuse, and withdrawals will occur with anyone on long-term opioids; it is not a sign of abuse or addiction in any way. Withdrawals are a physiological process that cannot be controlled via behavior, while addiction is 100% a psychological issue that can be 100% controlled by behavior. Big difference between the two. Huge. And as long as some amount of monitoring is done with the usage, studies show—including those from Harvard and Cochran—that there is an abuse rate of less than 1% with chronic opiate usage. This opioid hysteria has got to end because it is leaving people tortured and dead. It’s past time the government attacks the real crisis: the illicit drugs, especially the fentanyl and carfentanyl coming from China. And stop going after the low hanging fruit of chronic pain patients and their brave physicians just because society loves to hear objective numbers in the lowering of prescriptions, yet have we seen a decrease in overdose deaths? Not by a long shot! They continue to rise year after year, despite reductions in opioid prescriptions of 30+ percent over the past few years. It’s time the government actually does its job and stops attacking the wrong people; too many innocent people have died because of it. And give these veterans the right tools to handle their pain. Haven’t they’ve done enough for this country!? They don’t deserve to be tortured and killed because people don’t understand the real opioid crisis that’s occurring: The torturing and killing of innocent chronic pain patients who are usually in pain through no fault of their own.
Maybe they would have had something like this in place prior to abandoning and abruptly cutting off tens of thousands of veterans from their pain medications!! Funny they don’t mention all the veterans that have committed suicide since losing their pain meds. Over 3 veterans per day have committed suicide since losing medications. No tapering was done at all. There’s a huge difference between being dependent on and being addicted to medications. Even the CDC GL expressed tapering at 10% per month.
Anyone who thinks yoga & acupuncture helps chronic pain, has never experienced chronic pain! Some aspects may help certain pain, emotional trauma, PTSD, but when someone has experienced true physical pain, such as our veterans who fought for each and everyone of us,they should not have to suffer in pain everyday.
Pain patients alike have been abruptly cut off all opioid medications because 1% become addicted. Most can’t even find a physician to care for them at all any longer as Pajn Dr’s are being arrested or threatened to lose their license.
The 2016 CDC Guidelines were written for Primary Care Physicians for Acute Pain. GL have been misapplied, even the CDC, WHO, HHS, and more agree to this statement. The GLwere to be rewritten early 2021, but so far have not. No one will admit to who is even rewriting them at this time!
This was created by PROP, to have pain patients be prescribed Suboxine which is another drug being abused & being soldi illegally on the street. .
The fake Opioid Crisis is and always have been a HEROIN & ILLICIT FENTANYL CRISIS.
Stop allowing these drugs into our country. It is NOT prescription meds causing this crisis, and all these alphabet groups have acknowledged this as well.
How about thanking a Vet and support them by relieving more of their pain, with things that actually work with very little side affects. Everyone deserves Quality of Life!