Managing chronic pain and avoiding addiction

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Fully 50 percent of veterans in the Department of Veterans Affairs health-care system suffer from chronic pain, according to testimony before the House Committee on Veterans’ Affairs. That’s above the national average.

The treatment method for serious pain typically has been through the use of prescription opioids, which are habit-forming. In at-risk patients, use of these drugs can lead to abuse of the medications and “diversion,” which means they’re sold to others. Other patients are at risk just because of long-term use.

The methods to help at-risk veterans start before the drugs are even handed out — by improving the training of those who prescribe the drugs and by participation in state-level prescription monitoring programs.

The greatest effort has gone into determining when these opioids are appropriately prescribed when there are multiple medical conditions — physical as well as psychological — along with the risks for overdose because of a combination of the two.

One of the VA’s drug programs is showing great signs of success. The Opioid Safety Initiative, tested at eight sites in Minnesota, has been shown to reduce the dependency on habit-forming opioids.

This is accomplished via education, monitoring, other non-habit-forming drugs and alternative methods such as acupuncture and behavior therapy, as well as using a multi-disciplinary medical team. Patients were offered a trial of non-opioid drugs to test lower doses for pain management. The result: Dependency on high-dose opioids use was reduced by 50 percent.

Also in development is a pain-management app for cellphones — the self-management VA Pain Coach. The app includes the veteran’s health library, a management toolkit and assessments. To learn more about the cellphone app, go online to

Freddy Groves regrets that he cannot personally answer reader questions. Send email to © 2014 King Features Synd. Inc.