As the number of servicemembers returning from combat with severe wounds continues to rise, so do the reports of medication abuse and suicides with pain as a possible contributing factor.

As a result, Lt. Gen. Eric B. Schoomaker, Army Surgeon General and Commander, U.S. Army Medical Command, announced plans to make 109 changes to the way that soldiers are treated for pain.

"While these issues might not be directly related to pain management, I felt a thorough evaluation and assessment of current pain-management practice was indicated," Schoomaker said.

The plan to make the changes was announced in a report that Schoomaker initiated in 2009, when a Pain Management Task Force was created to address the lack of a comprehensive pain-management strategy, Army-wide, according to a press release. The report recommends alternative treatments to medication that include acupuncture, meditation, biofeedback and yoga.

Many of the recommendations stem from challenges in standardization for pain management practice, Schoomaker said in the release.

"In the military and civilian medical communities there is wide diversity in pain management training programs, standards of pain measurement, and acceptance of many new forms of treatment," Schoomaker said. "We expect this effort to help us tackle the complex problems with pain including the effective control of pain and overmedication. This will require an ambitious campaign intended to standardize pain management across the Army and a broadening of treatment approaches to provide more evidence-based choices to patients and clinicians. It has the prospect to fundamentally change the culture of pain management for our soldiers and their families."

Schoomaker attributed the problem in part to the fact that severely injured soldiers, like those in Warrior Transition Units, are often prescribed multiple medications and sometimes seen by several different doctors that can cause inconsistencies in care, he said.  However, this is not just an Army problem - it's a problem throughout the U.S. healthcare system, Schoomaker said.

During the report's fact-finding process, the task force visited 28 military, Veterans Affairs and civilian medical centers between October and January to observe treatment capabilities and best practices.

Schoomaker's said his goal is to form a pain-management strategy that is holistic, multidisciplinary and puts soldiers' quality of life first.

The general stressed that Army practices have always been in compliance with America's medical regulations, but he thinks the Army can do better.

"Everything we do in the Army, even managing a toothache, is all in compliance with national standards ... what we want to do is set the bar higher," Schoomaker said.

Schoomaker's higher standards include offering treatment alternatives that might not yet be prescribed in average doctor's offices, but which patients are already seeking out on their own, such as acupuncture.

Schoomaker said the recommendations that can be put into policy under his authority will be implemented in the coming months, and the 2010 National Defense Authorization Act asks the secretary of defense to integrate a pain-management policy into the military health-care system no later than March 2011.