A Painful Homecoming for Soldiers
Nearly half of all soldiers returning from Afghanistan and Iraq have chronic pain. This is in contrast to the civilian rate of about 26%. The prevalence of chronic pain in returning soldiers and veterans is unprecedented and probably related to the types of injuries and improved survival rates from successful medical interventions in the field. Of course it is good that more soldiers are saved on the battlefield and brought home, but with this comes an obligation to provide them care that can help them return to productive and enjoyable lives.
As I write in my forthcoming book, The Painful Truth, failure to “suck up” pain in the military is viewed as a weakness or character flaw and could blemish a soldier’s career. The stigma is worsened if the soldier develops an opioid-use problem due to pain and/or post-traumatic stress.
The use of pharmacotherapy in the military mirrors the use with civilians for the treatment of pain. In both instances it is too often a default because little else is available, reimbursed by insurance or provides any relief. No doubt there is a huge need for safer and more effective therapies. Current therapies fall far short of being adequate. As I say in my Pain Medicine News column, the U.S. Department of Veterans Affairs has an opportunity to do better by treating pain with an integrative approach. This means alternative therapies like acupuncture and mindfulness can be part of the core treatment.
However, make no mistake about it, alternative treatments are not going to cut it to control the mental and physical pain of many soldiers with severe injuries and trauma. It is time for a movement to address the lack of effective therapies for pain similar to those that addressed the AIDS crisis or cancer in the previous century. Today we have cures, not just palliation, for many cancers and help for most who would have gone on to develop AIDS. The disease of pain deserves the same commitment. Maybe in 10-20 years we can restore some of the dignity that has been sacrificed by those who dedicated their lives and souls to defending our country.