Samueli Institute: A Call to Action for Chronic Pain and Opioid Use in the U.S. Military

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In an article published by JAMA Internal Medicine, LTC Wayne B. Jonas, MD, USA (Ret.), President and CEO of Samueli Institute, and LTG Eric B. Schoomaker, MD, PhD, USA (Ret.) discuss the excessive use of opioids in the U.S. military and present a call to action to integrate medical practices that have proven to alleviate the symptoms of chronic pain.

With thousands of military personnel returning from war, the issue of chronic pain and its long-term effects on Service members is a growing issue. Opioids are the most widely-used method of treatment and patients are becoming addicted to the highly potent meds.

In an article published by JAMA Internal Medicine on June 30, LTC Wayne B. Jonas, MD, USA (Ret.) and LTG Eric B. Schoomaker, MD, PhD, USA (Ret.) discuss the excessive use of opioids in the U.S. military and present a call to action to integrate medical practices that have proven to alleviate the symptoms of chronic pain.

“The nation’s defense rests upon comprehensive fitness of its service members – mind, body and spirit,” the article said. “Chronic pain and use of opioids carries with it the risk of functional impairment of America’s fighting force.”

Jonas and Schoomaker’s commentary in this issue of JAMA Internal Medicine comes in response to “Chronic Pain and Opioid Use in U.S. Soldiers after Combat Deployment” by Robin L. Toblin, PhD, Philip J. Quartana, PhD, Lyndon A. Riviere, PhD, Kristina Clarke Walper, MPH, and Charles W. Hoge, MD. The report outlines a study of an Army unit in which 45 percent of Service members reported to have chronic pain, and of those 15 percent regularly use opioids.

The Department of Defense (DoD) has remained vigilant in the efforts to combat chronic pain in Service members. A pain management task force was formed in 2010. Samueli Institute was tasked with conducting a comprehensive set of systemic reviews on self-care and integrative approaches for pain. An expert committee was then charged with creating recommendations based on those reviews, which was recently published in Pain Medicine. Among the recommendations, the committee pointed to self-care modalities in the treatment of pain such as yoga, Tai Chi and music therapy.

Jonas and Schoomaker also point out that economic drivers present an obstacle when it comes to the delivery of the modalities laid out by DoD. The National Institutes of Health (NIH) currently devotes 1 percent of its $30 billion budget on pain research, a drop in the bucket compared to that of the private sector spending on pharmaceuticals, which allocates a whopping $48.5 billion for research and development and $57.5 billion for drug promotion.

Samueli Institute is committed to responsible medicine which places the patient at the center. At the core of its mission lies the need to approach wellness from a holistic standpoint, which includes the healing of the mind, body and spirit. This care goes beyond the use of pharmaceuticals for pain management, to include all evidence-based approaches.

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Jenny Swigoda
Samueli Institute
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