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Nov-17-2013 00:32printcomments

Is VA Involved in 'Pay for Play' With FDA & Big Pharma?

Our military heroes are victims of death and addiction.

Soldier with PTSD abusing drugs
Courtesy: U.S. Army

(MYRTLE BEACH, SC) - In my last article I wrote about the rise in prescriptions of painkillers by the Veterans Administration (VA) providers in the last 12 years -- a whooping 270%. Think our military heroes have more of a problem than fighting in the battlefields? They do -- and its massive amounts of painkillers being prescribed to them for the treatment of post traumatic stress disorder (PTSD) with opioids -- such as OxyContin. Our heroes are being killed at home by the Veterans Administration medical professionals. How? Read on.

I will be focusing this week on Robert D. Kerns, PhD and his part in opioid prescribing for PTSD while working for the VA to our military. Dr. Kerns is the National Program Director for Pain Management at the Department of Veterans Affairs. Dr. Kerns is not an MD (medical doctor) but rather a PhD -- but is very involved in the policy of prescribing painkillers to our military heroes. His primary area of scholarly and academic interest is in the fields of behavioral medicine and health psychology, with a more specific interest and expertise in the area of pain and pain management -- and he is not a medical doctor. Again, why the rise of 270% in the prescribing of painkillers to our military heroes? And is the Veterans Administration involved in a "Pay to Play" with the FDA and the pharmaceutical industry to push painkillers for long term use?

The Wall Street Journal recently did an article on a "Mr. Fazio" who left the Veterans Administration as a patient and was given 168 pills -- painkillers.  These were the same pills, or painkillers, he was hospitalized at the V.A. for which caused his addiction.  Mr. Fazio was given another 168  painkillers a couple of days after his discharge from the V.A.  Link to The Wall Street Journal article

A study by a Veterans Administration researcher found that veterans with post traumatic stress disorder (PTSD) were nearly twice as likely to be prescribed opioids as those without mental-health problems. According to The Wall Street Journal, in Mr. Fazio's case, between 2008 and 2011 the VA prescribed him more than 3,600 pills containing oxycodone (OxyContin), a narcotic painkiller compared to heroin and morphine. He overdosed a total of six times.

"It is of great concern within the VA to try to reduce the risk of harm for veterans with chronic pain who are prescribed opioids and to potentially provide for increasing alternatives," said Robert Kerns, the Veterans Administration's director of pain management. The same "Dr. Kerns" who is a PhD and not an M.D. - but yet has the prestigious title of "Director of Pain Management" while employed by the V.A. What are the alternatives you recommend Dr. Kerns, PhD?

The reason I am so interested in the explosive rate of opioids prescribed by the V.A. to our military is in part based on an Ohio attorney who has obtained emails that show that pharmaceutical companies have been paying tens of thousands of dollars to attend meetings of a panel of academics and health industry regulators that advise the Food and Drug Administration on its drug policies for painkillers, according to multiple news reports -- which has been named "Pay to Play."

Two medical professors, Robert Dworkin of the University of Rochester and Dennis Turk of the University of Washington, set up a panel known by the acronym IMMPACT to advise the FDA on how to test the safety and effectiveness of painkillers - a $9 billion market in the United States. Pharmaceutical companies paid huge sums that could go as high as $35,000 to fund and attend meetings of the panel, the emails show. The professors collected as much as $50,000 each, which they would use to fund academic research accounts, research assistants and expenses, among other things.

Veterans Affairs Committee to investigate painkiller overdoses
But for some, the e-mails raise concern about a possible pay-to-play relationship between drug companies and the FDA.
"These e-mails help explain the disastrous decisions the FDA's analgesic division has made over the last 10 years," Craig Mayton, an attorney from Columbus, Ohio, who requested the emails from University of Washington, told the Washington Post. "Instead of protecting the public health, the FDA has been allowing the drug companies to pay for a seat at a small table where all the rules were written." 
Below is information on the American Chronic Pain Association -- that ironically is not under U.S. Senate investigation for the over-prescribing of painkillers in the U.S.  The Senate may want to reconsider this oversight and also consider the phrase "pay to play" as relates to the American Chronic Pain Association and look into their part in the opioid prescribing epidemic in all 50 states -- especially when they see who serves on the Board of Directors of the American Chronic Pain Association and their link to the Veterans Administration.
American Chronic Pain Association Logo
Advisory Board
Members of our advisory board share their knowledge about pain issues with us and help us reach many of the people who can benefit from our programs. We are grateful for their support and the insights they bring to enrich our services. 
Dennis Turk, Ph.D.  (University of Washington)
Chairman and serves on the Board of Directors
Dr. Turk has been active for many years in national and international organizations and is past president of the American Pain Society (under Senate investigation). He was a member of the Council of the International Association for the Study of Pain for six years, and he is a special government employee (advisor) to the U.S. Food & Drug Administration (the Center for Drug Evaluation and Research and the Center for Devices and Radiological Health).-- conflict of interest?

Robert D. Kerns, Ph.D.  (Veterans Administration)
VA Connecticut Healthcare System
West Haven, Connecticut 



Robert H. Dworkin, Ph.D.  (University of Rochester)
Professor of Anesthesiology, Neurology, Oncology, and Psychiatry and Director of the Anesthesiology Clinical Research Center, University of Rochester School of Medicine and Dentistry

J. David Haddox, DDS, M.D., DABPM  (Purdue Pharma under US Senate investigation)
Purdue Pharma, Vice President Risk Management and Health Policy

Rollin M. "Mac"
Gallagher, MD, MPH

One of the physicians under U.S. Senate investigation is Rollin M. Gallagher, MD, Director of Pain Management, Philadelphia Veteran Affairs Medical Center. Dr. Gallagher has been editor-in-chief of Pain Medicine Journal (funded by Purdue Pharma and under Senate investigation), former president of the American Board of Pain Medicine  (under Senate investigation), and former director of the American Pain Foundation (under Senate investigation) and president of the American Academy of Pain Medicine (under Senate investigation). He served on several national Veterans Administration (VA) committees related to pain and on a joint project with the Veterans Administration and Department of Defense (DOD) to establish pain management guidelines.
A Veteran's Administration study entitled, “Association of Mental Health Disorders with Prescription Opioids and High-Risk Opioid Use in Veterans of Iraq and Afghanistan"  investigated the impact of mental health disorders, particularly post traumatic stress disorder (PTSD), on risks and harm associated with the use of prescription pain medications (called opioids) for the management of chronic pain.  The study authors concluded that among U.S. Veterans of Iraq and Afghanistan, those with mental health diagnoses, especially PTSD, were more likely to be prescribed opioid medications for pain management, and that Veterans with chronic pain and PTSD in particular, who were treated with opioids, experienced negative life events in the course of their care. 
This is directed to the U.S. Finance Committee -- how much more?  We have an epidemic of tens of thousands of deaths and addictions in the country because of the lies told about the safety of prescribing opioids for long term use.  We are losing young people every day by the hundreds -- and yes many prescribed opioids -- do not focus on the word "abusive" as the pharmaceutical wants..  Now we know the Veteran's Administration is prescribing opioids for post traumatic stress syndrome  (PTSD) and we are losing our military heroes to horrific addiction and death.
 If the names of the Board of Directors of the Chronic Pain Association doesn't cause you to come to attention as regards the military, the Veterans Administration and their leaders as well as citizens of the U.S. suffering loss of loved ones -- what will it take?  We already know the FDA turns a blind side to this opioid epidemic -- will you also?  Enough is enough.  We don't need you to ignore pay to play -- we need you to take action to save lives and not play with the lives of our military and families suffering with addiction and death due to the opioid epidemic. 
LP - Twisting a cap and knowing whether it should be clock-wise or counter-clockwise -- sheer brilliance.  Love you



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Anonymous November 19, 2013 1:04 pm (Pacific time)

Great article Ms. Skolek, we read your column every week, thank you.

Anonymous November 18, 2013 2:24 pm (Pacific time)

Harold good judgement on your part. Why take a pain med if you don't need it. Hopefully after more responsible leaders start seeing what the failed drug war has accomplished, we will go back to the days of responsibility and stop putting people in prison for a harmless herb with a thousand applications. I especially despise the former law in Oklahoma where you would get 20 years for a joint. We don't need to come down hard on pot users. Frankly I would strongly favor the death penalty to be carried out immediately against narcs and cops who make this their personal agenda. The appeals process takes too gosh darn long. Hang all the abusers.  Go Barack.

Harold Shine November 17, 2013 7:01 pm (Pacific time)

I use the VA all the time , as a victim of cancer & going through treatments they are always trying to push pain killers & other meds. The only co-pay I have is on prescriptions my co-pay starts at 11,000 $ per year I capped out on that 4 months ago . I tell my Dr.s I don't want them but they send them any way. My primary Dr. has been pushing pain killers & other un-needed meds. on me for 3 years now most of which go into the toilet .

Anonymous November 17, 2013 11:06 am (Pacific time)

A very tiny percentage of active military and veterans going back to the appropriate invasion of Iraq, who used WMD's on their own people, have/had regular combat exposure. Likewise a very small percentage of these veterans get hooked on painkillers compared to their civilian cohorts.  I would be more concerned about treating veterans with any type of chemical for PTSD. As we start to see more legalizing of MJ, we will soon see an uptick in other drug usage along with more accidents, deaths, and broken marriages/families. More kids will perform at lower levels in school while the union based public schools continue to lower standards for grad requirements. What a train wreck is coming.

Your last comment was racist, this one is a long-winded attempt to incorrectly portray the herb cannabis.  Got news for ya' - for many families the train wreck arrived quite some time ago.  

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