VA Explores Pain Management Alternatives to Delay Opioid Use

By Annette M. Boyle

WASHINGTON—Since the rollout of the VA’s Opioid Safety Initiative in 2014, the department has aggressively focused on developing non-narcotic alternatives to reduce opioid use for chronic pain. Now, attention is turning to options that delay or reduce the need for opioids for pain related to diseases, such as cancer or following trauma or surgery.

A multimodal approach to treating pain has gained traction in the VA and DoD as the preferred approach to management of acute as well as chronic pain. Multimodal pain management combines several agents from different pharmacologic analgesic classes that affect different mechanisms in the pain pathway to achieve more-effective pain control with fewer adverse side effects. This technique can combine regional anesthesia or nerve blocks, nonopioid medications and complementary integrative health services.

Multimodal pain management techniques can help delay and reduce opioid use following a procedure or injury by harnessing the synergistic action of multiple agents. The approach might also enable patients to avoid the complications of opioid-based analgesia, which include delayed recovery, hypoventilation, atelectasis, nausea, vomiting, urinary retention, pruritus, prolonged ileus, dizziness and confusion, according to Leopoldo Rodriguez, MD, a director of the Society for Ambulatory Anesthesia.

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  1. Mike Jarrett says:

    I was forced to be involved in the Opioid Safety Initiative,(OSI) at the Indy VAMC. When I and 6 other veterans showed up for the OSI intake briefing I was surprised to see that the clinic appointment scheduler was the person giving the briefing. This guy informed us all that this program was mandatory and if we did not participate and reduce our intake amount of opioids we would not be able to return to our prescribing physicians and the amount of opioids we take would still be reduced. I informed the lead NP and she told me that this guy just gets a little carried away at times. I felt as though I had no choice but to reduce the dosage of methadone I took even though I was still in bad pain caused by numerous spinal issues and other conditions causing me chronic pain which the NP was aware of. I felt that the NP was concerned because I was in so much pain. The VA is doing whatever they have to do no matter how the veterans are affected by the OSI so that they can get the politicians off of their asses !! The CAM therapies that are used, like acupuncture is absolutely a total joke to put it mildly !! Now the politicians are causing more of the veterans who have used heroine before to now go after the heroine that has the additional drug in it that is killing so many more people. Creating an entirely new problem for not only the public but for the veterans too you dumb asses.

  2. Lance says:

    CAM therapies are the only thing that have helped me recover from opioid addiction and chronic pain. I’m sorry that you didn’t have the same experience. I guess you have to be engaged enough to do self-care on your own, in addition to the other therapies. Yes, it requires effort on your part…

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