Why opioids and what can we do about them

Get After It

Thoughts and observations from Perry Jefferies.

Opioid use, addiction, and the challenges of overcoming addiction are hot topics for our Veterans and those that work with them today.  Many alternative therapies are springing up as Veterans look for ways to avoid or overcome addicting pills for real conditions they incurred in the service.  Months of carrying heavy loads, parachuting from aircraft, even continually jumping from armored vehicles onto concrete leave many Vets with a lifetime of chronic pain.  The VHA and others have used recommended solutions to this pain – prescribing painkillers.  This morning NPR highlighted a mistake in interpreting a short letter to a medical journal many years ago that helped give rise to what we now hear is an epidemic of addiction. 

"This has recently been a matter of a lot of angst for me," Dr. Hershel Jick, co-author of that letter, told Morning Edition host David Greene recently. "We have published nearly 400 papers on drug safety, but never before have we had one that got into such a bizarre and unhealthy situation."

Dr. Jick wrote a letter to the New England Journal of Medicine that said non-addicts who were administered opioids in a hospital setting didn’t become addicted to them.  What he couldn’t know was that these few lines would be taken out of context again and again and help fuel the opioid prescription storm we are fighting now.  Another doctor looked at citations referencing the short letter

He and his co-authors found more than 600 citations of the letter, a majority of which failed to note that the patients whom Jick and Porter described were in hospitals for brief stays when prescribed opioids. Some of the citations "grossly misrepresented the conclusions of the letter," they found.

Drug companies use his letter today to defend against claims of addiction:

"But that's not in any shape or form what we suggested in our letter."

And we know that Veterans are one class of folks hit extremely hard by these addictions.  What can we do about it?  One thing is to make sure you have the latest knowledge and not info from an advertisement based on this letter.  Listen to the whole broadcast here, then Tune in to the DCOE Webinar on opioid therapy:

Sign up for the webinar at http://dcoe.cds.pesgce.com. Please note, registration is required for each webinar regardless if the participant has an existing PESG account. Upon completion of registration, a confirmation email will be sent providing webinar event details.

Here’s the entire message about the webinar.  Get after it:

Opioid Therapy for Chronic Pain: Understanding Updated Guidelines

dcoe.mil/webinar

June 22, 2017; 1-2:30 p.m. (ET) 

Our nation’s service members and veterans are not immune to the current opioid misuse and opioid use disorder epidemic in America. Through dedicated research efforts, health care providers have more insight into the troublesome effects of long-term opioid therapy. To ensure providers use the latest information to treat patients, experts revised treatment guidelines in 2015. 

The new guideline, “Clinical Practice Guideline for Opioid Therapy for Chronic Pain,” includes evidence-based information to help providers manage all aspects of patient care. It also supports the Military Health System goal to improve patient health and well-being. 

The Department of Veterans Affairs, Army Medical Command and Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury partnered to develop clinical support tools to accompany the updated guideline. These tools include summaries, fact sheets, guides and pocket cards for providers and patients. 

This webinar will focus on how to access, use and distribute the opioid guideline and tools. Webinar participants will learn to:

  • Discern expectations of patients and practitioners regarding opioid therapy, and the risks and benefits of the treatment options for chronic pain
  • Evaluate the use of patient-centered care including self-management to improve function and quality of life
  • Choose an appropriate chronic pain therapy in conjunction with the patient
  • Minimize adverse outcomes of pain therapy, particularly opioid therapy, and effectively treat them if they do occur

Registration:  Sign up for the webinar at http://dcoe.cds.pesgce.com. Please note, registration is required for each webinar regardless if the participant has an existing PESG account. Upon completion of registration, a confirmation email will be sent providing webinar event details.