CONCORD, N.H. >> Veterans Administration officials from New Hampshire and Vermont say the VA is making progress in reducing opioid use among its patients, but members of Congress studying the issue remain concerned that successful approaches aren't being widely shared.

A U.S. House subcommittee heard testimony at a field hearing Friday in Concord about innovative pain management practices at VA medical centers in Manchester, New Hampshire, and White River Junction, Vermont.

Rep. Mike Coffman, a Republican from Colorado, questioned whether the VA is doing enough to evaluate the effectiveness of alternative treatments and promote their use across the country.

"The department can't simply introduce well-intentioned programs and then fail to manage them properly," said Coffman, chairman of the Veterans' Affairs Subcommittee on Oversight and Investigations. "If these alternative treatments really work, they need to be implemented rapidly."

Coffman was joined by New Hampshire's U.S. House members, Democrat Annie Kuster and Republican Frank Guinta.

In New Hampshire, drug overdose deaths are four times more common than car crash fatalities, and veterans have been particularly hard hit, Kuster said. She said she hoped the VA could be on the cutting edge in developing better treatment models that could be shared with the civilian health care system.


Dr. Julie Franklin said that in Vermont, she oversaw the creation of an Opioid Renewal Clinic and led efforts to reduce the number of veterans taking high doses of opioids. Both at her center and in New Hampshire, interdisciplinary pain teams work with patients to explore other options, including lower doses, acupuncture and chiropractic care.

When Kuster asked her how the VA is ensuring that veterans with chronic pain get the services they need if their doses are reduced, Franklin said the problem isn't likely to be solved with an across-the-board rule or policy.

"Hiring good people and ensuring they have time to do work they need to do is a good step," she said.

Asked why alternative treatments aren't more widespread, Dr. Grigory Chernyak from the Manchester center noted that acupuncturists are hired as health technicians at low salaries, and while medical doctors can practice acupuncture, not many are trained in it.

Opioid addiction has become a significant public health and safety problem across the country.