Department of Defense and Veterans Health Administration Initiatives Support Comprehensive Pain Management Approaches

The Joint Pain Education Program and the Acupuncture Training Across Clinical Settings are two initiatives currently underway to improve comprehensive pain management for veterans.

NATIONAL HARBOR, Md. – Many in the medical community are managing pain in patients coming home from combat. As is the case with treating civilians, alleviating pain in veterans can be challenging for many clinicians. 

Eric B. Schoomaker, MD, PhD, a scholar-in-residence distinguished professor of Military and Emergency Medicine at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, reviewed a comprehensive pain management approach for veterans that incorporated both complementary and alernative medicine (CAM) and comprehensive integrative medicine (CIM) at the American Academy of Pain Management 2015 meeting.1

Armed forces service members are more likely than ever before to survive combat. Survival for veterans has improved, up from 69.7% in World War II to 89.9% during the wars in Afghanistan and Iraq, data from the Joint Theater Trauma Registry indicate. 

At the same time, musculoskeletal and mental disorder ambulatory visits in the U.S. armed forces increased substantially from 2002 to 2012, from 1.2 to 2.2 and from 0.4 to 1.4 ambulatory visits per 100 person years, respectively, data abstracted from the April 2013 of Medical Surveillance Monthly Report indicate. During the same time period, hospitalizations for mental disorders more than doubled from 8 to 18 per 1,000 person years.2

Similar trends have been observed in the number of overall traumatic brain injury (TBI) cases, with those numbers increasing from 10,963 to 27,507 from 2000 to 2008, data from the Department of Defense indicate.

As for unintentional drug overdose deaths in the United States, prescription opioid-related overdoses are continuing to be a problem with prescription painkillers deaths nearly doubling from 2002 to 2007, hitting 36,450 in 2008, according to the CDC.