VA Leading Change On Opioid Use For Pain Management

Yoga instead of opioidsI was so proud of my colleagues at the VA.  They shared their data which demonstrated a continual decline in the usage of opioids and an increase in alternative treatments for pain management that include acupuncture, yoga, tai chi, and whole health coaching.  Dr. Robert Sproul, Pharmacy Pain Program Manager and a leading voice nationally, talked about the VA programs and shared the numbers.  Orlando went from one of the worst sites in the VA system to one of the best. Fortunately, the VA can use alternative treatments like acupuncture, equine therapy and more that are not yet available to the private sector since insurance companies will not cover them.  I’m working right now as a Board member of the McCormick Research Institute in St. Cloud, Florida to validate the use of equine therapy rather than the use of opioids to treat Post Traumatic Stress.  It is early days, but we are confident that the research will show the efficaciousness of this treatment.

Takeaway Medication Programs Working

Dr. Jacqueline Kill, Chief of Pharmacy, talked about the takeaway medication recovery system so that unneeded pills don’t end up on the street.  The VA has a system in which the individual can drop they unused medication into a pouch, postage paid, and mail it to a source for destruction.  Much of the opioid use today comes from children taking unused drugs from their parents medicine cabinets, or, nefarious people selling unused drugs in parking lots.  Dr. Norman Hooten, Clinical Pharmacy Specialist for Pain Management, talked about overdose detection mapping, which helps VA understand where geographically are the overdoses occurring.  This was obviously of great interest to the Sheriff given his jurisdiction.  It also showed the “highways” of drug problems.

The Whole Health Initiative for Veterans

Nurse Joanne Anderson talked about the Whole Health initiative, which assigns each Veteran a coach to develop their custom health and fitness plan.  This is very exciting.  If we can get each individual to work with a coach to develop their personal plan of nutrition, exercise, and the like; we can prevent the issues of poor health before they arise.  I do believe that this holistic health approach is the future.  And Chief of Police Nick Amen talked about how Naloxone is used to prevent overdose deaths.  It was a fabulous day of sharing and learning.

Important Points for Consideration

This time together pointed out a couple of points worth emphasizing, and the Sheriff mentioned.  First, to eradicate the scourge of opioid addiction, it requires tremendous collaboration.  For the VA many of the capabilities are in one, Federal agency.  For the public at large, it must involve many agencies, who must work together on holistic solutions.  For example, medical schools need to do a better job training pain management.  Communities need to have social workers and treatment facilities.  Federal must work with state and local governments.  Collaboration is critical.  Secondly, we need to prove out alternative treatments than just dispensing pills so that insurance companies will reimburse them and the medical community will prescribe them.  This is what we are working on at the McCormick Research Institute.

If you want to understand the future of American medicine, both good and bad, go observe the VA, the largest integrated health care system in the country.  It is our “canary in the coal mine” for U. S. medicine.

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