VA wants to keep you from an opioid overdose

Jonathan Kaupanger
March 06, 2018 - 12:37 pm

Photo by Amy Davis/Baltimore Sun/TNS

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Your pain medicine can kill you. 

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 has 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,” said Dr. Brian Sands, Section Chief for Substance Use Disorder Services at the VA’s New York Harbor HealthCare System.  “Even people who are taking meds as prescribed, they should be worried and prepared in this way.”

Before you are too worried, the Naloxone kits aren’t for everyone. For a tooth extraction or even a broken arm, you may get a few days’ worth of Percocet for something like that, but for the most part, you don’t need to worry too much. This overdose prevention initiative is all about getting kits in the hands of  at-risk veterans.

“Anyone who’s on an opiate for more than a few weeks to a month is going to be physiologically addicted to that,” said Dr. Sands.  “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. 

Sands is also quick to point out that the VA isn’t withholding treatment that helps as a way to avoid addiction.  “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 study of the electronic medical records and came up with a model that can predict your risk of dying from an overdose. The software they developed automatically looks through all the charts. Physicians then plug in the dosage of the opiates you are on, adding any other medications you’re taking, your medical diagnosis, age, gender and that populates a number. 

They can now not only identify veterans at risk for an overdose, but be pretty specific on the chances of it happening within a period of time. 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. This gives the VA a really good way to start the discussion. 

“We have a wonderful pain management program,” Sands says. “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 opiates, chances are, you’ve already had a conversation with you doctor about the drugs. With any new issues, you probably won’t be started on a regiment of opiates. “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 your VA physician.