Opioids are one of the world’s oldest known drugs. Opium harvested from poppies predates the common era and morphine has been marketed since the 19th century. Opioids are prescribed for pain from mild to severe in the forms of drugs such as Codeine, Morphine, Vicodin, Hydrocodone, Fentanyl, and Methadone. It is also found in the form of illicit drugs such as opium and heroin. Opioids are a form of central nervous depressant and act by attaching to opioid receptors in the brain that are responsible for causing the sensations of pleasure and for relieving pain, which is why they are so addictive. They also can slow breathing, which is why they are used as a cough suppressant, which is part of what makes them so dangerous.
If they are so dangerous, why are they prescribed so much?
Opioids work amazingly well on people with pain and were prescribed most often for chronic pain sufferers as discussed in a recent blog article on out website. In fact so well that they were once the standard for treating every type of pain from headaches and backaches to severe pain such as from broken bones and cancer. It was also found in almost every cough medicine you could find. But now the effectiveness v. the risks is being questioned and other medications are being utilized and sought as replacements due to the highly addictive nature of opioids. Opioids make up a class of drugs that is one of the highest causes of prescription medication overdoses and addiction in the world. Many people also believe that prescription medications are safer than street drugs, which is not true when they are being abused or taken without a doctor overseeing their use.
What Does This Have to do with Military Veterans?
In a recent study at Fort Bragg, it was shown that approximately 47% of all opioid prescriptions being filled at the installation were being abused. How did this happen? Well, it started off innocently enough. Doctors and medical professionals wanted to ease the pain of our Veterans and opioids were an easy way to do that. So they prescribed them, a lot. And not just VA doctors, but all doctors. Then, in 2013, the world, including the VA world, started cracking down as people started dying from overdoses and doctors were being caught prescribing opioids without even seeing patients. By this time, huge numbers of Veterans were addicted to these pain medications, many for legitimate reasons, but now they were cut off and the VA had nothing to replace these drugs with that were as effective. So Veterans started buying them on the street. Hydrocodone and Vicodin could go for as much as $5 a pill, which was out of reach for many Veterans, so they turned to less expensive forms such as Fentanyl or heroin.
What is the Effect on Veterans and Our Community?
In June 2016, the Commission on Care report was released that brought to light some of the treatment problems that the VA and the military was experiencing, including prescription practices. The report includes that fact that thousands of Veterans were given less than Honorable discharges due to drug abuse related to treatment problems with PTSD, TBI, and chronic pain that is service-connected but these Veterans are ineligible for benefits because of their discharge status. This, in turn, increases the rates of substance abuse, homelessness, and suicide among our most vulnerable Veterans.
How is the VA Responding?
It was shown in 2010 that substance abuse, not mental illness, was the number one cause of homelessness among Veterans. Many of those experiencing substance abuse problems do so because of either being addicted to painkillers or self-medicating because they are experiencing some form of pain or mental illness that is not being treated effectively or at all.
The VA, in 2015, created a new tool being utilized at all VA medical centers called the Opioid Therapy Risk Report. This tool includes information about dosages of narcotics, medical problems that could contribute to adverse reactions, and monitoring data to aid in management of complex patients. However, while the VA’s Opioid Safety Initiative, which was launched in 2012, reduced the number of patients receiving opioid medications by almost 100,000; what else is the VA doing to address the needs of those who were being treated and are now left with no viable alternatives?
So What Do I Do for the Pain?
Finding alternative healthcare treatments for chronic pain sufferers is also on the plate. Most VA healthcare systems have instituted pain management clinics who work with an array of treatment modalities such as physical therapy, aquatic therapy, yoga, mediation, psychological, and non-narcotic medication treatment for pain management.
Veterans can voice their concerns as well. If you are being treated for pain issues, talk to your doctors about alternative options for opioids or other narcotic medications. One of the main problems with these medications is that they only cause your brain to not recognize the pain, they actually do nothing to stop the causes of the pain. By working with your healthcare team to find out the origins of the pain you are experiencing and ways to relieve it, you may find yourself feeling better, being more mobile, and living a much healthier life then you would ever do so under the influence of opioids.