Category Archives: College

OVER-DRUGGED: VETERANS AT WAR WITH OPIOIDS AND THE DEPARTMENT OF VETERANS AFFAIRS’ CULPABILITY

The ever-growing list of veterans waiting for medical treatment has led to over-prescribed opioid pain medication. It is clear this is a problem that can only be fixed when everyone in the Veterans Affairs’ medical community is on the same page. Veteran Pete Savo offers a compelling look at this critical issue facing our country today.

By Dr. Pietro Savo

We return from the battle to find ourselves chasing our tail through life. Veterans are accustomed to taking on a mission bigger than life itself — we get banged up, sent home alive if we are lucky, and then the real battle begins. Our injuries at times are less severe than our treatments. We trust in the system, we trust in the military, and we trust in our nation to do what’s right to return us back to the completeness we began with. The reputation of the Department of Veterans Affairs’ (VA) medical system is crippled with standards that are different than those for the U.S. health system. Perhaps what we are witnessing is the symptom of a fragmented government project that has failed beyond hope. The ever-growing list of veterans waiting for medical treatment has led to over-prescribed opioid pain medication. Ryan Honl, veteran and VA whistleblower on opioids, points to the reality that the VA does not have the means to heal veterans, so it prescribes drugs that mask the pain, which has created new victims in the opioid crisis in the United States. By no means does this writer believe that creating opioid addiction was the VA’s intent. This is simply a textbook example of an unprepared, mismanaged and overburdened government department, clearly ill-equipped to support the modern war veteran.

Worse than the injury

A study conducted for the Journal of Rehabilitation Research & Development identified the frequency and severity of pain and psychiatric comorbidities among military personnel who had been deployed during Operation Iraqi Freedom (OIF), Operation Enduring Freedom (OEF) and Operation New Dawn (OND). Study results indicated pain was the most common complaint, with a debilitating occurrence of pain among veteran personnel returning from military deployment (Phillips, 2016).

Overwhelming numbers of veterans returning from battle placed the VA into a temporary-fix mindset that turned out to be worse than the injury — a form of government-sanctioned drug dealing. The VA’s opioid-prescribing mindset not only destroyed veterans, but it impacted their families who were not prepared to handle a wounded veteran with an opioid addiction. Studies conducted by the Department of Defense (DOD) identified another failure mode. The prescribed (and later the abuse of) opioid pain medication became a concern of the DOD as well because of its bearing on military readiness. Countless veterans are no longer ready or able to perform their duties, while the rate of healing wounded veterans diminished. Among veterans, opioid addiction is associated with post-traumatic stress disorder and other  mental health and substance abuse diagnoses. The growing rate of opioids prescribed to younger veterans has also been documented (Diana, 2014).

One-third of opioid medication prescribed is for pain conditions, and there appears to be little effort to eliminate the source of pain, only to mask it. Chronic pain is a common reason for emergency department visits. Civilian providers were more likely to prescribe an opioid than military providers (58 percent versus 42 percent); however, this is significant, as opioid practices for both medical practitioners and opioid drug dealers benefited from the pain mitigation strategy (Ganem, 2016).

Pressure to act

The American Medical Association recently adopted new policies at its annual convention to address what it agrees is an opioid epidemic. A priority included: 1) promoting access to other treatments for pain instead of simply masking pain with opioid-type drugs, and 2) supporting efforts for pain treatment to encourage doctors to co-prescribe naloxone with opioids to patients at risk of an overdose, as naloxone blocks or reverses the effects of opioids (Aleshire, 2016).

U.S. lawmakers have felt pressure to act. Title IX of the Comprehensive Addiction and Recovery Act (CARA) was introduced in the Senate by Sen. Tammy Baldwin, D-Wis., as the Jason Simcakoski Act, named in honor of U.S. Marine Veteran Jason Simcakoski, who died of an overdose after being prescribed 13 different medications, including opioids. The emphasis is on improving the VA response and countermeasure to military veteran opioid addiction.

The Jason Simcakoski Act would require the VA director to expand the VA’s Overdose Education and Naloxone Distribution (OEND) program, a strategy aimed at training health care providers to be prepared to mitigate and help veterans recover from opioid addiction by also making naloxone available to veterans at risk for opioid overdose (Creech, 2016).

Hope exists when state VA hospitals work independently. For example, two or three years before veteran opioid addiction became a crisis in New Hampshire, the New Hampshire VA hospital staff developed a better pain management program by hiring pain management experts from private practice. Practice experts identified a significant over-prescription problem and recommended a countermeasure strategy. The New Hampshire VA implemented programs that focused on hiring new pain management staff from the private sector and providing educational lectures to clinical staff on pain management issues. Rapid improvements turned this issue around locally, yet these initiatives were not embraced and adopted nationwide. We failed to learn from VA community lessons learned.

No magic bullet

There is no one magic bullet to solve the military veteran opioid addiction problem. Recommendations will have to come in different forms. First, we as a nation must admit that the problem exists. Second, we must reach out to every U.S. VA hospital to share over-medication reduction strategies that work. Finally, we must ask that U.S. VA hospitals share their own over-medication reduction strategy success stories.

It is clear this is a problem that can be fixed when everyone in the VA medical community is on the same page. This writer is confident that U.S. VA hospitals have developed creative solutions to reducing over-medication; it’s now time to share them with the entire medical community!

Dr. Pietro Savo served in the United States Navy. He is a respected lecturer and published author. If you’d like to contact Dr. Savo, you can reach him at pietrosavo@gmail.com or 603.321.6224

References

Aleshire, I. (2016, Jul 12). Opioids are winning. The Register —Guard Retrieved from https://search.proquest.com/docview/180 3250950?accountid=28844.

Creech, C. T. (2016). Increasing Access to Naloxone: Administrative Solutions to the Opioid Overdose Crisis. Administrative Law Review, 68(3), 517-550.

Diana, D., Jeffrey, D. D., May, L., Luckey, B., Balison, B. M., & Klette, K. L. (2014). Use and Abuse of Prescribed Opioids, Central Nervous System Depressants, and Stimulants Among U.S. Active Duty Military Personnel in FY 2010. Military Medicine, 179(10), 1141-1148.

Ganem, V. J., Mora, A. G., Nnamani, N., & Bebarta, V. S. (2016). A 3-Year Comparison of Overdoses Treated in a Military Emergency Department — Complications, Admission Rates, and Health Care Resources Consumed. Military Medicine, 181(10), 1281-1286.

Honl, R. (2016, May 19). Ryan Honl: Here are the facts about the Tomah VA scandal. University Wire Retrieved from:  https://search.proquest.com/docview/1789786612?accountid=28844.

Phillips, K. M., Clark, M. E., Gironda, R. J., McGarity, S., Kerns, R. W., Elnitsky, C. A., & Collins, R. C. (2016). Pain and psychiatric comorbidities among two groups of Iraq- and Afghanistan-era veterans. Journal of Rehabilitation Research & Development, 53(4), 413-432. doi:10.1682/JRRD.2014.05.0126.

Originally Published Career College Central Magazine May 2017

Advertisements

My Teaching Philosophy

My teaching philosophy revolves around the homeland security world; the most important element to communicate to students is that not all the textbooks have been written yet. These textbooks are being developed in the field everyday.quality_of_life

My teaching philosophy is based on the understanding that the teacher and student roles are interchangeable in a truly inspiring learning environment. My teaching philosophy; a homeland security teacher becomes an expert by never being content with the obvious. It is imperative that the teacher has the skills to best communicate one’s knowledge to his or her students, which inspires the student to seek out knowledge beyond the teacher’s expertise. This inspiration becomes expertise that is useful to both the student and teacher because to seek greater knowledge is never-ending in any direction.

My philosophy is to fashion a meaningful homeland security practitioner’s classroom environment for my students. A teacher is always obligated to deliver a meaningful education environment that results in noteworthy learning outcomes. Homeland security learning outcomes become a successful reality when the teacher forms the real-world connections between student and the global security community.

My principal goal is to ready and inspires future homeland security practitioners; the students of today become the safety security solution providers of tomorrow.

by Dr. Pietro Savo

 

 


Make a Difference to a Veteran

veteran difference

Make a Difference to a Veteran by Dr. Pietro (Pete) Savo, You might believe your school is doing all it can, but it’s likely you can do more to understand the sacrifices made by the former service members seated in your classrooms.

 You might believe your school is doing all it can, but it’s likely you can do more to understand the sacrifices made by the former service members seated in your classrooms.

What colleges can do to better understand the sacrifices made by our former service members seated in our class. The biggest repayment you can offer them is providing a quality education that will result in a lifelong career.

Original Published: Career College Central Magazine. May 2015

The Middle East and Afghanistan are the war zone regions that keep the United States military engaged. Regardless of what our politicians tell us, the end of war for our service members is far from over.

Military service members volunteer for two reasons:

1. An absolute patriotic love of our country.

2.To earn college tuition and ultimately a degree that will result in a productive life and career. Joining the greatest military organization in the world to go to college is an inspiring example of earning a college education the hard way.

The price of serving in the military is the loss of many future memories, such as missed birthdays, anniversaries, weddings and graduations while in training or deployed overseas away from family and home. To me, the worst part of military deployment was not the risk of war, but missing family and not being home for those special memories. The true emotional discomfort came from having to read about those missed family events in a handwritten letter. Today, with so many technologic advances, email, Skype and cell phones have replaced the letters of yesterday. With technology, missed special memories are in real time and are equally as painful.

The greatest thank-you for your service can come in the form of providing quality education that will result in a lifelong career. The perfect thank-you comes not through special treatment, but through understanding that a veteran student is someone who has excelled in unimaginable environments.

Returning from war, service members become lost in the crowd of their surroundings. We are often thanked for our service, but I will admit it does feel unnatural when this happens – although I do remember a time when service members were not thanked or even acknowledged for their service. For that reason, I find myself thanking service members every chance I can as well. In the story of service members, we see the spirit of America’s past and future. When our country needed us most, we stepped forward. We raised our right hand and swore a solemn oath. We put on that uniform and earned the title veteran, which we carry to this day, regardless of whether we were a soldier, sailor, airman, Marine or Coast Guardsman. We are part of a brotherhood and sisterhood that often stops us in our tracks to listen to the latest news reported from the war zone. We listen to the newscasters; we remember our own time serving; we understand, and this connection is never severed.

We return from serving with battles won and many more battles forgotten with the hope that our military detour in life was not in vain. For some, this detour is our life. We return much different from when we left because we are different. We take on life’s tasks as if they represent a mission. We are regimented, mature, task oriented and focused on the goal of obtaining a higher education.

Many of us who have landed in academia as professors find ourselves as challenged as the non-veteran professors to support the strengths and needs of veterans as they transition from a military life to pursuing higher education. What can colleges do to better understand the sacrifices made by our former service members seated in our classrooms? The greatest thank-you for your service can come in the form of providing quality education that will result in a lifelong career. The perfect thank-you comes not through special treatment, but through understanding that a veteran student is someone who has excelled in unimaginable environments. For professors who understand this reality, veteran students become the inspiration for the remainder of their class and faculty.

The value of a veteran student is this: Veterans read what is assigned, have a serious look of interest during your lecture, and are the first to raise their hands to ask a question or volunteer an answer. The veterans in your class find each other before you find them. Therefore, you ask, what is the problem we need to solve for veterans in our colleges? Perhaps it’s more of a solution we need to recognize. For example, one problem service members have when transitioning from the military environment to college is having to wait a whole month for the VA housing allowance check to arrive. During this period, service members are homeless. My suggestion is that colleges can solve this problem simply by donating unused dorm rooms to enrolled veterans until the VA housing allowance money is available.

Another problem veterans face is finding summer jobs that allow them to earn money to keep their apartments during summer break. Perhaps my first suggestion applies here as well. Colleges can solve this problem simply by donating unused dorm rooms to the enrolled veterans. The big picture is that the veteran population is less than 1 percent of the U.S. population, and no veteran should ever be homeless. Today, the majority of veterans using their GI education benefits are war veterans. This logical housing solution becomes common sense. Colleges that offer free housing to their enrolled veteran students become the recognized patriots and recognized leaders in the higher education community.

Be the one to make a difference to a veteran!

by  Dr. Pietro Savo © 2015

US Navy Veteran  “Non Sibi Sed Patriae”

pietrosavousa@me.com 


The K-12 system isn’t graduating students ready to take on a higher education

The gap between K-12 and higher education

The gap between K-12 and higher education

The gap between K-12 and higher education – Disconnected

Originally Published NOVEMBER 2012 www.CareerCollegeCentral.com

The true power of higher education has been receiving a great deal of attention in the media lately. This exposure appears to gain greater momentum during the national elections. Modern U.S. high school students have developed heightened educational ambitions. More than 88 percent of middle school students surveyed expect to partake in some form of post secondary education. In October 2011, the U.S. Bureau of Labor Statistics reported that 68.3 percent of 2011 high school graduates were currently enrolled in colleges or universities. American College Testing (ACT) released the 2012 edition of “The Condition of College & Career Readiness” report based on information collected from high school graduates taking the ACT College and Career Readiness exam. This year is the first time more than half of the U.S. high school graduating class took the ACT exam. The data reported indicates that more than a quarter of the students did not meet the ACT College Readiness Benchmarks for English, mathematics, reading and science.

The results clearly suggest that a significant number of students enrolled as college and university freshmen this fall have not been adequately prepared by their high schools to produce college level work or to adequately perform in a rigorous higher education environment (Lawrence, 2012). This lack of preparation is not an entirely new phenomenon; the Stanford Policy Brief released in 2003 indicated that 40 percent of students in four-year institutions took some remedial education as compared with 63 percent at two-year institutions. These rates are symptoms of a greater problem: Our high-school students are not prepared for college and university work, a reality that has clearly become the norm. The current compulsory education systems result in a lack of understanding among students, parents and K-12 teachers regarding what conditions students require to be able to succeed in higher education (Venezia, 2003). A contributing problem is a lack of student preparedness – the education preparedness link between high school and college simply does not exist.

High schools teach from knowledge bases and skill sets that do not fulfill college entrance and placement requirements. This lack of consistency leads to students graduating from high school under one set of academic principles and, three months later, finding themselves required to participate under a completely new set of academic principles in college and university settings. As a result, higher education resources are fruitlessly spent on inadequately prepared students – education dollars that could be better spent cultivating knowledge that would prove relevant to higher education and prepare students for successful, productive futures. We can all agree that students entering higher education without the basic skills needed to be successful, competitive and truly efficient in the higher education environment is unacceptable.

Is the end goal a set of deliberately defined classes of people? Regardless, we as a community are wasting our number one resource: our children.

Former U.S. Secretary of State Condoleezza Rice said at the 2012 Republican Convention, “The greatest ally in controlling your response to your circumstances has been a quality education. But today, when I can look at your Zip code and I can tell whether you’re going to get a good education, can I honestly say it does not matter where you came from, it matters where you are going? The crisis in K-12 education is a threat to the very fabric of who we are.”

Clearly, students’ locales determine the standard of education and this standard has become a dollars-and-cents problem. Poor communities have a demonstrably lower quality of education. Does this discrepancy really have financial causes, or do schools have too many standards and no accountability? Is the end goal a set of deliberately defined classes of people? Regardless, we as a community are wasting our number one resource: our children.

Linked – LinkedIn connection

The main problem as I see it is that the students’ preparations between high school and college are not linked; pondering the need for this “linked” element leads me to surmise that perhaps social media and its limitless education outreach could possibly support the joined efforts of many stakeholders in education, resulting in reducing or eliminating the K-12 and college /university disconnect altogether. To test this idea, I turned to LinkedIn. LinkedIn purports itself to be the world’s largest professional network, with more than 175 million members; the site permits its users to exchange knowledge, ideas and opportunities with a large network of professionals. This exchange of knowledge and ideas stimulated me to write this article.

I posted the following question on five education-related discussion groups on LinkedIn: “I believe higher education cannot create success unless K-12 does; what do you say?” I found that many members shared a similar opinion to mine, regardless of where the members were located in the world. The current education systems are not prepared to address students’ needs across education systems, many members agreed, and no one is held accountable for issues related to student transitions from high school to college/university. This was the consensus among LinkedIn professionals from the United States, United Kingdom, Germany, Trinidad/Tobago, Australia, India and South Africa.

These ideas were suggested as solutions during our discussion:

  1. Greater talk about the skill of learning; increased communication internally and externally with the entire education community
  2. Equipping students for learning for the rest of their lives, both for higher education and for life beyond college
  3. Competent administrators who have a clear vision of what 21st century teaching and a removal of the “this is how we have always done it” mindset from the education community
  4. Removal of barriers earlier in K-12 to create a quality education environment before postsecondary education
  5. Adoption of ideas that work, which are shared with the entire education community
  6. Parent involvement and resources offered to parents that instruct them on how to support their children in learning
  7. Provision of “thirteenth-year” counselors at the high school level
  8. Creation of partnerships between colleges/universities and elementary/high schools
  9. Programs patterned after Google’s Successful Transitions And Retention Track (START), a program that takes high school dropouts and creates amazing success stories.

Perhaps the education community can take this concept and engage students before they drop out of school altogether and create this type of successful environments in high schools.

From these nine points, a picture emerges of engaging students earlier in the education process and promoting a successful educational transition from K-12 to higher education. For this to happen, partnerships must be formed between colleges, universities and their local K-12 schools. I believe that the great minds and spirits of all our citizens are clearly our number one natural resource. Collaborative efforts between the K-12 and the higher education community are important and powerful.

Modern technology forces change upon us at an unlimited pace; can the education community keep up and adapt to this change while improving education quality? Since belief is 99 percent of reality, I believe the education community can keep up and adapt to this change while improving educational quality when we collaborate, communicate and equip students to learn for the rest of their lives.

Citations:

Lawrence, J. (2012). “ACT Report Shows 2/3 of US Students Aren’t College-Ready.” Retrieved from EducationNews.org, August 2012, (2)

Zelkowski, J. (2011, May). “Defining the intensity of high school mathematics: Distinguishing the difference between college-ready and college-eligible students.” American Secondary Education, 39 (2), 27-49. Available from:

Academic Search Premier, Ipswich, MA.

Venezia, A., Kirst, M., Antonio, A., (2003). “Betraying the College Dream: How Disconnected K-12 and Postsecondary Education Systems Undermine Student Aspirations, Final Policy Report From Stanford.” University Bridge Project., 72

by AMERICAN WRITER
Dr. Pietro Savo © 2012, 2013, 2014, 2015