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Salt Lake VA Develops New Approach To Curb Opioid Use Among Veterans

SALT LAKE CITY, Utah — The opioid epidemic has taken a terrible toll on American military veterans, as many try to manage pain from battle wounds with the painkillers and get addicted. However, doctors with the Salt Lake City Veterans Affairs Healthcare System have developed a different approach and are sharing it with others.

Two years ago, a pain management team at the SLCVA committed to help veterans manage chronic pain without opioids. Their approach has already helped nearly 1,000 veterans, including Guy “AJ” Ethridge Jr., who never thought he would kick his addiction to opioids.

“I didn’t have any hope for the future,” he said. “I thought my pain was going to get worse until the day I died from it.”

Ethridge joined the Air Force right after 9-11 when he was 19. He said he felt like he was born for the military.

“Ever since I was knee-high to a grasshopper, I always told my dad I was going to join the military,” said Ethridge. “I loved it. Deploy everywhere … Have fun.”

He served in the Middle East during the war in Iraq. He was medically retired with a traumatic brain injury 18 years ago.

Ten years ago, he threw out his back and was given opioids for the pain. That was the beginning of a downward spiral.

“I started needing more, and more, and more, and more,” Ethridge said. “Nothing was ever enough. I started injuring myself to go to the emergency room so that I could get an opioid shot.”

He spent a decade in the throes of addiction and eventually needed a wheelchair to get around.

In January, as he prepared for his fourth back surgery, a pain management team stepped in and helped him. He was exactly the kind of veteran they believed they could help.

“We started talking about a plan to get me off,” he said. “I never thought I could get off of opioids because I just thought my pain would never stop.”

He felt hopeless, but he desperately wanted to repair his relationships with his wife and children. That was the motivation that might just work for him.

“We individualize their care,” said Dr. Kimberlee Bayless, director of transitional pain service at the Salt Lake City VA. “We individualize their treatment plan.”

Bayless said her team targets patients at high risk for developing chronic post-surgical pain.

“Looking at how can I improve my life and what matters most to me. We use a whole health approach,” she said.

So veterans can make positive moves for their lives.

After surgery, they helped Ethridge ween himself off of opioids with counseling, physical therapy and chiropractic care.

“It’s gotten me my family back,” he said. “It’s gotten me my life back. It’s gotten me my head back.”

He recently landed a job at the VA, and the wheelchair is gone.

“My head was clear,” said Ethridge. “My relationships with my wife and my family and my kids started improving. My attitude improved.”

Before changing their approach at the VA, Bayless said, about 6 percent of the veterans went on chronic opioid therapy after surgery.

Nationally, she said, the rate is five-to-13%.

“That’s not acceptable for us,” she said. “We want to do better. Our veterans deserve better.”

Two years later, they have helped more than 1,000 veterans get off of opioids.

“None of our patients that have surgery here at the Salt Lake City VA go on to be on chronic opioids after surgery,” Bayless said.

The team recently published their work in Regional Anesthesia & Pain Medicine journal — selected as editor’s choice and the cover story for the November issue.

In June, Ethridge had another surgery on his hip, and he recovered without opioids.

“It’s like night and day difference from when I was on the opioids versus now,” Ethridge said.

He still has pain, but he doesn’t treat it with opioids anymore. He said he’s thrilled about the improvement in his family relationships and wants to keep that headed in the right direction.
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