An initiative begun at the Minneapolis VA hospital has greatly reduced the use of opioids among veterans in its care, improving the chances for a better quality of life for veterans suffering from chronic pain.
The protocols at the Minneapolis VA are being embraced nationwide and come as the VA faces an explosion in the use of prescription medications for chronic pain (Vets enrolled in the VA system suffer from higher rates of chronic pain than the rest of the population).
Through some remarkable reporting, the California-based Center for Investigative Reporting found that in 2012, VA doctors wrote more than 6.5 million prescriptions for hydrocodone, oxycodone, methadone and morphine — more than the total number of patients they saw and a 270 percent increase from 2001.
"We started running numbers on our patients and realized that we did have a large number of patients on high dosages of opioids," said Dr. Peter Marshall, who directs pain management programs at the Minneapolis VA and the VA's Upper Midwest region.
That led to a program known as the Opioid Safety Initiative, which was launched early in 2012. The initiative incorporates a team approach to reducing opioid use with an emphasis on patient education, close patient monitoring with frequent feedback and alternative medicine practices like acupuncture and exercise such as yoga and meditation. The idea is to teach patients how to manage their pain.
Since beginning the program, the Minneapolis VA has been able to decrease high-dosage risky opioid use among patients by 67 percent.
Marshall said the VA is hiring experts in various areas of pain management but also is training primary care providers to recognize aspects of difficulties in pain management.
"We are focusing on how we help people live a more normal life, even if they have chronic pain which is not curable, not fixable," Marshall said. "We're trying to deal with the whole person here."
