Hey VA: “Get Your Act Together”

Hey VA: “Get Your Act Together”

veterans affairsI 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.TelevisionAcademyHonors

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

Authored by: Darisse Smith

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Darisse Smith

I want to thank everyone who read and shared comments. I agree that we need to advocate, advocate, advocate as much as we can. Imagine if we all said something to the “powers that be” not just about VA or specific doctors, but the whole system for treating pain. Why do people go to the doctor? If they are in pain or if they are sick. Yet doctors aren’t very educated about pain in their formal training.

Susan Scherer HIcks

Seems like everyone has had different VA experiences of all types. But I do believe the folks who are in this writer’s type of frustration regarding pain. In hospice care or palliative care, I could get a patient some help with fear and pain. But it takes advocacy, in my opinion. Without the VA we would be unable to develop what is needed in locales where people suffer in pain, and all types of overlapping conditions. Lets become advocates or encourage those who do that in our own areas.
lnstead of thinking we cannot improve a local VA, we can bring our current real experiences to the attention of local and national advocates and believers in the principal of receiving, having, sharing and giving . It works.


Once again we see ADDICTION determining who gets relief. There is a big difference between addiction and dependence. Heart patients are dependent on heart meds, diabetes patients are dependent on their meds. A legitimate pain patient rarely becomes addicted. Is this how we treat vets?


Thank You For Your Service & Thank Your Family For Theirs.

Yes, our Veterans Deserve The Best Heathcare The U.S. Has. Unfortunately, the politicians and those incharge of VA don’t share this belief. I have seen some Veterans treated by medical students, interns and residents in a VA Hospital and VA Clinics where I live. We also have a large medical school in the same town and a large public hospital where they also are trained.

The powers that be want to stop the national evening news stories of Veterans dying from overdoses of pain meds. I doesn’t matter to them how they do it. I am Thankful that you and so many others are able to have your pain managed by the private sector.

Mark Ibsen

Mmj is appropriate for pain and PTSD.


I’ve had issues with my local VA with chronic pain as well. While I was still in the AF, I started to develop a weird pain in my left leg in early 2006. Within a month, it had spread to my entire low body. Early 2007, my records were sent before a med board. July 2007, I was out. I still had no idea what the problem was. Nothing seemed to turn up anything. I had low back issues, but nothing showed what could be causing my pain. The AF focused on depression and put low back as an aside, despite my insistence that I wouldn’t be so depressed if I wasn’t in so much pain. I then went into the VA system. Them taking 2 years to get my disability percentage right aside, the hospital there was horrid. I had no choice though. The bases were even harder to get into, and some wouldn’t even take non active patients. We ended up having to move back to the area of my first duty station. The VA there was just as bad. The doctor they assigned me to wouldn’t listen to me at all. Insinuated that taking prescription opioids a certain way (2 at a time) meant the person was after the high. Many don’t get that high when there is so much pain to push through. It was obvious he had never experienced a persistent high state of chronic pain. During intake, he had no interest in a description of the pain. He had no interest in what test I had done, repeatedly, and told me over and over that he wanted me to see “his specialist”. The other appointments I had with him fared no better. After the 4th, I decided I needed a new doc. Only problem was, the VA refused to change me over. I ended up going to my local base. The doc there is the best I’ve ever been to. Ironically, he used to be a VA doc. After slipping a disc in 2010, I saw a neurosurgeon. I did an mri, but wasn’t scheduled to see him again until the end of the month. 2 weeks into the month I started having more serious issues. I was having trouble moving my leg and foot. The pain was almost unbearable. I somehow drove myself to the local VA ER. They told me I was fine, gave me a shot and sent me on my way. The next day, I drove there again. Same thing. 2 days later my wife dragged me to a civilian ER and they admitted me. By then, I couldn’t move my leg at all anymore. Turned out, from the mri at the beginning of the month, I had slipped L4/L5. After that incident, I had had enough. I wrote a very long scathing letter to the white house. I printed it, signed it and physically mailed it. 3 years later, I got a call from the local VA about the… Read more »