gettyimages 585811356 Two ways the VA can keep you from overdosing on opioids

View of an ‘Overdose Rescue Kit,’ which includes naloxone, a syringe for nasal atomization, and instructions.  Naloxone can block the effects of opioids. The center provides a needle exchange program, supplies, counseling, and other services for an average of 80 people a day. (Photo by Robert Nickelsberg/Getty Images)

By Jonathan Kaupanger

Your pain medicine can kill you.

Let’s say it’s been a few years since your doctor started you on an opiate to manage your chronic pain. Your body has changed, maybe you’re on more meds now.  The very medication prescribed to you by the VA can cause you to overdose and die.

The VA wants to make sure this doesn’t happen to you, and they have two ways to do it.

First, there’s the Naloxone rescue kit. This isn’t something just for drug abusers; it’s for anyone who’s been given opiates as long-term pain relief.

“It’s absolutely possible that someone taking opiates as prescribed, something else can go wrong that could change their reaction to it,” Dr. Brian Sands, Section Chief for Substance Use Disorder Services at the VA’s New York Harbor HealthCare System, said. “Even people who are taking meds as prescribed, they should be worried and prepared in this way.”

Before you get too worried, the Naloxone kits aren’t necessary for absolutely everyone on pain meds. Things like a tooth extraction or even a broken arm may get you a few days’ worth of Percocet, and in those cases, you don’t need to worry too much.  This overdose prevention initiative is all about getting kits in the hands of the veterans on long-term pain meds who are at risk of overmedicating.

“Anyone who’s on an opiate for more than a few weeks to a month is going to be physiologically addicted to that,” Dr. Sands said. “And there’s no shame in that, it’s just a fact of the medicine. There are many people taking it, but if they stop, they will go through withdrawal—but they aren’t addicted.”

Sands went on to explain that if you are taking opiates for more than a month, even when it’s prescribed by your doctor, you need one of these kits.

He is also quick to point out that in terms of pain management for injured veterans, opioids aren’t even a good solution.

“It actually turns out that being on opioids long term for something like back pain is useless,” he explains.  “After a few years you’re not in any less pain and your functioning isn’t any better.”

And this brings us to the second way Veterans Affairs can keep you from overdosing. VA did a huge study of the electronic medical records, and they came up with a model that can predict your risk of dying from an overdose.

The software they developed automatically looks through all your charts.  Your doctor then just plugs in the dosage of the opiates you are on, adds in your other medications, medical diagnosis, age and gender, and then they get a number indicating your likelihood of overdose.

Beyond just identifying veterans at risk for an overdose; doctors can be pretty specific on the chances of it happening within a period of time and react to the situation. Each medical center has a pain specialist; they look at these risk numbers and then take the information to a committee which comes up with a plan for the person.  And this gives the VA a really good way to start the discussion.

“We have a wonderful pain management program,” Sands said. “They can do anything from setting you up with acupuncture, swim therapy, to injecting steroids or other medications into nerves that will block the pain, but won’t affect your level of consciousness in any way.  We have a really good comprehensive pain program and that is really the best way to treat pain.”

If you are in the VA’s system and you are taking any form of opioids, chances are you’ve already had a conversation with you doctor about the drugs. And with any new issues, you probably won’t be started on a regiment of opioids.

“It’s universally the case, if you have pain the most important thing is to get an accurate diagnosis of the underlying pathology causing the pain,“ Dr. Sands said.

The most important thing to remember according to Dr. Sands is that overdoses can be prevented.

“If you have a family member taking meds long term, the family should get one of these kits,” he said. To get your Naloxone Rescue Kit, start by having a conversation with you VA physician.

Connect: @JonathanVets1 | Jonathan@ConnectingVets.com

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