No Pain, No Gain: How The American Military Wants Big Pharma To Cure The Opioid Crisis

U.S. Army Spc. Brian Wilhelm was stationed in the Iraqi town of Balad when a rocket-propelled grenade blew up his leg. The pain was as bad as the actual injury that would eventually claim the demolished limb.

Wilhelm was rushed to a MASH unit on the front. An Army colonel and anesthesiologist named Chester “Trip” Buckenmaier III, who had studied ground-breaking pain management techniques at Duke University, tried something different than the usual method of putting wounded soldiers on painkillers.

He administered what women who have experienced excruciating childbirths already know: a nerve-deadening, localized epidermal rather than a potentially addictive dose of morphine - named after the Greek god Morpheus - that has created a literal army of addicts since the Civil War.

The localized nerve block was the first battlefield use of a technique that Buckenmaier picked up at Duke. The colonel became a “painiac” dedicated to finding an alternative to addictive opioids that has led to an epidemic of abuse and overdoses, including a 19-percent jump in OD deaths among teens since last year.

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Buckenmaier is the director for the Uniformed Services University’s Defense and Veterans Center for Integrative Pain Management in Maryland -- sort of the painkiller-in-chief. He’s also a widely recognized advocate of alternative methods of pain management, which can range from nerve-deadening regional treatments to yoga to massage therapy to acupuncture.

Biofeedback and behavior modification also are essential elements in defeating chronic pain. Too much of the culture, Buckenmaier believes, is trained to have zero tolerance for pain. Sometimes, people just have to suck it up and walk it off.

The battlefield has always been a laboratory for pioneering medicine. And painkillers definitely have their place. But opioid addiction has been an issue in the U.S. military long before it became today’s headline on Main Street.

“We were recognizing a decade before the country is recognizing now that managing pain with just one drug was not the best,” says Buckenmaier. “Morphine is not bad. I would shudder to think about being deployed without it. Opioids are still part of the plan.

“When you have your leg blown off, you’re not screaming for acupuncture.”

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Doctors, pharmacists and pharmaceutical companies share blame for the opioid crisis, and the illegal tangent of synthetic substitutes out on the streets, says Buckenmaier.

“I do think that there is a profit motive that is driving the current crisis,” he says. “I don’t have a profit motive. That is one of the beauties of socialized medicine, which is what the military has. Money has unfortunately corrupted the system. Military medicine can serve as a model for the rest of the country.”

The colonel’s moment of, as they say, clarity came when he needed to ease the pain of Specialist Wilhelm in a field hospital in Iraq on Oct. 7, 2003. Two lives were changed that day.

“I started out as an anesthesiologist.” he says. “I never planned on becoming a painiac.”

Coping with a certain level of pain is a viable option, he says, because the alternative can lead to something much more debilitating.