New Navy policy ensures opioid therapy is appropriate for patients with chronic pain

The Navy has instituted new policies and training designed to ensure safe opioid use by patients in its medical care system who are seeking access to opioid medications for the long-term treatment of chronic pain.

Sailors, Marines and family members wishing to receive such care under Navy Medicine will now undergo psychiatric and substance abuse screening prior to being prescribed opioid medications.

The move is a proactive measure by Navy Medicine since the Navy and Marine Corps have not identified a broader opioid abuse problem within its patient population. According to the Navy, in 2015 and 2016 opioid abuse among its active duty service members was 7.5 to 10 times lower than the rate of the general U.S. population.

On March 14, Rear Adm. Terry J. Moulton, the Navy’s deputy surgeon general, authorized the new safety program that is believed to be the first among the military services.

“Abuse and addiction can happen, and we are tackling this issue head-on in a thoughtful and methodical way, as these medications can greatly decrease pain and improve quality of life,” said Moulton. “At the same time, we have a duty to ensure we are using them in a way that minimizes abuse and addiction.”

He went on, “Over reliance on opioids can be harmful to patients with chronic pain; patients especially at risk are teenagers or young adults, patients with a personal or family history of alcohol or other substance abuse disorder, and patients with psychiatric co-morbidities. Therefore, clinician efforts to maximize the benefit and minimize the risk of long-term opioid therapy are imperative to ensure the safety of the patients, their families, and society.”

The new rules will apply to sailors, Marines and family members currently being treated by Navy Medicine.

Patients will be required to undergo a psychiatric and substance abuse history screening prior to being prescribed opioid medications. They will also be subject to mandatory urine tests to ensure the treatments are working and that there are no signs of opioid abuse.

“Long-term use of opioids can be effective in limited, select cases, but beginning and continuing such therapy should be an informed, careful decision,” said Cmdr. Leo Carney, director, Navy Primary Care and Mental Health. “Once it’s decided long-term opioid therapy is the best option to promote healthy functioning for the patient, the new treatment program requires consistent monitoring to ensure the therapy is still effective with no signs of addiction or misuse.”

One way that health care officials nationwide have tried to lower a patient’s risk to potential opioid addiction is to stress alternative treatments.

Navy Medicine is doing the same by educating patients and clinicians on alternative pain management methods like physical therapy, lifestyle changes, chiropractic massage therapy, acupuncture and surgery.

“Navy Medicine is committed to providing the best medical care to our Sailors, Marines and their families,” said Ed Gullick, a spokesman for the Navy’s Bureau of Medicine. “We’re also committed to ensuring our health care professionals are equipped with information and tools they need to effectively treat patients requiring long-term opioid therapy.”