July 28, 2014
TO: Sec. Sloan Gibson
Secretary of Veterans Affairs
Department of Veterans Affairs
810 Vermont Ave NW
Washington, DC 20420
RE: Say No to Drugs: Say Yes to Chiropractors
FROM: JC Smith, MA, DC
You 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.
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—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 recently on NPR’s All Things Considered. “No matter what you needed, there was a pill. Everything under the sun, from Adderall to Percocet to hydrocodone, oxycodone, you name it.”
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. 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.
My suggestion to you is to hire more Doctors of Chiropractic as primary spine providers to manage the pandemic of back pain cases without drugs, shots, or surgery. Plus, comparative studies have found chiropractic care is faster, safer, and cheaper than medical care.
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.”
Back Pain #1 Disability in Military
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.
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.
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.
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 2013 study published in the medical journal Spine by Christine Goertz, DC, PhD, 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.
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.” 
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, cheaper, and drugless chiropractic care.
If the DVA is to win the war on chronic back pain and reduce the Hillbilly Heroin epidemic, you should implement chiropractic care at every DVA hospital and/or refer to field chiropractors when necessary.
 VA chief: Fixes would take two years and $17 billion, by Jacqueline Klimas, The Washington Times, July 16, 2014
 A Growing Number Of Veterans Struggles To Quit Powerful Painkillers by Quil Lawrence, All Things Considered, NPR, July 10, 2014
 Veterans Kick The Prescription Pill Habit, Against Doctors’ Orders, by Quil Lawrence, All Things Considered, NPR, July 11, 2014
 Veterans Kick The Prescription Pill Habit, Against Doctors’ Orders, by Quil Lawrence, ,All Things Considered, NPR, July 11, 2014
 P Manga, D Angus, C Papadopoulos, W Swan, “The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low Back Pain,” (funded by the Ontario Ministry of Health) (August, 1993):104
 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)
 Inteli-Health (Johns Hopkins); March 15, 2000.
 Adding Chiropractic Manipulative Therapy to Standard Medical Care for Patients With Acute Low Back Pain: Results of a Pragmatic Randomized Comparative Effectiveness Study, Goertz, Christine M. DC, PhD, et al., Spine:
15 April 2013 – Volume 38 – Issue 8 – p 627–634
 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.