The price of freedom isn’t paid in full by the valiant American servicemen and women who now rest beneath white marble tombstones. An ongoing toll is also exacted from those who return home in pain from wounds that are physical, mental or both.
The nation has long acknowledged its obligation to care for those who have served and who struggle back on the homefront. The hospitals and clinics run by the Department of Veterans Affairs have long tended to the medical needs of returning soldiers. Nothing short of the best possible care is acceptable for those who risked all for country.
But a recent Star Tribune series raised a troubling new set of questions about whether the VA system is still falling short of that duty when it comes to pain management — a care component that is critical for recovery and health.
The VA system has been under fire in recent years for overprescribing potent yet addicting pain medications, particularly opioids such as OxyContin. A 2013 congressional hearing provided harrowing details about tragic personal costs of abuse. Spouses, parents and children also suffer as veterans struggle with addiction.
The two-part Star Tribune series, which ran Sunday and Monday, documented a different though equally disturbing facet of pain medication mismanagement. The series’ findings suggest that the VA system swung too suddenly in the other direction after the national spotlight on overprescribing. Veterans with a legitimate need for powerful pain medications aren’t getting them or are facing unacceptable delays in getting refills. The VA also appears to have been ill-prepared to help veterans access alternative therapies — such as acupuncture — during pain medication tapering.
The series’ findings merit the same kind of scrutiny that overprescribing did. Veterans should not be imprisoned by pain because doctors are unwilling or unable to prescribe the medications they need.
Some point out that medicine in general still struggles with pain management. That is a fair point. But it does not excuse the VA from striking a better balance than it has for this critical care. The agency must continue addressing concerns about opioid abuse. But veterans absolutely cannot be left to suffer with life-limiting pain.
Minnesota U.S. Rep. Tim Walz, a veteran, rightly points out that the Veterans Health Administration has failed to fully implement a best-practices medical treatment blueprint — the Stepped Care Model of Pain Management — that was established by a systemwide “Pain Directive” in 2009. Walz authored the 2008 legislation that led to the pain directive’s creation.
No delays should have been brooked in carrying out this best-practices model. It’s not too late to embrace it now. Doing so would be a solid step toward striking the improved balance desperately needed for this crucial component of medical care.