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Opening Statement of The Honorable Dan Benishek M.D.

Opening Statement of the Honorable Dan Benishek M.D.
Chairman, Subcommittee on Health
House Committee on Veterans’ Affairs

“Between Peril and Promise: Facing the Dangers of VA’s Skyrocketing Use of Prescription
Painkillers to Treat Veterans”

October 10, 2013

 

           Good morning and thank you all for being here today.

           I welcome you all to today’s hearing, “Between Peril and Promise: Facing the Dangers of VA’s Skyrocketing Use of Prescription Painkillers to Treat Veterans”

           Today’s subject is one of the most serious and significant we will discuss all year. It is also one that is particularly poignant and personal to me.

           I spent twenty years serving our veterans as a doctor at the Oscar G. Johnson VA Medical Center in Iron Mountain, Michigan.

            In that capacity, I understand all too well what it means for a veteran and a patient to be in pain. 

            Pain can be an unrelenting enemy – one that thwarts an individual’s ability to work and enjoy the activities they once loved, hinders their relationships with their family and friends, and impacts their capacity to be comfortable in their own home. 

            On a daily basis, my veteran patients would confide in me about the pain they were in, the many ways in which they were hurting, and – more than anything - their desperate desire to find relief.

           Perhaps nowhere else is that more clear than in the heartbreaking testimony we will hear shortly from two surviving spouses, Heather McDonald and Kimberly Green.

           Their husbands, Scott McDonald and Ricky Green, honorably served our nation in uniform and came home -as far too many of our returning veterans do - hurting and in pain.

           These men sought treatment from the Department charged with caring for them – the VA – hoping to get the help they needed so they could once again take full and successful ownerships of their own lives, without pain as their constant companion.

           Sadly, rather than getting the best care anywhere, Scott and Rickey were prescribed a disturbing array of pain, psychiatric, and sleeping medications without any clear consideration or special attention paid to how these powerful drugs were interacting with each other or affecting Scott and Rickey’s physical and mental well-being. 

           The combined effects of these multiple medications ultimately took their lives.

           We will also hear from two veterans – Joshua Renschler and Justin Minyard – who will give us a first-hand account of the struggles they faced with VA’s apparent overreliance on opioid-based medications for pain management.

           At one time, Joshua was prescribed thirteen different medications.  Despite his pleas that the medications weren’t working, he was never referred to a pain specialist.

           Justin was prescribed enough opioid pain medications on a daily basis to treat four terminally ill cancer patients. He eventually sought care outside of VA to find an effective treatment to manage his pain.

           To say that I am disturbed by these accounts and by the multiple reports we hear every day about the skyrocketing use of prescription painkillers – particularly opioids – to treat veterans in pain would be a major understatement.

           VA’s band aid approach to suppressing the symptoms of pain rather than treating the root causes must stop.

           VA maintains a pain management treatment model that makes primary care, rather than specialty care, the predominant treatment setting for veterans suffering from pain. 

           Yet – as I know from personal experience - the multifaceted nature of chronic pain, particularly when multiple medications are being prescribed, should not be managed by a primary care physician, but rather by a qualified pain specialist who is trained to understand the complexities of treating these conditions.

           I want to be very clear that this hearing is not intended to vilify the many hard working primary care providers working every day to care for veterans in pain at VA medical facilities across the country. I have been in their shoes and I know the challenges they face in providing the high-quality care our veterans deserve.

           Rather, our intent here today is to initiate better provider practices and, most importantly, better care coordination for our veterans and their loved ones so that no other family has to experience the pain, the suffering, or the loss that our witnesses on the first panel have already experienced.

           It is critical for VA to take responsibility for its failures and rise to the challenge to change and take immediate action to adopt effective pain management policies, protocols, and practices.  

           We have already lost too many veterans on the home front to battles with chronic pain.

           The stakes are too high for VA to continue getting it wrong.