Features Research
New research projects aimed at addressing pain conditions among U.S. war vets

The National Institutes of Health’s National Center for Complementary
and Alternative Medicine (NCCAM), the National Institute on Drug Abuse
(NIDA) and the U.S. Department of Veterans Affairs (VA) Health Services
Research and Development Division provided funding for this initiative.
The research projects are located at academic institutions and VA
medical centres across the United States.

“Pain is the most
common reason Americans turn to complementary and integrative health
practices,” said Josephine P. Briggs, M.D., director of NCCAM. “The need
for nondrug treatment options is a significant and urgent public health
imperative. We believe this research will provide much-needed
information that will help our military and their family members, and
ultimately anyone suffering from chronic pain and related conditions.”

A
2011 Institute of Medicine (IOM) report states that nearly 100 million
American adults suffer from chronic pain at a cost of $635 billion per
year and notes a need for a cultural transformation to change this
problem. Chronic pain disproportionately affects those who have served
or are serving in the military. A June 2014 report in JAMA Internal
Medicine showed an alarmingly high rate of chronic pain – 44 per cent –
among members of the U.S. military after combat deployment compared to
26 per cent in the general public.

“Unless the ‘cultural
transformation’ called for by the IOM begins in earnest, our nation
faces additional crises in the future. Many service members and veterans
with pain also have comorbid conditions such as posttraumatic stress
syndrome or traumatic brain injury,” a commentary in the journal said.
“Many of them are at risk for a lifetime progression of increasing
disability unless the quality, variety, and accessibility of
evidenced-based ‘self-management’ skills are improved. Without more
effective and less costly approaches to pain management, the estimated
costs of care and disability to the country will approach $5 trillion.”

One
co-author of the commentary is Dr. Eric Schoomaker, a retired U.S. Army
lieutenant general who is a scholar-in-residence and distinguished
professor of military and emergency medicine at the Uniformed Services
University of the Health Sciences in Bethesda, Md., and is a member of
NCCAM’s Advisory Council. The other is Dr. Wayne B. Jonas, a retired
U.S. Army lieutenant colonel who is president of the Samueli Institute, a
nonprofit organization in Alexandria, Va., with a mission that includes
applying academic rigor to research on healing, well-being and
resilience; and translating evidence into action for the U.S. military
and large-scale health systems.

Pain is not the only issue.
According to the JAMA Internal Medicine report, 15 per cent of U.S.
military post-deployment use opioids, compared to four per cent of the
general public. Drugs such as opioids that are available to manage
chronic pain are not consistently effective, have disabling side
effects, may exacerbate pain conditions in some patients, and are often
misused. According to NIDA, an estimated 52 million people (20 per cent
of those aged 12 and older) have used prescription drugs for nonmedical
reasons at least once in their lifetimes.

“Prescription opioids
are important tools for managing pain, but their greater availability
and increased prescribing may contribute to their growing misuse,” said
Dr. Nora Volkow, director of NIDA. “This body of research will add to
the growing arsenal of pain management options to give relief while
minimizing the potential for abuse, especially for those bravely serving
our nation in the armed forces.”

To find out more about the 13 new research projects, visit the NCCAM website.