Since the report from the Army’s Pain Management Task Force a year ago, the military has been focusing on efforts to make sure that patients and medical providers are not over-relying on medications but are taking advantage of other treatment modalities for pain management. That May 2010 report examined pain management at DoD facilities and suggested a holistic, multimodal and multidisciplinary approach to pain management that also included Complementary Alternative Medicine (CAM).

Col. Kevin Galloway, chief of staff for the Army’s Pain Management Task Force, said that there is a serious commitment on the part of the Army Surgeon General to see the Task Force’s recommendations implemented. “When we delivered the task force report, he told us to go out and make this happen,” he said.

One important aspect of the Army’s pain management strategy is that it focuses on early, effective interventions in pain management. “You want to decrease the number of people who require opioids,” Galloway said. “The more effective you are at the beginning, the less likely you will be to have these chronic conditions that require long-term use.”

Another key feature of the Army’s plan to improve pain management involves multi-disciplinary teams at MTFs.

“We have a plan that involves every medical treatment facility, regardless of size, that we are in the process right now of funding,” Galloway explained. “They are doing renovations to accommodate the new group of people who we are tasking to manage pain in their facility and in their region, in some cases, and then building the network of people who will be a part of this cultural transformation of pain management in the U.S. Army Medical Command.”

While pain management resources may have varied from facility-to-facility in the past, Galloway said that the Army is seeking to “brand” its new pain management approach, so that it is recognizable to both patients and providers as they move across the MHS and even the VA. That standard approach to pain management should offer comfort to patients as they transition from MHS facility-to-facility or even MTFs to VAMCs, he said.

A memo in March from Assistant Secretary of Defense for Health Affairs Jonathan Woodson to the services said that the report’s recommendations were presented to the VA/DoD Joint Executive Council (JEC), which, in turn, chartered a work group to actively collaborate on a standardized VA/DoD approach to pain management.

Efforts to improve pain management systems will not end with these plans, according to Galloway, who noted that mechanisms are being put into place to continuously collect data on what pain interventions are most effective for patients.

Spevak also suggested that the need to address the issue of pain medication overuse will continue.

“One of the things we are up against is that we have, just like the civilian world, a ‘pill society’ and we are trying to overcome some of those barriers,” Spevak said. “What we have seen mirrors what is going on in the civilian population with the prescription medication that is used.”