My name is Marc Rosen.
I run the addiction service at VA Connecticut,
I'm an addiction psychiatrist
and I'm a professor at the Yale School of Medicine.
The idea behind our work is to test whether
you can engage Veterans for treatment
when they apply for Service Connection,
as a way to intervene early.
When Veterans file claims for Service Connection,
they're asking for financial compensation
for a condition that was caused by their military service,
but they're also in distress
and the idea behind our research is to offer them treatment,
in addition to financial compensation.
To make this encounter not just
an insurance processing claims review,
but outreach, and an offer of VA treatment.
That's what we're trying to do.
The worry, if someone doesn't get appropriate pain care is,
the person may ignore the problem and use the pain,
the injured joint in some way
that just makes the problem worse;
they may find their way to someone
who just prescribes them opiates...
Appropriate, what's appropriate VA pain care?
It's an evaluation of what treatment
goes with the particular injury.
So it starts with just an evaluation and... physical therapy,
counseling about how to manage the pain,
prevention of things that would make the pain worse
like depression, sleep disturbance,
treatment with non-addicting medications
that can help relieve the pain.
All of those are early steps
that can keep a pain condition
from getting worse.
In a clinical trial, we found that Veterans who received counseling
around the time of their compensation exam
were more likely to use VA pain-related services
than Veterans who didn't.
So the intervention was effective
in reducing the amount of risky substance use.
The collaborative partners who we work with
are the people who evaluate these Service Connection claims,
and what's gratifying about it is,
they like the idea of making the encounter
not just a review of claims,
but an offer of treatment.
That's been gratifying on both sides.
And Research is a little bit like making music with a group:
there's a team of us who work together.
There's a statistician and methodologist, Anne Black.
There are experts in pain treatment, Will Becker,
in our group.
There are experts on treatment engagement, Steve Martino.
It really is a collaborative effort.