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VA accused of bad pain-management practices

VA accused of bad pain-management practices

In an emotional, sometimes tearful hearing before members of Congress Thursday,  widows of veterans and others blamed the Department of Veterans Affairs' Veterans Health Administration for improperly treating chronic pain, occasionally with fatal results.

In addition to the two widows, lawmakers heard from two veterans who describe themselves as victims of VA medical malpractice and former VA doctors who reported instances of personal abuse, alteration of medical records by VA staff, “bullying” of well-meaning physicians and other offenses. One witness characterized some practitioners of VA medicine as favoring “quick and cheap over good and thorough.”

“No one who watched today’s testimony could help but be moved and profoundly angered,” said Daniel M. Dellinger, national commander of The American Legion, which submitted written testimony for the hearing. “If there is even a modicum of truth in the accusations leveled today, VA has much to explain. Whether these problems are contained within certain facilities or wider in scope, they are inexcusable and must be corrected.”

The Thursday morning hearing before the House Committee on Veterans Affairs' Subcommittee on Health Care was titled “Between Peril and Promise: Facing the Dangers of VA’s Skyrocketing Use of Prescription Painkillers to Treat Veterans.” It opened with an emotional statement by Heather McDonald, widow of Army Spec. Scott McDonald, who she found dead in their home, she explained, after a deadly cocktail of painkillers and psychotropic drugs prescribed by VA to help McDonald cope with severe, chronic physical and emotional wounds related to combat.

A fellow service widow and 21-year Air Force veteran, Kimberly Green, told how her Army veteran husband, Ricky, died as the result “mixed-drug intoxication… because of the prescription pain and sleeping medications that the VA and its doctors prescribed for him and dispensed for him out of the VA pharmacy.”

Both widows accused VA of uneven, sometimes-contradictory methods of pain treatment marked by frequent changes of doctors and an over-reliance on opiates – narcotics – while ignoring less dangerous, alternative medical methods.

Two former servicemembers then told of their own struggles with service-connected chronic pain and what they consider outmoded and harmful methods of pain treatment employed by at least some VA medical facilities.

VA offered rebuttal arguments, pointing to the complexity of the medical issues involved in pain management with its mix of severe and individualized physical and psychological factors. VA’s witnesses also told of VHA’s continuously evolving and increasingly effective program of chronic pain treatment with an emphasis on quality, safety and proper training of practitioners. VA offered no explanations about the cases cited in the hearing testimony. 

The three-hour session ended with agreements between VHA officials and members of Congress to follow up on the issue and track progress carefully.

In its written testimony submitted to the congressional subcommittee prior to the hearing, The American Legion noted that it has long been concerned about the negative aspects of exclusive, drug-based therapies for severe, chronic pain, and its related psychological and emotional effects. In 2010, Legion leadership commissioned an ad hoc committee to investigate existing and alternative methods of treating traumatic brain injury and post-traumatic stress disorder – conditions often accompanied by chronic physical pain. During the three-year study, the Legion committee held six meetings and met with leading authorities in VA and the Department of Defense (DoD), and interviewed a number of stricken veterans. As a result, the Legion launched a campaign favoring non-pharmacological treatment modalities for pain management, including the employment of “hyperbaric oxygen therapy, virtual reality therapy and other complementary and alternative medicines.”

The American Legion also mentioned its adoption of a resolution calling for federal funding of pain management research, treatment and therapies at DoD, VA, and at the National Institutes of Health to be increased significantly, and that Congress and the administration re-double their efforts to ensure that an effective pain-management program be uniformly established and implemented.  The resolution also called on DoD and VA to increase their investment in pain-management clinical research by improving and accelerating clinical trials at military and VA treatment facilities, as well as at affiliated university medical centers and research programs.

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Jeff Geurin

July 6, 2014 - 8:39pm

The VA's response to stories in the media like this has been to start drastically reducing my prescriptions of Oxycontin and Percocet (which I have taken for 8 years now for chronic pain), without doing anything else to treat the pain. They intend to have me totally off here soon, and I am in so much pain I don't know what to do. When I ran out early, they started treating me like a drug addict and refused to give me more. This is no way to treat vets. I agree pain medicine isn't ideal, but if I'm in pain, their primary duty is to stop the pain. There is no bigger threat to a person's well-being than unmanaged pain.

0311infantrysir

June 30, 2014 - 5:53pm

Well, I just got a call from the VA and they will no longer dispense Narcotic Pain medication and Benzodiazapines so I have to "choose" one ailement to have treated, PTSD or Broken Neck? Wow. Happy Fourth of July America. Semper F.U.C.K.

Anonymous

May 25, 2014 - 5:05pm

I have hip pain and back pain. The VA in Ohio would not give me any pain meds except Naproxan, I'm taking that by the hand full, they gave me an appointment for physical therapy somewhere in Ohio, couldn't find it and gave up. They want me to drive hundreds of miles for therapy. I feel I'll have to seek and procure medication in the black market. I don't have any regrets serving my country. I do have regrets ever seeing VA doctor who I have only seen one time last year, she offered me a cane. Thanks I'll buy my own cane. The mental health therapist that was seeing me wont see me either. Thank you very much.

AJBCARS

December 6, 2013 - 2:56pm

My wife worked for the VA for a little less than 2 years as a nurse and was surprised. She resigned and told me if any thing should happen to you, the VA is the last place I will take you. I am a retired 20 year Army disabled combat vet and do not use the VA. She told me that there is a severe lack of leadership and accountability. She was shocked at how things are done and how the staff did as little as possible.

Cal Perry

October 15, 2013 - 8:20pm

I am a vietnam veteran(1969-1970). I have chronic pain also in my legs,feet and hands. Pain is something you deal with medication or natural way. I have taken the shot in the behind(temporary fix).Medicine that effect your vital organs is not good for you in the long run. Tell me what I need to do help myself now.

Randall Wendt

October 15, 2013 - 4:22am

I am in severe chronic pain. The VA performed a MRI but that is all. I receive steriod injections in my back on a frequent basis but they do not help. I have expressed this to my physican but he demands I lose 50 lbs and quit smoking or he will not help me with further testing. I asked for a physical assessment to my primary physician and my pain managment physician but they both state this is not something the VA does. I haven't gone to physical therapy or any other type of treatments -- steriod injections in the surgery center and narcotics is all. I want to work but the pain I am in I am incapable of working but part-time and I cannot live on part-time work. PLEASE Something must be done with the limitations or attitudes of the VA doctors. I want to find a resolution instead of a band aid.

Stuck between a rock and a hard place

October 15, 2013 - 12:59am

Major crush-type injury caused c-spine fractures and disk rupture resulting in cervical cord flattening due to the disk contents and bone pushing on my cord. Also suffered torn radial nerves in both arms and ruptured l-spine disks impinging nerves into my legs. Due to having a cardiac stent placed (bare metal) 1 month prior to the accident , cardiology refused medical clearance for the 6 required surgeries for 5 months. The short story is that I now suffer from permanent cord and peripheral nerve damage which causes a great deal of pain, especially on days when I feel better and attempt even a small portion of my pre-accident activities. I had been on the strongest narcotic pain meds available. Over the last 3 years I have reduced the pain meds to mild strength narcotics routinely with low dose narcotics for break through pain. I was told by my VA primary MD last year that the VA is going to stop supplying narcotic analgesics. I have tried every other type of med used for nerve pain to no avail. I have failed a spinal cord stimulator trial. I have attended VA counseling for depression, PTSD and chronic pain for 2 1/2 years monthly and have reduced my anxiety dramatically and am off all anti-anxiety meds for several months .The pain however has remained constantly up and down, but more tolerable and my narcotic meds have not changed for 2 years. All this yet the VA wants me to stop using the only medications that are working. Their are medical centers performing investigational therapies for pain management, yet VA won't pay for these therapies. There are only 2 therapies to date which have shown promise for Cervical Sympathetic Dystrophy and I can't afford them. I have not developed tolerance to these current pain meds and they allow me to get out of bed and perform my activities of daily living . I can only assume that the VA wants to take me off the only pain meds that work and subsequently slip back into depression and once again become anxiety and bed ridden. The pendulum never stops in the middle, it always swings wildly from one apex to the other. Those I between are sol.

Barberian

October 12, 2013 - 4:50am

I suffer from several things including Fibromyalgia. Fibro is a pain feedback loop that ramps up the pain exponentially for me. I am in extreme pain often if I have to stand, walk or sit straight up for more than 10-20 min. I asked for a reclining electric wheelchair and was denied. A self powered wheelchair would cause the same pain I'm trying to avoid. Reclining takes most of the weight off my spine and hips. You almost have to be dead before the VA will give you one. That one thing alone would decrease my pain meds dramatically.

Anonymous

October 11, 2013 - 4:00pm

Have any of you taken a good look at the Joint Commission?? They REQUIRE Dr's and nurses to over medicate patients, then document until the patient says stop! Great system, absolutely disregards any education, clinical experience,or assessment skills a trained medical professional may have. Perfect for drug abusers and patients/families that insist on NO PAIN at all, even post op!

Stuck between a rock and a hard place

October 15, 2013 - 1:10am

Yes, Joint Commission which is the major certifying agency for hospitals, rehab and long term care centers, home health agencies, et al. They have guidelines in place just as Anonymous has described exhaling that you have the right to be pain free and the facilities have to asses you regularly for pain and do whatever it takes to provide you relief. Here are the 2 major practice guidelines for the treatment of pain in this county, and they contradict one another. The VA has directed its MDs to get their patients off narcotic pain meds no matter what, and the rest of the country is humane enough to manage your pain in whatever manner is necessary (and safe).

Wade Taylor

October 11, 2013 - 8:19am

I see things like this at the VA further evidence of the spiraling down of medical treatment in this country--both in the public and private sectors. Obamacare will make it worse as it will increase demand(patients) with less supply(doctors). Hurry up and wait will be the new normal and destroy the greatest health care system we have.

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