Articles by JCS

DVA letter to editor

                                                                                                                                          
Dear DCs:
Feel free to use this Letter to the Editor yourself with your local newspaper. Change, shorten, or add whatever you feel, and put your own personal info on the tag. The more distribution about this important issue, the better it will be for patients and DCs alike.
You can glean more info from my lengthy article on the same issue, Uncle Sam Needs You.

Word count: 694

Letter to Editor

VA Healthcare Needs Realignment

Scrutiny into the Department of Veteran Affairs (DVA) continues after efforts to reform the DVA by the former Secretary of Veterans Affairs Eric Shinseki were deemed “a stunning period of dysfunction” by Senate Minority Leader Mitch McConnell, (R-KY).

Adding to the many dysfunctional administrative issues and exploding costs in the DVA, new media reports have also surfaced about a huge Hillbilly Heroin drug problem in the VA—the ‘pill mill’ mentality and the abuse and addiction to prescription painkillers like OxyContin, Hydrocodone, and Percocet indiscriminately handed out like Halloween candy to veterans.

“They'd just shove you a bag of pills,” said one veteran addicted to painkillers.  “No matter what you needed, there was a pill. Everything under the sun, from Adderall to Percocet to hydrocodone, oxycodone, you name it."[1]

The VA this year will treat about 650,000 veterans with opiates. One in 3 veterans polled say they are on 10 or more different medications. [2]

Abuse of prescription drugs is also high among Active Duty Service Members. On average, ADSM are prescribed narcotic painkillers three times more often than civilians.[3]

Back Pain #1 Disability in Military

The DoD readily admits that 20% of their disabled vets and 30% of hospitalizations stem from low back pain that is also the largest disabling condition among active forces resulting in more soldiers missing time from work than any other health condition.[4]

A 2009 Johns Hopkins study, Back Pain Permanently Sidelines Soldiers At War: Few Rejoin Units In Iraq Or Afghanistan Regardless Of Treatment, found that the top reasons for medical evacuation from Iraq and Afghanistan were musculoskeletal disorders at 24% compared to 14% who had suffered combat injuries.[5]

Colonel Steven P. Cohen, MD, found only 13% of ADSM who left their units with back pain eventually returned to duty in the field.  He admits, “If you have only a 13 percent success rate, this is a failure. There’s a systemic problem…Back pain has notoriously low success rates for treatment.”

Dr. Cohen should have been more specific by stating “notoriously low success rates for medical treatment,” the typical arsenal of opioid painkillers, epidural steroid injections, physiotherapeutics, and spine fusions.

Positive Findings in Military Low-Back Pain Study

Where chiropractic care has been offered in the military health services, it has been deemed very successful. A recent study led by Christine Goertz, DC, PhD, that found 73% of patients who received standard medical care and chiropractic care rated their improvement as pain "completely gone," "much better" or "moderately better." In comparison, 17% of participants who received only standard medical care comparably rated their improvement as high.[6]

In March of 2009, the DoD Chiropractic Care Study revealed praise from Unit Commanders, ADSM, and military treatment facilities (MTF) personnel concerning chiropractic care. Overall, the Chiropractic Care Study showed that MTFs consider chiropractic care a “valuable adjunct” to the care offered in the MTFs. “Chiropractors returned ADSMs to duty faster, and they would select a chiropractor as much or more than a Doctor of Osteopathy or physical therapist.” [7]

Despite these good results, the military health services have not fully implemented chiropractors on all bases and at all VA hospitals as called for by federal law. Ironically, the military medical corps has no problem plying ADSM or vets with narcotics while deterring full access to more effective and drugless chiropractic care.

Say No to Drugs

Acting DVA Secretary Sloan Gibson recently told the Senate Veterans Affairs Committee it will take two years, 1,500 more doctors and more than $17 billion in taxpayer money to fix the problems plaguing the VA.[8]

My suggestion to Sec. Gibson is to hire more Doctors of Chiropractic as primary spine providers to manage the pandemic of back pain cases without drugs, shots, or surgery. Simply adding more MDs and DOs with the same ‘pill mill’ approach will be equivalent to a statement attributed to Albert Einstein: “Insanity is doing the same thing over and over again and expecting different results.”

Dr. Cohen admits, “We must and can do better.” If so, it’s time for both the DVA and DoD to “Say No to Drugs” and to “Say Yes to Chiropractors” who offer a non-drug and proven treatment for back pain.[9]

 



[1] A Growing Number Of Veterans Struggles To Quit Powerful Painkillers by Quil Lawrence, All Things Considered,  NPR, July 10, 2014

[2] Veterans Kick The Prescription Pill Habit, Against Doctors' Orders, by Quil Lawrence, All Things Considered,  NPR, July 11, 2014

[3] Veterans Kick The Prescription Pill Habit, Against Doctors' Orders, by Quil Lawrence, ,All Things Considered, NPR, July 11, 2014

[4] Inteli-Health (Johns Hopkins); March 15, 2000.

[5] Back Pain Permanently Sidelines Soldiers At War, Johns Hopkins New release, Nov. 2009.

[7] Chiropractic Care Study, Senate Report 110-335 accompanying the National Defense Authorization Act for FY 2009; letter sent to Congressmen by Ellen P. Embrey, Deputy Assistant Secretary of Defense (September 22, 2009): p. 3.

[8] VA chief: Fixes would take two years and $17 billion, by Jacqueline Klimas, The Washington Times, July 16, 2014

[9] Bigos et al. US Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 14: Acute Low Back Problems in Adults AHCPR Publication No. 95-0642, (December 1994)



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