I moved from North Carolina to California a year ago and decided to try the highly rated VA Hospital near my new home. Initially, I had no trouble getting the care I needed. Once I was an established patient, though, I was officially diagnosed with PTSD and was referred to the Pain Management Clinic. I had been on a stable dosage of 50 mcg/Fentanyl patch for 2 years but was having trouble getting the patch to stick to my skin. The Pain Management Clinic saw my PTSD diagnosis and reduced my dosage by 80%. The VA had recently decreed that veterans with PTSD could not be on long-term opiate therapy and had set a ceiling for the dosage. This was their knee-jerk response to veteran’s suicides and an uptick in overdoses.
I was offered no counseling or additional help to deal with this, and any phone call I made to the clinic remained unanswered. I was struggling to take care of my son because a bureaucrat far away made a decree that threw my life into a complete tailspin. Out of desperation, I saw another doctor and got the appropriate medication. When I returned to the VA, I was instantly accused of being a doctor shopper and drug abuser. They kicked me to the curb. Several months later, I got a letter requesting that I admit to drug abuse. I refused.
What disturbed me most was that amongst the accusations were no references to a Substance Abuse Treatment program. No one mentioned the myriad of 12 Step programs that I could attend as soon as I walked out the door. I hope you are shocked. You should be. When bureaucrats make knee-jerk decrees without analysis, research or thought to the collateral damage, innocent bystanders such as pain patients are needlessly harmed. Our lives are tough enough dealing with the physical and emotional toil of bearing constant pain.
Substance Abuse needs to be viewed for what it is: a disease. We view addiction as a person’s failure, lack of integrity and bad decisions. Certainly, all of these factors occur during one’s addiction, but these negative things occur because that person’s brain chemistry is misfiring. I did things in my addiction that I never thought I’d do. It changes you. Just because we call addiction a “disease” doesn’t mean responsibility escapes the addict. The Director of the National Institute of Drug Abuse (NIDA), Dr. Volkow explains it eloquently: “
“People say if you consider drug addiction a disease, you are taking the responsibility away from the drug addict. But that’s wrong. If we say a person has heart disease, are we eliminating their responsibility? No. We’re having them exercise. We want them to eat less, stop smoking. The fact that we have a disease recognizes that there are changes, in this case, in the brain.” (
Sometimes pain patients prefer to distance themselves from addicts especially because as a pain patient you’re always defending yourself from being labeled an “addict.” The truth is that we are in this together. The more knowledgeable our doctors, pharmacists, health systems and law enforcement are about Addiction the better off legitimate pain patients will be. Can you imagine a day where you go to a doctor or pharmacist without being interrogated about your meds? Or imagine a day where the pharmacy has your medication on time? The answer for pain patients and addicts alike is better treatment of our collective diseases.
Our healthcare and law enforcement systems are putting the focus solely on making these useful medications unavailable. The answer to the prescription drug epidemic is providing and creating more incentives and opportunities for substance abusers to find treatment. Did you know that there is an AA meeting every second of the day? I didn’t know that until I sought recovery from my addiction. I’ve been clean for 4 years. The answer for the 100 million people suffering from pain is similar. We need to research and study pain like we do heart disease, diabetes, cancer and erectile dysfunction. We need to give our medical students and doctors more education about pain: how to measure it, how to assess is, how to be empathetic, the incidence of pain, etc. Finally, we need to include our veteran’s into the private insurance arena. The VA is an unrecoverable failure. Unless the VA hospitals are competing with the Johns Hopkins and Cedars-Sinai of the world, they aren’t helping veterans.
Do veterans not deserve the very best we have to offer?
Darisse Smith is a columnist for the National Pain Report. She is a chronic pain sufferer, a veteran and a mother.
The information in this column is not intended to be considered as professional medical advice, diagnosis or treatment. Only your doctor can do that! It is for informational purposes only and represents the author’s personal experiences and opinions alone. It does not inherently or expressly reflect the views, opinions and/or positions of National Pain Report or Microcast Media