CHARLESTON, SC (WCSC) –
The fight against the prescription opioid epidemic continues nationwide, and the Ralph H. Johnson VA Medical Center is working to curb opioid use among local veterans.
“On a scale of one to ten, some days it can be a one. Some days it could be a fifteen,” Air Force veteran Rae Carlers said of her chronic back pain.
Not a candidate for further surgery, Carlers was put on a new pain management program, without the help of pain pills.
That plan included a trip to see Chief of Pain Clinic, Dr. Robert Friedman.
“He looks at my chart and says ‘you’re on this and you’re on this and you’re on that. I want you to stop taking all of it.’” I looked around the room to see what college he graduated from,” Carlers said, adding she couldn’t envision a life without opioids to deal with the spontaneous pain.
Yet, Carlers followed Dr. Friedman’s plan, which didn’t include any prescriptions.
“I don’t write prescriptions,” Friedman said. “They said ‘what are you going to do for chronic pain?’ I said, well we can do mindfulness, we can do acupuncture, we can look at diet, we can look at exercise. We can look at things people have been looking at for chronic pain since the early 70’s, but we kinda forgot as the opioid epidemic developed.”
According to Friedman, chronic opioid therapy can actually have a detrimental effect to some patients, especially veterans dealing with post traumatic stress disorder or PTSD.
“Based on that, the VA changed its whole approach to chronic pain beginning in 2009 by looking very carefully at how patients were doing on chronic opioid therapy and also, looking for alternatives on chronic opioid therapy to their pain,” Friedman said. “Veterans, unfortunately, have lots of different things that make their pain more difficult, harder to manage their pain than people outside of the VA that aren’t veterans.”
Instead, Friedman recommends a care plan based on diet, sleep, physical therapy and acupuncture to manage pain. He said patients are started by acupuncture’s relief.
“I haven’t changed your MRI. I haven’t changed your disk disease. I haven’t changed your torn rotator cuff, but I’ve changed the way your brain and body is processing that information. Almost like fixing a virus in a super computer,” Friedman said.
According to Friedman, mindfulness and meditation, yoga, even tai chi classes help maintain acupunctures’ effect.
As a result of Friedman’s program, Ralph H. Johnson VA has reduced opioid use by more than 30 percent over the last four years.
According to data provided by the VA, out of all outpatient pharmacy patients, only 7.2 percent of Charleston VA patients are dispensed opioids. That’s compared to 11.6 percent nationally.
“Medication is not a fix, it’s a band aid,” Carlers said. “You need to tear away that band aid and find out what that problem is.”
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