VA study uncovers critical link between pain intensity and suicide attempts

New study finds pain intensity is a telling risk factor for suicide


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Many factors are associated with suicide risk. These factors range from PTSD, depression and anxiety disorder to financial and interpersonal concerns to access to opioids and other lethal means, like firearms. Even when we take these risk factors into consideration, moderate to severe pain intensity is associated with suicide risk.

Veterans are a particularly vulnerable group. The suicide rate among Veterans is 1.5 times that of the general population. Also, Veterans develop chronic pain conditions at higher rates and report greater pain severity than members of the general population.

VA’s Behavioral Health Autopsy Program: Executive Summary reports pain is the most common factor Veterans experience before they die by suicide. The VISN 2 Center of Excellence (CoE) for Suicide Prevention studied the link between reported pain intensity and suicide attempts. The results may uncover how effective pain treatment can be a critical suicide prevention tactic.

Managing pain in daily life

Veterans have several treatment options through VA to cope with pain and reduce pain intensity. Nonmedication interventions are considered first-line treatments. They include physical therapy, cognitive behavioral therapy for chronic pain and chiropractic care. Medication-based treatments include nonsteroidal anti-inflammatory medications and injections. Examples are cortisone for low back pain and botulinum toxin for migraines. Opioids may be used under close monitoring when they are taken appropriately and the benefits outweigh the risks.

Strategies

Strategies that improve psychological well-being can also help Veterans cope with pain in everyday life. Veterans can discuss the following tactics with care providers to see which may work best:

  • Be honest about the pain you’re experiencing. An important step in managing chronic pain is accepting that it is part of your life. Accepting the presence of pain can help you move on and engage in enjoyable and everyday activities despite that pain.
  • Pace your activities. Although you may not be able to do everything you did before the pain began, try to find ways to reintroduce some activities in a moderated way and create more balance in the activities you’re doing. For example, if you plan to go for a long walk in the morning, consider taking a break mid-day to give your body time to recover and to prevent a pain flare-up. Even if you start to feel better over time, avoid overdoing it to avoid a relapse or further injury.
  • Explore mindfulness. Increasing awareness of the present moment can help relieve emotional and mental tension that can intensify physical pain. Meditation and other mindfulness practices help you become more comfortable in feeling the way you feel without judgement, helping to prevent pain from taking over your thoughts and acting on autopilot.

To learn more about pain management treatment provided by VA, explore VA’s pain management webpage for Veterans.

People with higher pain intensity had lower survival rates than those who had mild pain or no pain at all.

Study findings

A CoE study looked at Veterans’ average pain intensity scores in the year after they began receiving pain specialty services to determine whether pain intensity was associated with suicide attempts. Based on data from 2012–2014, moderate and severe pain over the course of a year increased the risk of a suicide attempt, even after considering other factors like a Veteran’s history of suicide attempts.

As the graph to the right shows, those with higher pain intensity had lower survival rates than those who had mild pain or no pain at all. This close correlation between pain intensity and suicide risk and death rates suggests that reducing pain, or the perception of that pain, can help prevent Veteran suicide.

Advice for Veterans’ family members and friends

Family members and friends are often the first to realize that a Veteran may be at risk for suicide. Warning signs include changes in mood or behaviors, outward comments about suicidal thoughts or increased interest in lethal means, such as firearms and opioids. If you see these signs in a Veteran in your life:

  • Start the conversation. Topics of pain and suicide can be challenging to talk about. Still, don’t be afraid to begin the conversation with the Veteran you’re concerned about. Starting the conversation can help the Veteran realize the need to address pain. It also reassures the Veteran that you’re willing to help.
  • #BeThere for the Veteran and engage in healthy activities. Invite your friend or loved one to a movie or dinner or for a walk around the neighborhood. Getting a Veteran out of the house can remind them of activities they can enjoy, despite their pain. Research suggests changing a Veteran’s mindset and engaging them in activities can improve overall wellness.

Learn more

  • Visit VA’s pain management page to learn more about resources specific to pain management.
  • Explore VA’s suicide prevention resources for information on how to identify and address thoughts of suicide.
  • If you or a Veteran you know is in immediate crisis, contact the Veterans Crisis Line: Call 1-800-273-8255 and press 1, text to 838255 or chat online.

 


Lisham Ashrafioun, Ph.D., is a research investigator at the VA Center of Excellence for Suicide Prevention at the VA Finger Lakes Healthcare System and an Assistant Professor of Psychiatry at the University of Rochester.

Author

VAntagePoint Contributor

— VAntage Point Contributors provide insight and perspective on a wide range of Veterans issues. If you’d like to contribute a story to VAntage Point, learn how you can submit a guest blog at http://www.blogs.va.gov/VAntage/how-to-submit-a-guest-post/

Comments

  1. Richard A Lawhern, PhD    

    I speak and write as a non-physician subject matter expert and literature analyst, working as a volunteer in online chronic pain communities and studying public policy for regulation of prescription opioid pain medications. I have 23 years experience in the field with thousands of person to person contacts and over 75 publications. From this background, I must assert that the VA – under Congressional direction dating from the December 2015 budget resolution bill – is actively harming veterans by advocating fraudulent clap-trap as a substitution for therapies that work and are safe for almost all patients.

    While not all patients do well on opioid medication, we know that for moderate to severe pain in many patients, opioids are the only therapies that work. The state of trials literature for non-pharmacologic / non-invasive alternatives is absolutely abysmal! Pain improvement in this class of alternative therapies is uniformly small and transient, even when it occurs — and in the great majority of therapies, no significant improvements are noted. No large scale Phase II or Phase III multi-center trials have been published and there are no scientifically sound data comparing non-opioid therapies as substitutes for opioids.

    There are also no published trials demonstrating benefits to patients from involuntary taper or de-prescription of opioids. It is not going too far to say that mandated opioid taper in a patient who is otherwise stable and has demonstrated benefit in reduced pain levels and improved quality of life constitutes patient abuse and abandonment and should be legally actionable as malpractice.

    It is time for the VA to seek legislative relief from Congressional direction to implement the 2016 CDC Guidelines on prescription of opioids to adults with chronic pain. The guidelines have been publicly repudiated by multiple professional medical academies as biased against opioids, founded upon weak or no actual medical evidence, and silent on the effects of genetics in creating a very wide range of minimum effective opioid dose from individual to individual. The guidelines must be recalled and removed from CDC authority as soon as possible. Veterans will continue to die from suicide prompted by the desertion of VA doctors and refusal of opioid therapy until this step is taken and prominently announced in public media.

  2. Glen Cooper    

    VA Secretary Willie has made his Veteran’s Day speeches. Again bragging that health care meets or exceeds all other agencies. Bragging about suicide prevention. These statistics are created by the VA, not Veterans. He “sites” life liberty and the pursuit of happiness” when Veterans have lost the liberty of choosing available pain medications. It is not the Government’s job to decide. They are suppose to work for us. Instead they persecute the Doctors who support opioid therapy. Be assured that the VA is getting them out of Veteran hospitals. Be assured that they not hire these Doctors. Be assured that the VA tells staff NOT to prescribe. Be assured that CDC guidelines for “palliative” care will not stop primary care providers from tapering and stopping every patient from getting treatment. On this VETERAN’S day be assured there is a VETERAN with a gun in his mouth. He has pleaded with doctors and law makers. His death is on people like Willie. Who pushed this person? Secretary Wilkie says “60% of suicides were not VA related at the time it happened”. NO ONE COULD KNOW THAT. (except the dead Veteran). This is s preventable death. Wilkie goes on to say that only 1% of Americans serve defending all of us yet admits that 20 Veterans kill themselves daily. They admit that the VA overprescribed for years and now “the fix” is to cut off opiates that have been safely used for years. Even the State regulations differentiate between initial and long term usage. No one knows the permanent brain/body changes in people like me who were started on Vicodin 15 years ago. We are no longer “wired” for tapering and we should not be forced to re-do alternatives AGAIN. The VA. is not taking the responsibility for starting us on opiates. We need Veteran organizations to start filing VA 1151’s for compensation for treatment while some of us are still alive. Saying “we know better now” and creating conditions for suicide is not Okay. I have said that if my dog gets run over by a car it is my fault for letting him get in the road. The VA HAS PUSHED VETERANS on to a road that they did not want to cross!

  3. Randy H    

    I’ve had my pain med cut back once against my wishes. I began using even more over the counter NSAIDS, I developed an ulcer. I tried other OTC’s, Topicals. I used Icy-Hot, until I developed a tolerance for it, then I used Capsaicin until I developed the same tolerance. Even if I accidentally got either of those in my eye, it eventually became a non-event. The pain was unrelenting, walking anywhere was out of the question because it meant several days of pain afterwards. All I really wanted was to be healed. It took the VA a full year to discover my back had been broken. A VA surgeon said he would do surgery if I prehabbed. He prescribed Baclofen, it made me aphasiac for several days, but it definitely worked for spasms. After I prehabbed, he said I didn’t need surgery anymore. WTF?!! By then I was using IcyHot and Capsaicin together; 4 capsules Naproxen BID; 4 capsules Ibuprofen BID; plus the Baclofen and the narcotic. Which narcotic? Tramadol, I decided on it because it offers no euphoria, if there is no high, I’m not inclined to abuse it. Did I mention I’ve been on Topomax since 2004? I was trying, dammit, to stay off of pain meds, but PAIN has ended my life, and truly, I HATE being on mind altering drugs. I’m taking 5 CNS depressants, I feel stupid, I lose words, trains of thought, I forget everything, long and short term, I have false memories now. I’ve gained 20lbs, many inches, several sizes, I’m fat, breathless sometimes, I just plain look awful. I used to, backpack, mtn bike, kayaking, I was a gymrat. Standing in the kitchen long enough to actually cook Is agony, it means I will be down for days. standing or walking longer than 30 minutes is painful. Still I don’t want to be on Baclofen and Tramadol f—king forever. I asked my doctor to take my Tramadol down by one pill a day, I’m at TID. I also asked her for a stronger NSAID, Naproxen and Ibuprofen were not enough, and a Prescription Strength (5%) Lidocaine Patch. Surprisingly the Patch was stronger than I had imagined it would be, especially when used regularly as prescribed. The Meloxicam works well too, but I needed more, I sent her a message. Together we decided on 7.5 BID. It’s been a year, with my doctor’s help I’ve managed to get it to 2 Tramadol a day with the extra pills being used PRN. I know it’s time to cut back on the Tramadol again, but this time I’m really scared. Those PRN pills make it possible to take a shower, do my hair, brush my teeth, get dressed, even put on makeup. PRN pills make it possible to go out when I am invited somewhere. I want to get off drugs, but I don’t want more pain than I have. When I injured my back at the gym, I lost everything that is me and inherited a useless body wracked with pain. Drugged or not drugged, who I am is gone, if it didn’t hurt everyone else I would have left it already. Quality of life is sh!t.

  4. Glen Cooper    

    It is always about Money. (Well, not for people in terrible pain). When people no longer profit from drug sales, just switch over to the profitable Rehabilitation industry. You cannot turn the TV without a “plug” for a treatment center. Isn’t Capitalism great? Addiction will increase anyway and people in the illegal trade can increase prices and expect more business than ever. Now….Why are drugs so valuable? Laws and Government control. If they were legal it would be like coffee and you could get it at Wal-Mart. Junkies wouldn’t have to break into your house. Dealers would not need guns and stupid people would overdose! Sure, some kids would overdose but they are doing that anyway. That is a side effect of bad parenting. Smart kids will figure it out or not. Ever notice when famous people lose a kid to drugs they they get TV time, blame the drugs and try to make themselves feel better by campaigning about the evil opiates. If my kid overdoses I wasn’t paying attention. If my dog gets run over by a car, I’m the one that left him get on the road!

  5. Glen Cooper    

    You can’t fix stupid. The worst kind of stupid is when intelligent people get an idea into their heads. They will defend it and insist that if we were as smart as they are we would agree. There is another stupid and that would be the “herd instinct” that allows people to let someone else think for them. Even Doctors become “sheep” and follow self proclaimed addiction experts. The national “herd” is now dominant and cannot be changed. People have died that did not have to. I am certain that there are hundreds maybe thousands that feel like they are being murdered. (Because they are). They have a power that all these happy expert Doctors and Politicians do not. If you are going to die anyway, there are no consequences. War heroes are the result of soldiers doing “brave” things when in reality they thought they were not going to survive. As everyone knows reading here there have been stories in the news of doctors getting shot. Rest assured, the Media will slant it this way: “A troubled Veteran on drugs killed a wonderful doctor”. Well,
    What if a wonderful human being ended his own life to stop a murdering doctor? I am sure others here have thought about this and keep these thoughts to themselves fearing they would be accused of inciting violence. What these doctors are doing is the clear and present danger to life and freedom. They are inciting all doctors to ignore their oath to do no harm. I would plead to all Veterans and citizens “do not shoot your doctor.” In closing, I hope this message gets posted and it should be taken as freedom of speech. It is not putting ideas in the heads of readers. They are already thought about it. The ones that should be thinking about it is the doctors playing God!

  6. William Bryce    

    This story was posted on the Veterans Day “Thank You” email. My first thought was WTF, what idiot wrote this and how much tax payers $$ was wasted on this? Anyone with chronic pain can tell you this.
    I live with Chronic Pain and some days are extremely dark.

    So VA give me a cup to piss in and tell me everything is OK and pain is something I have to live with.
    One day you might get cancer and will see if you have same flippant reasoning.

    1. Jeff Kummerow    

      It makes THEM feel better about ignoring us, and your absolutely right, about if stupid doctors had to deal with what we do, they would ABSOLUTELY prescribe themselves the pain medication they need to improve THEIR quality of life, and they would avoid the liver damaging pills they make us take. Doctors are dumber than a box of rocks, they don’t know how to read and understand our medical records, and have know idea how to think for themselves. They leave us with only the choices of letting them wreck our livers, and put up with the crazy side affects on top of all the pain, or end it. Unfortunately for so of us suicide isn’t an option, so instead I pray for terminal cancer. Of course when I try and refuse that body burning medication they will declare me incompetent and force medication on me. My mom died of cancer, I don’t plan ongoing out that way either……doctors suck!

  7. Evelyn Shannon    

    The Va in el paso tx refuses to give pain meds, sleep meds, tranquilizers. They love psycho meds like lithium, seroquil. These meds gave me akasthesia so bad that i ended up with major spinal cord injury and broke knee replacement.

  8. Glen Cooper    

    There is s paragraph in this article that gives VA providers the excuse to refuse opiates. “managing pain in daily life”. Stop regurgitating the alternatives as if they have not already been tried! Many of us were using chiropractic back when the VA would not support it. We have been poisoned with chemicals. We know that the opiates have not damaged our livers. If indeed the opiates cause low “T” …..fine. With severe pain there is no libeto anyway! We don’t need “educated”. Just because we have depended on opiates didn’t make us stupid. With years of pain we have studied. We know that opiates depress breathing. We know not to mix medication (including alcohol). We accept the risks. We experience the benefits of increased function. Some of us have outlived the Doctors that started us on this medication. Many of us are assigned to new primary care prescribed who do not know our history, do not accept the earlier decisions, and the worst issue is they are setting up pain departments staffed by Nurse Practioners who can over ride all previous Doctor opinions. AND. It is true POWER corrupts. These people have been “annointed ” by Doctors that give them the power that Medical School gave them. They are not qualified and do not have to be.The CDC has not taken away the power to prescribe that a medical license grants. They can still prescribe if they want to. Why require Medical school when a Doctor can give the power to a nurse?

  9. Glen Cooper    

    I have my Behavioral Health record (12/17/2008) “Thoughts are coherent without delusions or hallucinations. When questioned he denies current suicidal ideation however died not rule out suicide as an option in the future if he becomes more debilitated”. Now, ten years later, after 15 years of improved function (with opiates) they are taking them away. I have asked so many politicians and doctors for help as have many other Veterans. Our alternative treatment is death. I am a man, and a Veteran with pride. I would indeed “die on my feet rather than live on my knees!”. The Veterans who did go to their knees are dead anyway. Veterans died for the freedom we have lost. “Welcome home, thank you for your service, now urinate in this cup”! I do not have to live in this fallen Government that leaves the wounded suffer. I have been getting dental work due to pain causing clenching teeth. I have spit out prices of tooth twice in the last year. I am told that I yell and swear. (I don’t remember it). My primary care providers focus only on reduction of medication and listen to nothing else. Have I already died and didn’t notice it?

  10. Branwen    

    Our Veterans deserve better than this! The VA, the CDC, and the NIH ignored the correlation between unrelieved intractable chronic pain, suicide and adverse events. Instead of applying fact based science and humanely treating pain, they instead misled the public, and lied to veterans. Many veterans had adverse events like suicide, when not only was their pain not adequately treated, they were Gas Lighted by medical practitioners. They were given random assortments of psycho active drugs, anti inflammatories or whatever the pharma industry was pushing as an “alternative.” Of course the side effects, increased depression and suicidal behavior were not counted.

    The various “alternative therapies” the VA pushed without clear scientific evidence, based on limited data and biased studies, made things even worse. MBT, chiropractic and even acupuncture, are not scientifically proven to relieve intractable chronic pain, yet they were foisted on veterans and the general public. Clear data points like the number of suicides, hospitalizations, and quality of life were ignored, by design. The reaction of the VA and other agencies to the so called opioid crisis, led to even more deaths, and forced injured veterans into pursuing illegal drugs.

    More industry interests seek to undermine the VA, profit from the dysfunction and attempt to privatize the federal government, so there is no incentive to fix this problem. The number of suicides are a Fact while the various attempts to monetize all of the deaths and despair, are science fiction. There is a really big element of denial. obfuscation and Gaslighting, as evidenced by the “Resilience Training” and other dangerous programs, the VA implemented without any scientific evidence. The “Resilience Training” was based on one of the Torture Doctors Richard Seligman’s work torturing dogs.

    The VA decided they would ignore the pain and trauma, and re-frame it. The NIH has spent millions of dollars on research, looking for a different outcome, instead of treating pain. Plenty of psychological researchers took the money, not to find a solution, but to make pain seem less intrusive and soul killing. They had to justify the damage they did, and the massive amount of money they gave to unscientific, research to discredit and blame people with pain got the results they intended.

    The VA ignored Robert Rose a decorated Marine Veteran, with intractable chronic pain. We can see how the mass media deliberately misinformed the public, denigrated, harassed, and incarcerated physicians who treated pain. The misinformation campaign was to protect the pharma industry and place blame on sick people. We are 22 years out from the Perdue marketing campaign and things have gotten much worse. The CDC and FTC are still protecting the pharmaceutical marketing establishment while demonizing people with pain. The CDC ensured that thousands of people with addiction would die, when they first released their unscientific guidelines, written by industry insiders who profiteered from the deaths.

    1. Glen Cooper    

      It is worse than people think. I have reported my own story to Congessmen, Media, and the Whitehouse Hotline. The CDC “experts” THINK they have provided guidelines that insure palliative patients will be taken care of. At this time decisions for prescribing have been passed down to the lowest level of treatment. They can do whatever they want including ignoring recommendations from the (VA) medical centers they are suppose to follow. These prescribed are assigned authority even if they are Nurse Practioners. Lowering the prescribing by VA is reported as Veterans taken off opiates. Just as I did, Veterans go to private pain clinics. Some go to “the street” and some give up and kill themselves. Statistically, the VA claims success. (The Government also saves money on disability compensation). Two years in a row now my primary care (team?) Has insisted on sending be to the Pittsburgh VA Review. “The benefits outweigh the risks, this unfortunate Veteran is racked with reasons for pain, 15mg of oxycodone QID was working well, helping him significantly,was tolerated without issue, he is considered low risk, and this is within the upper limit of the CDC recommendation, I recommend continuation of this therapy.” When I got back my local primary clinic, I was told that the Pittsburgh Doctors, physciatrists, physical therapists, and pharmacists were “old school” and they did not have to listen. So they first reduced to by 40% and this month another 5%. I was told that was because I would not accept alternatives. Since 2003, I have used the alternatives that were only condoned recently. (They would not pay for chiropractics or acupuncture then.)

  11. Glen Cooper    

    Why is this blog not being published where it might save lives? Why aren’t NBC, CBS, ABC, FOX broadcasting and reporting UNNECESSARY DEATHS? If there is even a chance that a patient will take there own life give them the opiates, continue to monitor for as long as it takes to determine IF the patients are using the threat to manipulate prescribers. Don’t kill them all just to get the liers. A living addict is better than a drug free dead one! What is the rush? Some have safely used opiates for many years. Real abusers will shorten their own lives. Non abusers will have their lives cut short by “experts” who honestly believe they are helping them. Stop spending taxes trying to legislate morality! It didn’t work with Prohibition and it won’t work now. Alcohol is the national drug crisis. Alcohol killed the President’s brother! A Constitutional President would give pain sufferers the same rights as drunks. He would protect our civil privacy rights. The need for opiates is not Probabe Cause to force a citizen to urinate into a bottle.

  12. Teri Cottone    

    I’m just going to say it, What did you expect to happen?? There was a reason the USA recognized the under-treatment of pain a human rights abuse. It took us until 1961 to do that.
    Then y’all listened to a group of addiction Psychiatrists ( look to history to find out why this was a BAD idea) that founda correlation in prescribing rates and OD deaths, there is no denying that existed BUT what were the demographics of the deaths?? Deaths vs WHO WAS PRESCRIBED the Rx? Were some diverted, yes. Was it as bad as they said it was??

    zif avoiding death was the goal which is what we were told, you all have FAILED and miserably. Now admit the mistakes, give people back their pain control.. PROP says there is no study that says it works for long term pain> well did you ever think to aks the researchers why that was?? because the group without meds would drop out, not the group with meds. That right there should be a HINT! Do you need a “study” to show you penicillin works for strep throat?? Quit e being flat stupid! Go tell a 75-year-old with a walker to do yoga. The fact is still the under-treatment of pain is a human rights abuse, that MORE people not less become disabled, the UW study showed HALF of those forced off meds were hospitalized or at least had an ER visit, I know a Doctor who accused me of drug-seeking almost cost me my life and cost my insurance company 1.2 Million dollars in hospital stays.. Me more pain and suffering because of this rhetoric.. 06% of the population should not dictate policy for the rest. Let us just say it causes addiction as PROP says so a veteran is stable on their meds or they’re dead due to suicide to pain. It is time to fess up to the mistakes and implement sane policy because when you apply it to literally anything else you sound like idiots.. You have a heart problem sir, why try mindfulness to steady your heartbeat. We have a Psychiatrist here for you to see, your stress, our Cardiologists have to pass this by addiction Psychiatrists before we can put ina pacemaker.

    I realize that you stepped on an IED sir. I know it blew off your limbs but addiction Psychiatrists over at PROP say this is noncancer pain, you’ve been on pain meds for 3 months, I know the burns still hurt but why don’t you do Yoga? Oh the wheelchair gets in the way? Uh, what about mindfulness?

    FIX this now.. Admit your mistakes and restore sanity! What you’re doing now is FORCED experimentation and the UW study showed what a big mistake this has been.

  13. Tammy Malik    

    How about just letting them have pain medication that works? Its cheap, too!.

  14. Jessica Skistad    

    The VA should be ashamed of themselves, with how they’ve purposely, consistently let our Veterns down, leave them to suffer & Pretending they didn’t know why Suicide is more common. Anyone with common sense could tell you that untreated or under treated moderate-severe, excruciating pain can make someone/anyone suicidal, or wish it would end. Most don’t just need alternatives such as CBT, mindfulness, yoga, chiro, etc, that have low quality evidence of effectiveness & are also anecdotally largely Ineffective on their own or in combination for moderate-severe pain. They need medications that work to treat their pain, along with whatever other modalities help ease (not eliminate) their pain. The VA needs to stop disregarding their suffering after the sacrifices they’ve made & injuries they’ve endured.

  15. Sally Goodin    

    To attack veterans in pain is cruel and unusual. We don’t have the right people in charge. Veterans don’t deserve this! Every one has the right to seek pain relief with out judgement from others.

  16. Kim Buchholtz    

    CHRONIC PAIN DISTROYS YOU MENTALLY AND PHYSICALLY…
    TAKING VETERANS AND CHRONIC PAIN PATIENTS, OFF THEIR PAIN MEDICATIONS IS A DEATH SENTENCE….STOP THE LIES AND STAND UP FOR VETERANS AND PAIN PATIENTS.
    THEY ALL DESERVE BETTER THAN TO SUFFER UNTIL THEIR DEATH

  17. Kimberly Ann Flippen    

    Chronic Pain. Have any of you sat down with real, everyday people that suffer? Your suggestions lead me to believe that you haven’t. We don’t “go for long walks” we don’t sit and talk about our pain all the time. We are real people, from all walks of life from soldier to child. All colors, nationalities, all incomes, both genders and all ages. Chronic Pain does not discriminate. It can be debilitating and it can and does drive a rational person insane. Insanity is what causes the suicide and the insanity is caused by the needless pain that is being inflicted on us daily. I appreciate all efforts to “look into” the problem, however, please, please, from someone with Chronic Pain, sit down with us and really listen. Our story needs to be told, but it needs to be felt too, and only by talking with us will you really come to understand. We are not your common junkie, we are your friends, and family, we are real people who are being treated inhumanely. We need an interest in
    what we are going through, but we need a much more thorough research. We are here, please take the time to talk with us?

  18. Gretchen    

    Well no kidding.Common sense has been lost.Pretty sure the FACA laws were broken when the CDC guidelines were made.Why is no-one talking about that?

  19. Eileen Griffin    

    The illegal “opioid crisis” perception (mentality) has astoundingly migrated into the patient/doctor relationship, been fueled by our overreaching and controlling government and has left people who have done nothing but suffer from chronic pain, either in fear of losing or have lost hope of ever regaining their lives. To have the government punish doctors, pharmaceutical companies, and PATIENTS who are in life altering pain intensified by the threat of forced tapers is both unethical and immoral and will be seen as the largest civil rights violation in our history. The VA is a mess which reflects our current state of healthcare. The Veterans are tragically casualties of a much bigger war than they every encountered outside our borders.

    1. Sharon Rose    

      Fantastic comment so accurate!

  20. Kristin Ford    

    This just in: Water is wet!

    Veterans knew this. The VA knew this. The CDC knew this. The DEA knew this. Legislators knew this.

    Chronic pain sufferers are not accidental collateral in the “WaR on dRuGs.” Those with chronic conditions are expensive and annoying to look at and deal with by the Able-bodied Elite. This war on narcotic prescriptions has created the prefect storm to get rid of those of us “undesirables.” Those of us that can no longer get safe narcotic prescriptions may turn to dangerous street drugs, such as Heroin cut with Fentanyl. And then we are looked at, not as the untreated chronic pain patients abandoned by their physicians, but as useless junkies that fought and were injured by our service to this ungrateful country.

    Our country is ungrateful to its veterans. We were promised adequate care through the VA and we get subpar medical treatment. I don’t want a “thanks for your service,” I want proper care without humiliation and consternation.

  21. Linda Cheek    

    The VA proudly reports a 65% reduction in opioid prescriptions when they come before any organization. But drugs are not the cause of addiction, and taking people off needed pain medicines causes personal injury, leading to suicide. Instead of putting doctors in prison for treating pain, we should be putting heads of organizations like the VA, DOJ, etc in prison for the deaths they are causing.

  22. David Acevedo    

    Needless to say this applies to ANYONE with untreated, chronic, incurable SEVERE pain. It applies to FIFTY-MILLION American Citizens as we speak and too many of these have suicided. TRUE genetic opiate “addiction” is RARE, 996 in 1000 with NEVER true addict. Inexperienced youths using illicit substances illicitly is our ONLY concernable source of over-dose dying. Unfortunately the black market can NOT be stopped short of legalizing everything and returning to controlled dosing, or the overdoses will continue. Portugal PROVED that. “Opioid (opiate) Crisis” was NEVER a Doctor, pharmaceutical manufacturing or severe pain patient issue.

  23. Gina Robertshaw    

    Nothing surprising in this study. But I need to address 2 things the article mentions. First….It says, “if you plan to go for a long walk in the morning, consider taking a break mid-day to give your body time to recover…” I don’t know ANYONE living in chronic pain who can take a LONG walk! That’s unrealistic! Often, a short walk requires a pain patient to stop and rest several times. If a doctor were to give me this advice it would tell me the doctor has no idea how bad my pain is! Second…It says, “Invite your friend or loved one to a movie or dinner or for a walk around the neighborhood.” Again–unrealistic for someone in moderate-to-severe pain. Sitting in a movie theater is one of the hardest things for a pain patient to do! And going out for dinner is another problem. Many of us cannot sit on a normal chair long enough to get through dinner. So we need to check out a restaurant first to see if they have comfortable booths or other seating options that we can tolerate. I have not accepted most dinner invitations because I don’t want to put my friends through the extra trouble that my pain creates. Also, people often like to socialize and have a few drinks after eating–but we’re holding back tears by this time because the pain has escalated from sitting up too long to eat. Pain patients don’t want to interfere with our friends having a good time so we say nothing. We put on a fake smile while holding back the tears and use breathing and visualization techniques to get through. But it’s not easy to try and participate in conversations while doing this! Then we suffer even more for 2-3 days from sitting too long and walking to the car and from the car into the house, restaurant, etc. So we learn the hard way not to accept these invitations.

    I appreciate the study, but it’s also sad that it takes a “study” to prove common sense!

  24. Joshua Jones    

    Veterans have now started committing suicide on top of their medical records what does that tell you

  25. mike huyter    

    what about the chronic pain related to the years one has lived with the severe pain.

  26. Joshua Jones    

    Veterans have been forced tapered off of their pain medication across the country as they have suicide rates have soared this is the first article I’ve ever read that says anything about what we already knew. We can thank the unintended consequences of the CDC guidelines and the United States government for starters for what’s going on.

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