Back to Top Skip to main content

Drug-monitoring innovations help providers help their patients

Two Military Health System innovations are helping to ensure best practices for patients with pain, and for patients who’ve been diagnosed with post-traumatic stress disorder. (U.S. Air Force photo by Senior Airman Curt Beach) Two Military Health System innovations are helping to ensure best practices for patients with pain, and for patients who’ve been diagnosed with post-traumatic stress disorder. (U.S. Air Force photo by Senior Airman Curt Beach)

Recommended Content:

Innovation | Substance Abuse | Posttraumatic Stress Disorder | Pain Management | Opioid Safety

FALLS CHURCH, Va. — Two Military Health System innovations are helping to ensure best practices for patients with pain, and for patients who’ve been diagnosed with post-traumatic stress disorder.

The MHS Opioid Registry utilizes cutting-edge technology for data management and reporting to identify patients who’ve been prescribed opioids, said Chris Nichols, the Defense Health Agency’s program manager for Enterprise Intelligence and Data Solutions. Clinical pharmacy professionals, physicians, and other authorized providers can use the patient lookup capability to proactively monitor and manage patients, and intervene as appropriate.

Opioids such as oxycodone, hydrocodone, codeine, and morphine are prescribed to relieve pain. But they are highly addictive, health care experts say, and overuse can lead to death.

The rates of opioid addiction and overdose deaths are lower in the military than among the general population, said Vice Adm. Raquel Bono, DHA director, during a House Armed Service Committee hearing in June on Military Health System reform. Still, she said, the MHS has a role to play.

“Our beneficiaries are no strangers to chronic pain,” Bono said.  “While our primary focus is on our own patient population, we’re also cognizant of the larger public health crisis surrounding opioids. As health professionals and public servants, we have an obligation to help confront that crisis.”

The MHS Opioid Registry was launched in December 2016 and released to all sites in 2017.  Data in the registry includes more than 200 variables including demographics, medications, morphine equivalence daily dose, results of urine drug testing, and opioid risk factors. In the future, MHS Opioid Registry users will also be able to evaluate and track alternative non-opioid therapies for pain management.

Nichols said a registry that’s accessible by both DoD and VA providers and staff is currently under development.

The PTS Provider Prescribing Profile was developed by the DHA’s Pharmacy Operations Division. It lists all providers at military treatment facilities who are treating patients with PTSD or acute stress disorder, said Sushma Roberts, Ph.D., a clinical psychologist and senior program manager for DoD/VA Integrated Behavioral Health, Clinical Communities Support Section, Clinical Support Division. The tool also documents the medications providers are prescribing. 

From February 2000 to June 2018, about 230,000 active-duty service members were diagnosed with PTSD, Roberts said, adding that 75 percent were diagnosed following a deployment of 30 days or longer. 

The clinical practice guideline released in 2017 recommended against prescribing benzodiazepines for PTSD patients, Roberts said. Benzos, also known as tranquilizers, act on the brain and central nervous system to produce a calming effect. People can easily develop a tolerance to benzos, health care experts say, needing higher doses and increased frequency to achieve the same effects. People also may suffer withdrawal symptoms, including insomnia, irritability, anxiety, panic attacks, and seizures.

 “Benzos aren’t necessarily bad,” said Army Lt. Col. Dennis Sarmiento, a psychiatrist and chair of the DHA’s Behavioral Health Clinical Community. “There are indications for their use. Short-term, they can help with anxiety, panic, and sleep. Treating such symptoms can help providers engage patients in care and better establish or reinforce rapport.”

But medications other than benzos are recommended for treating PTSD because they’re more effective, Sarmiento said. For example, antidepressants such as Zoloft, Paxil, Prozac, and Effexor raise the brain’s level of serotonin, a chemical that reduces symptoms of depression and anxiety. 

They also can be used with trauma-focused psychotherapy, Sarmiento said. Those therapies include talking or writing about traumatic events, or learning and practicing meditation or deep-breathing exercises to manage anxiety.

Sarmiento notes that throughout the MHS, benzo prescriptions have been on a downward trend since peaking in 2012.

According to the tool, the number of benzos prescriptions for MHS beneficiaries diagnosed with PTSD dropped from 1,922 in the first quarter of fiscal year 2017 to 1,622 for second quarter of FY 2018.

You also may be interested in...

Breaking the pain cycle

Article
4/9/2019
Ashley Blake, an acupuncture nurse at Naval Hospital Pensacola’s Pain Management Clinic, treats a patient with Battlefield Acupuncture (BFA), one of many opioid alternatives offered at many treatment facilities in the Military Health System. BFA consists of inserting five tiny and sterile 2 mm needles into specific points of the ear where they can remain for up to three days. (U.S. Navy photo by Petty Officer 1st Class Brannon Deugan)

Live in agony or risk addiction? MHS pain management initiatives offer options

Recommended Content:

Prescription Monitoring Program | Mental Wellness | Mental Health Care | Substance Abuse | Physical Disability | Warrior Care | Opioid Safety | Pain Management

MHS Pain Management 2019

Fact Sheet
4/3/2019

This document provides images for a pain rating scale, from 0 to 10, along with supplemental questions.

Recommended Content:

Pain Management

Gaining new perspective through vision-correcting surgery

Article
1/29/2019
The Warfighter Refractive Eye Surgery Program, available to active duty service members, provides an opportunity to correct vision with ease thanks to advancing technology. (Department of Defense photo by Reese Brown)

Once deemed a disqualifying factor for service, refractive surgery is now available to active duty service members through a Department of Defense approved program

Recommended Content:

Technology | Innovation | Vision Loss

Military Health System, industry allies work together to improve health care technology

Article
1/29/2019
Air Force Maj. Gen. Lee Payne, assistant director for combat support at Defense Health Agency, dual-hatted as the Defense Health Agency assistant director for Combat Support and MHS EHR functional champion, and Air Force Col. Thomas Cantilina, chief health informatics officer and EHR deputy functional champion at the DHA, visit the Tiger Institute Jan. 17. (Courtesy photo by University of Missouri Health Care)

Air Force Maj. Gen. Lee Payne visits University of Missouri’s Tiger Institute for Health Innovation

Recommended Content:

Innovation | Secure Messaging | MHS GENESIS | Military Health System Electronic Health Record | Technology | Patient Safety Reporting | Combat Support

To drink, or not to drink

Article
11/9/2018
If you are battling substance abuse, consider attending an alcohol-free holiday party or host your own alcohol-free small gathering

If you are battling substance abuse, consider attending an alcohol-free holiday party or host your own alcohol-free small gathering

Recommended Content:

Substance Abuse

Pilot Program on Investigational Treatment of Members of the Armed Forces for TBI and PTSD

Congressional Testimony
10/9/2018

HR 3304, NDAA for FY 2014, Sec. 704

Recommended Content:

Traumatic Brain Injury | Physical Disability | Mental Health Care | Posttraumatic Stress Disorder

PTSD Trauma Triggers and Memories Overview

Fact Sheet
9/27/2018

An overview of what trauma triggers are and how they can impact those with PTSD

Recommended Content:

Posttraumatic Stress Disorder

Air Force's first Invisible Wounds Center opens

Article
9/10/2018
Lt. Gen. Dorothy Hogg, Air Force Surgeon General, talks with a veteran during a tour of the Air Force’s first Invisible Wounds Center at the Eglin Air Force Base, Fla. The IWC will serve as a regional treatment center for post-traumatic stress, traumatic brain injury, associated pain conditions and psychological injuries. (U.S. Air Force photo)

The center will serve as a regional treatment center for post-traumatic stress, traumatic brain injury, associated pain conditions and psychological injuries

Recommended Content:

Posttraumatic Stress Disorder | Traumatic Brain Injury

Helping the healers through the power of mobile technology

Article
7/23/2018
The Provider Resilience app offers health care providers tools to guard against emotional occupational hazards, including compassion fatigue and burnout. An updated version of the app is expected to be released in the fall. (Courtesy photo)

App guards against emotional occupational hazards

Recommended Content:

Technology | Innovation

Soldiers test Army's newest transport telemedicine technology

Article
7/20/2018
Soldiers test MEDHUB during an exercise at Camp Atterbury, Indianapolis. (U.S. Army photo by Greg Pugh)

MEDHUB is really about life-saving situational awareness

Recommended Content:

Technology | Innovation

Air Force, NASA seek potential medical collaboration

Article
7/19/2018
David Loftus M.D., PH.D, medical officer and principal investigator space biometrics research branch, NASA Ames Research Center, meets with members of the 60th Medical Group at Travis Air Force Base, California. NASA and David Grant Medical Center are meeting for a potential collaboration between the two organizations to help in future space exploration. (U.S. Air Force photo by Louis Briscese)

NASA and the military share a lot of similar medical issues

Recommended Content:

Innovation

Navy Care app enables medical appointments from work, home

Article
7/13/2018
A Sailor uses the Navy Care app on her cell phone for a virtual health visit with a Naval Hospital Jacksonville provider. Navy Care enables patients to have a live video visit with a clinician on a smartphone, tablet, or computer. It’s private, secure, and free. (U.S. Navy photo by Petty Officer 1st Class Jacob Sippel)

The app delivers convenient care with the quality of a face-to-face visit

Recommended Content:

Technology | Innovation

DHA PI 6490.01: BH Treatment and Outcomes Monitoring

Policy

This Defense Health Agency-Procedural Instruction (DHA-PI), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (k): a. Establishes the Defense Health Agency’s (DHA) procedures for the collection and analysis of BH outcome data. b. Addresses how DoD will standardize BH outcome data collection to: assess variations in mental health and substance use care among in-garrison medical treatment facilities (MTFs) and clinics; assess the relationship of treatment protocols and practices to BH outcomes; and identify barriers to provider implementation of evidence-based clinical guidance approved by DoD. c. Designates the Army as the DoD lead Service for maintenance and sustainment of the Behavioral Health Data Portal (BHDP) in specialty care mental health and substance use clinics, referred to collectively as BH clinics, until BHDP functionality can be integrated with GENESIS or another electronic health record (EHR) system managed by DHA. d. Designates DHA Information Operations (J-6) as lead on transitioning BHDP functional requirements related to outcomes monitoring to future EHR data collection platforms and processes.

There is hope

Article
7/12/2018
Medically assisted treatment for opioid use can break the cycle of addiction.

More than 350,000 deaths are attributed to opioid overdoses nationwide since 1999

Recommended Content:

Mental Health Care | Substance Abuse | Addiction | Mental Wellness | Opioid Safety

Life without liquor

Article
6/29/2018
There are 2.5 million alcohol-related deaths worldwide each year, according to the National Council on Alcoholism and Drug Dependence. (Courtesy photo)

One service member’s story of how he overcame a drinking problem

Recommended Content:

Mental Wellness | Substance Abuse
<< < 1 2 3 4 > >> 
Showing results 16 - 30 Page 2 of 4

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing; Download a PDF Reader or learn more about PDFs.