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Submission For The Record of National Association for Alcoholism and Drug Abuse Counselors

Public Policy Subcommittee on Veterans Health Care
October 10, 2013

Committee Members
Larry Ashley, Ed.S, LADC, CPGC • U.S. Army 1969-1971• Subcommittee Chair
Peter Formaz, NCAC II, LAC • U.S. Marine Corps 1960-1969, Chair
Michael Hurst, MS, MAC, CSAC, CEAP • U.S. Army 1978-1998
Ronald Pritchard, BS, CSAC, CAS • U.S. Navy 1960-1988
Kelly Shanley-Johnson, CDPT • U.S. Navy civilian contractor 1990-2006

Cynthia Moreno Tuohy, NCAC II, CCDC III, SAP • NAADAC Executive Director
Gerard Schmidt, MA, LPC, MAC • NAADAC Public Policy Committee Chair
Craig Muenzer, Government Relations Coordinator
Ryan F. Flynn, Digital Communications Coordinator

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Pain Management Programs and the Use of Opioids to Treat Veterans

Current evidenced-based practice is supported through research and application showing that medication assisted treatment can be an effective means of treating individuals with opioid addiction.

NAADAC, the Association for Addiction Professionals, does not discount the significant positive medical uses use of opioids to treat pain; however, NAADAC remains deeply concerned by the trend that has rendered opioids as the first choice for pain management by doctors.   Behavioral therapeutic intervention, used in conjunction with medication assisted treatment, is far more effective in managing pain, as well as treating addiction, in terms of increasing the prospects for long-term recovery.

Given the inherent risk of dependence precipitated by opioids, NAADAC fully recommends that all non-opioid treatment options be explored before opioids are prescribed.  In other words, NAADAC more strongly urges and supports the use of other clinical techniques and therapeutic interventions before the use of opioid administration for pain management.

Many veterans have been exposed to the use of use of prescription medication while serving in Afghanistan and Iraq and other service related involvement.  In fact, it has been estimated that between 20 - 25 percent of troops stationed in these war zones have received prescriptions for sleep, anxiety, and depression, among some of the more prevalent issues being addressed.  There is concern that the treatment community is creating a pill culture because of the large numbers of prescriptions being issued by the Departments of Defense and Veterans Affairs.  This uptick in prescribed medication will continue to cause a higher likelihood of diversion incidences.

        NAADAC would endorse and support a recommendation that all prescribers of pain and psychotropic medications be required to receive education and training in addictive disorders.  This increased knowledge of the addiction process and evidenced-based therapeutic interventions, in addition to medication assisted treatment, would go a long way towards stemming the ever-increasing tide of overprescribing opioids before considering other options in pain management treatment.

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"NAADAC's Mission is to lead, unify, and empower addiction focused professionals to          achieve excellence through education, advocacy, knowledge, standards of practice, ethics, professional development and research."  - NAADAC Mission Statement

NAADAC, the Association for Addiction Professionals, is the largest membership organization serving addiction counselors, educators and other addiction-focused health care professionals, who specialize in addiction prevention, treatment, research and education. With more than 9,000 members and over fifty affiliates, NAADAC's members work to create healthier individuals, families and communities through prevention, intervention, treatment, continuing care and recovery support.  NAADAC promotes excellence in care by promoting the highest quality and most up-to-date, science-based services to our addiction professionals and the clients, families and communities they serve. NAADAC does this by providing education, clinical training and certification. In the last eight years NAADAC has credentialed more than 15,000 counselors, playing an important role in sustaining quality health care services and protecting the well-being of the public.