Opiates, Opioids and the Veterans Administration

veteran soldiersThere seems to be a lot of conversations about prescription drugs these days and that’s a good thing. We have been developing a serious problem related to abuse of prescription drugs for several years so the more we talk about it, the more we may be able to join forces to overcome it.

For example, there was an article about the way the Veterans Administration has been dispensing and monitoring the use of painkillers. According to VA policy, before a person is started on opioids (semi-synthetic or fully synthetic opiate-like painkillers), they are supposed to get a urine test and then get a follow-up within 30 days. These actions would prevent a veteran from coming in to the VA to get drugs for an addiction and would help reduce the chance of long-term abuse and addiction. But a report from the VA stated that an examination of VA procedures showed that these actions were only done in 6.4% of cases.

This failure really means two things.

The failure to drug test the person up front means that the VA has less ability to spot a person who is coming to the doctor just to get drugs to maintain an addiction. The person who already has opiates in his body may be looking for a source of more drugs.

The follow-up failure means that a person who might no longer need these drugs will not be monitored 30 days down the line. This failure opens the door wide to continued use and addiction. The prescribing standard for opiate painkillers is supposed to be no longer than six to eight weeks. But really, unless a person has had a very bad accident, is disabled or has cancer, the chances are pretty good that an ideal course of painkillers is short. There are, of course, other conditions that cause lasting, severe pain. But in general, there are some signs that the medical industry is beginning to see that short courses of painkillers are better for many patients.

When Withdrawal Sets in

Many people who properly use their pain medication will probably experience withdrawal symptoms if they quit after less than six to eight weeks of opiate or opioid use. This just points out how quickly the human body adjusts to the presence of opiates and opioids. Unfortunately, the patient may just feel miserable for a while.

Take the case of a person who spends several days in the hospital and is medicated for pain while he is there. When he goes home, either he no longer needs pain medication or soon discontinues it. He may suffer flu symptoms and think he picked up a case of the flu while in the hospital.

The truth may very well be that the individual is going through withdrawal. It doesn’t mean that he is an addict unless he continues to seek drugs and depends on them to get through life. He may just need to be gradually tapered off the drugs with the help of his doctor. But in this case, with the VA not doing a followup up in 30 days, there is a better chance for a person to begin to depend on the oblivion of opiates. Kindness and consideration would dictate that a doctor prescribe the shortest possible course of opiates; that a followup be done to assess the level of pain; that signs of addiction or abuse be carefully noted; that when these signs exist, a patient be cared for to eliminate these drugs in a humane fashion.