According to a recent article in USA Today, military doctors in 2009 wrote nearly 3.8 million prescriptions for pain medications, a greater than four fold increase in such military prescriptions since 9/11. Prescription drug abuse, by the Pentagon’s own studies, has been shown to be more than twice as prevalent in the active military component than in civilian society at large. Given the median age of the demographic, this is even more alarming. In a survey conducted by the Department of the Army, one in four soldiers currently serving on active duty admitted to abusing prescription pain medications at one time or another. If these figures are true in the active component, one can only imagine what those numbers look like amongst the wounded veteran population.
Certainly pain medication has its place. But how large of a place should it occupy, and is there an alternative?
As a regular visitor at Walter Reed and Bethesda Medical Centers in Washington, D.C., I was troubled by the reports of a lack of long-term pain management plans or goals for the severely injured veterans who were being treated while on active duty. Medication, in my observation, seemed to be the preferred pain management tool. Is that a decision based on cost? When you consider that the wounded veteran is likely to remain on active duty for 12-18 months before being medically discharged into the VA Healthcare system, then pain medication may be the most cost effective way to treat the condition. However, there exist other options which are generally unknown to the veterans.
One of the great benefits of events like the Lt. Dan Weekend coming to Beaufort this October (in conjunction with Main Street Beaufort’s 16th annual Shrimp Festival) is the bringing together of a significant number of veterans. Here, veterans can share information and ideas, and network in a manner that they normally cannot. Information is exchanged regarding changes in benefits; changes in legislation; and knowledge is exchanged regarding relatively unknown medical treatments. Events such as this provide a great forum for these veterans to share such information. Pain management is one of the topics that we are going to tackle in depth with the veterans during their four-day stay in Beaufort.
Central in this discussion will be one of the Independence Fund’s Board Members, Phil Levine. In 2004, Phil was a USMC Corporal wounded during the battle of Fallujah.
“When I was wounded in Iraq during a firefight, I knew that there would be painful days ahead,” Phil recently told me. “How painful… I had no idea.”
The first two years of Phil’s recovery included multiple operations and seemingly endless hours of physical therapy. For the pain, his treatment plan relied on significant amounts of Vicodin and Percocet. Time passed, the medications became less effective, and the pain got worse. But being a Marine, Phil felt like he should be able to handle the pain.
“We have a saying in the Corps that pain is weakness leaving the body,” Phil continued. “Well, I wanted the whole limb to leave.” Phil went so far as to ask his doctors to remove his limb because of the intensity of the pain. The doctors explained to him that the pain was now registered in his brain and would be there with or without the limb, a condition known as phantom limb syndrome.
Medically retired from the Marine Corps, Phil wanted to return to school and complete his degree. However, he found the pain depressing and limiting to his productivity. It was hard to concentrate, and reading and writing were no longer pleasurable. Like other veterans, he worried about becoming dependant on the medications. But six months ago, things changed when Phil was informed of a procedure called Spinal Cord Stimulation (SCS) that was being offered by the VA.
Without getting into a technical explanation, the SCS procedure basically involves the surgical implantation of a wire electrode alongside the spinal column. This electrode then emits controllable electro-magnetic impulses to specific locations on the spinal column which mask the pain signals to the brain. These pulses are controlled by the user (Phil in this case) via a wireless remote control. The end result is that the user manages the pain, drug-free, through these electrical impulses when needed. Drug free. Is it the right answer for everyone? Probably not, but it is a viable answer for many, and few are aware of it.
And the cost of the procedure? According to Samuel Holiday, National Manager of Market Development for Boston Scientific Neuromodulation, one of the VA approved providers of the SCS procedure, in terms of dollars, the surgery and device implantation is roughly equal to six years worth of traditional opiate-based therapy. Considering the young age of most of today’s wounded veterans, six years sounds like a very short span of time and worth the long-term investment in these heroes.