Treating pain without opioids, Veterans improve their quality of life



In recent years, there has been a drastic surge in opioid prescriptions to treat pain. While opioids can be helpful for some pain treatment, their use on a chronic basis is controversial due to a significant number of opioid-related overdoses, which highlights a compelling need for chronic pain treatment that does not focus solely on medication.

Options available include programs that combine various health care disciplines and work together with the individual to offer comprehensive guidance on pain management.

“[Pain treatment programs] are much more limited in the private sector because unfortunately when you have the constraints of private insurance, it doesn’t necessarily mean you’re going to get the most effective care. In VA, we are able to provide these interdisciplinary programs, which is the best comprehensive way to treat pain,” said Jennifer Murphy Ph.D., clinical director of the Chronic Pain Rehabilitation Program (CPRP) at the Tampa, Florida VA Medical Center.

Veterans at the Tampa, Florida VAMC CPRP are introduced to adaptive sports.

Veterans at the Tampa, Florida VAMC CPRP are introduced to adaptive sports.

Veterans undergo an intensive regimen of treatments and therapies but also are taught skills than what would not normally be prescribed in the private sector.

“Instead of being dependent on pills and other passive treatment ‘fixes’ that too often fall short, our program and those like ours teach patients daily skills to take with them so that their pain does not feel so overwhelming,” said Murphy.

Veterans are taught a simple, but often overlooked, technique that is highly effective for pain management: relaxation, which helps reduce muscle tension. They are also given the choice of several arts and crafts projects, including painting, copper matting, and leather crafting which serve as a coping method and a means to increase pleasurable activities, something that has often been sacrificed due to pain limitations. Dietitians and chaplains also help by providing information about how nutrition and spirituality can help them manage pain.

These techniques combined with more traditional treatments such as physical and aquatic therapies as well as counseling from psychologists create a comprehensive alternative to opioids that focuses on the whole person with the goal of making life more tolerable and increasing the overall quality and personal enjoyment.

Pain psychologist Curtis Takagishi, PhD teaches pain management methods at the Tampa, Florida VAMC CPRP

Pain psychologist Curtis Takagishi, PhD teaches pain management methods at the Tampa, Florida VAMC CPRP

The ability to treat pain without taking opioids means everything to Veterans like Christopher Anderson, a U.S. Army Veteran who traveled across the country to attend the inpatient CPRP in Tampa.

“You know the amount of relief you are going to get [from opioids] and what kind of function you are going to have after. I have the tools to do the same thing now, without having to take opioids,” Anderson said.

Like Anderson, the American Pain Society has saw the benefits of the program and recognized the CPRP as a clinical center of excellence for helping Veterans achieve a better quality of life by optimizing their level of physical, emotional and social functioning in the home, community, and workplace.

While some of the pain may never go away, Veterans can take back control of their lives by actively managing their pain through various treat options.  VA is one of the country’s leader in providing comprehensive pain treatments and now offers 20 Chronic Pain Rehabilitation Programs across the country.

Veterans can learn more about pain treatment options at http://www.va.gov/painmanagement/ or consult your local VA physician.

Author

Tim Hudak

  joined the VA in December 2013 and is on the Veterans Experience Office team. Tim, a Chicago-land native enlisted in the Marine Corps straight out of high school. As an intelligence analyst he deployed to Al Anbar province, Iraq with Marine Heavy Helicopter Squadron 363 in 2006 and 2008. After the Marine Corps, Tim used the GI Bill to earn a degree in Intelligence Studies from Mercyhurst University in Erie, Pa., and co-founded the university’s first student Veteran organization. Tim is active in many Veteran organizations.

Comments

  1. Benjamin H Willis    

    The VA had me on 2 pain killer at once they just both off no notice just said that Obama said stop pain killer for veterans even though my high blood pressure is service related and I was wounded 4 times in Vietnam one being shot just above my left eye blinding me in that eye right chect right forearm and blown up in a tank I have had a headache since I was 18 1/5 years old I was working making up to 100,000 a year as a machinist tool and die make accounting to how many hours I wanted to work 9 trip to the VA in one year for nose bleeds and the VA and the place I was working told me I had to go because of the blood not just a nose bleed blowing out my nose no I wasn’t taking any drugs! I took a cut of 2/3 my pay to live! To this day after being just cut off 2 heavy pain killer cool turkey at home by myself the VA has done nothing I asked my primary and my phyc to send me to pain management nothing in over a year! I honestly believe the VA is trying to kill us off one by one over 300,000 veterans died in 2014 waiting for care or lack of it! No body will help! Not even family I live along at 66 years old except for my dog. The VA SYSTEM SUCKS

  2. Charlie stevy    

    Another B/S medical study done at the request of some paper pusher that fails to address the real issues of the systems incompetence. Wait three months for an appointment for service connected damage, then wait another month or so for the meds, and that is just a renewal. And this is what I put my butt on the line for?

  3. Cindy Lawrence    

    Why doesn’t the VA include in their alternative therapy treatments the use of medicinal marijuana? It has already helped all those who have used it AND saved lives! It helps with chronic pain and PTSD, which is the #1 cause of Veteran suicides. Taking away their meds after getting them hooked will surely kill a Veteran, if it didn’t already because taking all those toxic drugs kills them slowly from the inside out. Try studying that, won’t you! Opioids kill, MMJ does not.

    1. Dorothy Wheeler    

      I take a CBD tincture. CBD is the part of cannabis that has the high medicinal properties. It is more effective for pain when ingested rather than smoking. Smoking is faster and better for my anxiety I live where marijuana is legal, I am very thankful for that. But yes I have to pay for it myself and my income is below poverty line. It is worth it!

      Yes the VA now requires at least “a yearly” (????) drug test for all VA patients on pain meds including Tramadol (which is not an opioid and does not show up on the drug test).

      It is small children and babies suffering from untreatable seizures that is changing some gov’t people to push for intense studies on cannabis medical benefits. This is a good step that we hope will educate not just the Fed gov’t but citizens also.

  4. Linda Ford    

    I totally agree with you, Robert. Lousy Dr’s, if they’re good they get a capital Do but most are little d’s in doctor. The pendulum swinging this way is outrageous and they will pee test you until you’re dehydrated. I will do anything for some.pain relief, even take pills from a neighbor if offered. And I have been offered. I never would have made it for 3 mo when my hip surgery was schedueled after it crumbled apart. I truly wish I could have sued my primary care dr.

  5. Linda Ford    

    I have read the other Vets replies and I agree with them in regard to chronic pain. I have arthritis and my joints are crumbling one by one. My VA Dr in Grayson Co. KY refused to see me as I was waiting for hip replacement in July & this was April. I was on Tylenol # 4 and got 120/mo. I called him and told him my pain had increased quite a bit. Another Dr saw me & told me that I had “put us in quite a pickle.” She then wrote for 20 more #4s & that was it. I received no further pain Rx from VA until post-op in mid July. Ortho Dr refused as it was up to primary care. ER in Louisville useless bc I signed paper saying PC was only dr to prescribe. Needless to say Ortho Dr had a picnic picking out my crushed hip & no dr thought to take another xray. I’m now back in Phoenix, had a great Doc for 9 mo but she was kicked upstairs to Admin. Then I got ROBODOCOP. She had me off my codeine in 6 mo. as she was concerned about my liver function. (It’s fine). She also sent me Tylenol 500 me 3 btl of 100 unasked for as I was eligible for Medicare & was weaning myself off the Phx VAMC. VA Ortho dr told me they’d replace my knee & put metal plates across my wrists in a 5 min office visit. I told him I’d think about it. He even yelled after me that I “will be begging him to do the surgery” (on wrists) because I would.be in extreme pain. He’s right about the pain but I no longer trust the VA.

  6. David W.Sorrell    

    I seeing a private physician for pain management because I can’t get in my VA because it is full or no Dr. so I am told. I pay for my med’s separate and tried to have the VA pick it up, my Dr was supposed to request outside the VA sense I can’t be took care there NO ANSWER from my Dr .
    I have tried exercise and I will agree that it helped until I get home then I am back to the samething pain is back and sometimes worse.
    My pain management Dr. said that I need to face the fact that the pain will be there take what I can get for any relief there is nothing more I can do.

  7. Gary E Tipton    

    I also have ran into a brick wall with the VA trying to get treatment for my Degenerative Disc condition in Neck and Back which causes me great pain. When Washington decides what’s the best course of treatment for each of us we don’t need Doctors, and that’s what has happened! We now have Politicians deciding every facet of our lives and what’s good for them.
    Our forefathers saw the future very clearly if government became to intrusive and now some of us see it all too clearly ourselves.

    God Bless all that have served this nation…..it seems the appreciation of this once great Country is only truly known among us few.

  8. Jack R Greenwood    

    I have come to believe that anything that is brought forward from the, US Department of Veteran Affairs, is just another way to cause confusion. I have been fighting for my rights since 1971, and mail being sent to erroneous addresses and finally being sent to a doctor for evaluation. The DR did not touch me, he only asked me questions like, “What makes you think that you have a service connected disability?”. Guess what happened, I was only given 10%even though I had civilian Dr i indicating that my injuries may have been caused from my jobs in the service. The last evaluation was from a civilian DR and received an additional 20%, however the statement of the case showed 30% , only 10% was not given for some reason I did not understand. Sorry if I sound bitter.

  9. Christel Davies    

    “In recent years, there has been a drastic in opioid prescriptions to treat pain.” A drastic what? Also, when does the VA plan to make these interdisciplinary programs available to all veterans, not just veterans in some limited pilot program. My experience has been that my doctors want to reduce my opioids without providing any other supplementary care. This reduction in my level of pain meds has decreased my quality of life and increased my frequency of depressive episodes. Also the studies that critique the use of pain meds to treat chronic pain have taken the concept of dose tolerance and rephrased it so it implies that a person’s perception of pain is increasing. Whereas before it was phrased that an individual’s minimum effective dosage increases over time. There is no novel science, and no new statistics that occured in these recent study that wasn’t known 30-40 years ago. All that has changed is the turn of phrase in an age of media induced moral panic… And the victim is one of the most suicide prone populations in this nation. This is shameful.

    I’m 3/4 done with my AS in general engineering. Instead of being in class this Fall or at all this year, I’m in bed with my legs elevated, I’m in great pain, I can’t even do the dishes in the house… So right now my life totally sucks, and I’m going totally stir crazy.

  10. Kenneth Leslie kaehn Jr    

    I served my country for 11yrs. Honorable did my job was injured ,my back now it’s in my medical records from around 1986 til 1994 my warrent officer told me to copy them all and I did and I still have them I have given copies to everyone who is going to help me get army disability. Well I got it! Right in the ass, I get 10% and the ssb the government asked us to take yeah I have to suppose to now pay back, I cannot even get paid to drive 120+ miles for my gas because there’s anything closer and there is a lot more thanks for serving now stay in pain. Good luck

  11. Ralph Stewart    

    I wrote a long reply only to have it erased because the captcha code said I wrote it down wrong. What A joke!

  12. No, No Reprisals    

    I have tried just about everything under the sun!! Unfortunately the VA thinks, or, maybe I should say, the US Government thinks that by offering Non-Opiods Meds, and, other programs that “all” vets will be fine and get along “without” any vicodin, percocet, or, any other opiod med, unfortunately that will be “IMPOSSIBLE” for many, many of us!! I, myself, am in excruciating pain 24 hours a day in my lower back. Have had pain treatments by the “pain management program” which only made the pain worse, especially when the doctor was an “intern” being directed by another doctor who oversaw the procedure on me. It took over 1 hour when normally it takes only 15 minutes!! Move the needles more sideways, more straight up, more this way, more that way, all of this because they use us as “ginny-pigs!!” I’m suppose to have another procedure done this week and to tell the truth I’m NOT sure if I want to go through the pain I went through the last time. Not only that, but, the VA “NEVER” wants, or, should I say, “gives me any opiod medication…..NEVER!!” So, what choices do I have if I CAN’T take the pain because it’s sooooo BAD!!! I have to find it somewhere else!! I shouldn’t have to and I shouldn’t do it…..I know!! BUT< the pain is SOOOO BAD that I HAVE TO DO IT!!! I CAN'T HELP IT!!! Why doesn't the VA understand that "human beings" need to relief the extreme symtems of PAIN and that for many, many of us only "opiods" are the only "relief medication that gives us the relief that takes the "edge-off" the extreme PAIN that we are suffering!!…..why don't they understand….I wish it was them that felt this pain, then, they would see just how bad it is and they would need the opiods themselves……open your eyes VA!!!!!….JAMES HALLEY VA HOSPITAL, Tampa, Florida

  13. Chad Cardenas    

    Before I was medically retired I was going through some of these programs and they did help to an extent. After getting out the VA had me on pain meds that helped with the pain but had horrible withdrawls. Now I dont receive anything from the VA especially an appt.

  14. Glynn Talley    

    I have Psoriatic Arthritis and a few other conditions which cause both chronic and acute pain. I have been taking Methadone for pain for over 10 years and I have never had a problem with side effects. I have not experienced a problem with tolerance as I did with other Opioid based pain meds.

    However, I have experienced many side effects from the Methotrexate, Prednisone, and TNF inhibitors. The side effects for these meds can be life threatening even when taken as prescribed. The problem with Opioids is that physicians prescribed these meds for short term and acute pain the same way they do for chronic pain…BIG Mistake. Also, the goal of pain management with Opioids is NOT to make a patient PAIN FREE…BIGGER MISTAKE.

    Patients and physicians need to be educated that the proper goal for Opioid pain meds is to achieve a level of pain control which allows a patient to participate in the type of activities noted in the article as part of a pain management plan. And, as duly noted…most VA facilities are ill equipped to deliver a comprehensive care plan for management of chronic pain.

  15. Mark Conner    

    I get my pain treated outside the VA. The pcp I had didn’t give a damn about my pain so now I pay out of pocket to see a neurologist. I’m 100% SC and was promised another pcp at the VA. The one I had just flat out lied to the patients advocate and the head of the clinic about my treatment. I see an excellent rheumatologist and endocrinologist at the VA but unfortunately they can’t do what my pcp is supposed to do. Anyway I spend $80 or more a month getting treatment I was promised to receive at the VA.

  16. Glynn Talley    

    I have Psoriatic Arthritis and take numerous medications to manage my symptoms. The side effects of Prednisone, Methotrexate, and TNF alpha inhibitors are far more troublesome and potentially life-threatening, even when taken as prescribed. My pain meds, Methadone, when taken as prescribed have caused minimal side-effects. I find that the problem with the Opioids is that many patients seem to take them in amounts needed to completely ameliorate their pain… in simple terms “people expect to be pain free” and that is how overdoses happen. I have been on Methadone for over 10 years and when I first started the doctor (not VA) counseled me that I should take an amount which allows me to participate in the other therapeutic activities included in my pain management plan…mainly the activities discussed in the article. And that if I am completely pain free with just the pain meds then I am taking too much. So, my point is that, “yes, opioids can be dangerous, but cutting people off is not the answer because most VA facilities are not equipped to provide the ancillary services described in the article. MDs need to be better educated about the proper use of Opioids, and a comprehensive Opioid Counseling protocol must be developed to address what the appropriate goal of Opioid use should be.

    1. Linda Ford    

      I agree. You take.pain Rx as needed not.because you can and that’s an eventual OD.

  17. Robert McCarty    

    My VA hospital does not have any program like this either. I have been asking if their was ant solution other than Oxycodone for 11 years. I finally went outside the VA for back surgery that the VA would not pay for. I am happy I can move my legs without pain now. The VA used to be known as a pill mill now it is very difficult to get the necessary pain meds. The pendulum has swung too far to the other side. Bad doctors are the number one reason the VA fails in so many areas. I have asked the VA doctors if bad pay is the reason they quit, they say no, they complain about the workload and the time they are allowed per patient (15 mins). I have had over 10 different primary care doctors in 12 plus years, that is way too many for me to get the care I need to live. Get primary care doctors before you start these wonderful pie in the sky programs.

    1. michael willett    

      glad acupuncture works for some was sent to VA acupuncturist looked at my chart and pain level would not touch me told me to go to er and get injection, I have had 4 back surgeries damaged spinal cord cannot take NSAID s had to transfer pain management to private doctors as VA refused to fill my pain meds after being on them since 2004 would have put in me into withdrawals wish I did not have to take them but according to all my blood work kidneys and everything else is in normal range if used as prescribed they at least let me get around and enjoy as normal of a life as possible

  18. David W Mair    

    I started “pain management” a few years ago and, thanks to advice from my Neurosurgeon, I started “Accupuncture” treatments. I have been opioid free since then! I hope that the VA will increase the use of Accupuncturists on a wider basis. Currently, I am still receiving treatment privately! I have found, in my case, that a regiment of deep tissue massage and Accupuncture work the best to keep me out of trouble! Both of which I must pay for privately.
    Thank You for your attention….

  19. Ralph Maddox    

    That is all good for some. But what sucks is they seem to think everyone is the same, And we ARE.. NOT! These Holistic approaches do not work on everyone. And I have tried some, to NO avail. So because some get the pain relief without pain meds, then they are going to take away mine??!! Without my meds I am a basket case. And NO! Not withdrawals! Yes, I do have some symptoms of withdrawal, but I have dealt with that part, more than once. It is the excruciating pain that I can’t handle, without the help of my meds. There are pain meds that will help you have all these good quality of life experiences too. The trick is finding the right dosage and combinations. Most of the people I know of that had the crazy negative experiences from Opiates, either did not really need them or refused to take them as directed. It is ALL about control. You control your meds and your pain/// OR THEY CONTROL YOU!!!~ And now because of all the weak ass people abusing their meds., I am going to suffer. Because doctors are being FORCED to limit what and how much, pain medication I can get. I say GREAT FOR YOU!!! If these other methods work for you. But we are ALL INDIVIDUALS!! And we need for our medical treatment to be given accordingly! This from a man that knows!! Been there done that, have tried them all. I know what works for me, and my doctor and I should be allowed to treat my pain, and other medical conditions, the way we se fit!! Thank you!!

    1. Gary Edward rouillard    

      Right on the nose. Out of the ball park

      1. Danny Blakemore    

        I am so sick and tired of the DEA trying to fit everyone in the same round peg hole…This is becoming so ridiculous that is sad! I have knee pain in both knees because i have had surgery when I was in the military from a service connected injury. My knees now are practically bone-on-bone the pain is so excruciating that it has caused severe depression and anxiety because the pain constant 24/7 at my pain level is always between a 7 or 8 even with my pain meds…I have been on every pain med that the VA offers and I and my doctor have finally found a combination of meds that work. I too have tried all of these voodoo doctor treatments along with aquatic and phsical therapy and none of them relieve or reduce my pain and actually after I paticipated in them it made the pain worse because of swelling and stiffness which took days and my pain meds to get some relief!!!! Yes, there are those who have and will continue to abuse the pain meds that they are prescribed, but every situation is different and not all lumped together as though we are all out for some drug induced high!!! I cannot function without my pain meds and would literally be bedridden without them I wear double knee braces and use a walker to stay mobile so pain meds used as prescribed are a great benefit for some of us who really need them!!!!!!!

  20. Joseph Oliver    

    My Va doesn’t do this either nor do they care but yet they think just by pulling us off of our medication that we need to function daytoday think it’s funny [redacted]. The Va says we care what a joke I have been asking for a wheelchair because I keep falling and they keep refusing it thanks to them not giving me a wheelchair I now have 17 staples in my head I’m going to need now and operation on my left eye due to recent fall because I didn’t have a wheelchair I’m sorry but the Va does not care lick [redacted].

    1. Megan Moloney    

      Mr. Oliver, we wanted to include your comment, but due to our social media policy had to do so with some of the language redacted. We did, however, ask our team at VHA to review your full comment and respond to you via the email you provided.

      1. Jimmy Leftwich    

        Perhaps a few valid points are grandstanded here, however the video and the Title is misleading the consensus of the Veterans; in fact the proscription of opioid(s) in pain management has increased the suicide rate of wounded warriors; speak with the parent’s, grand-parents’ and their children, and finally their primary care physician. I have personal firsthand knowledge the veterans PCP is not allowed to practice as their oath of physicians demand, but by a bureaucracy that has parked money and been scandal ridden with the Choice Program; yes that was a hoax to save face with the 98-99% of Americans who never wore a uniform.

    2. George Secord    

      Hey Joe I am in the same boat no wheel chair.I fall about 2 times a day I have perferal neuropathy in my legs and feet and ankles.The va diagnosed it ,all they do is give me more meds and go buy yourself a cane.What I need is to have some Dr in the Va to write a prescription for a wheelchair,no one wants to do that,but I was told if I get prostate cancer or become a diabetic the can help This isn’t rite.

  21. Mike randall    

    Well nice they can do this my VA has NONE of these abilities. So no chance for me at all. Any help at all is only after a fight.

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