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Veteran Addiction: How Soldiers Lose the Mental Battle

When the US Department of Veterans Affairs faced the issue of rising veteran addictions to prescription painkillers, its immediate reaction was to diminish and destroy its opiate enemy. And so, the Opioid Safety Initiative set into motion in 2013, reducing numbers on prescription handouts of opioids to active military and veteran soldiers.

However, this also led to sudden cancellations of patients’ prescriptions, even for people who had been taking prescribed opioids for several years without any history of addiction, which meant veterans across the United States were suddenly going into opioid withdrawals. Whether they couldn’t make a VA doctor’s appointment in time to refill their prescriptions or they were denied medications until they signed an Opioid Pain Care Agreement, veterans were met with the grim reality of dealing with chronic pain on their own.

From heroin to suicide, veteran addiction to opioids would send soldiers down dark roads with terrible consequences. While opioid addiction and withdrawal began as a physical dependence battle among soldiers, inevitably the struggle transformed itself into a mental health issue. Veteran addiction would become a plague among the military.

Concern Over Heroin Entering the Picture

According to the Centers for Disease Control and Prevention (CDC), people who are addicted to prescription painkillers are 40 times more likely to switch to heroin. In the civilian world, the reason mainly revolves around cost—heroin being cheaper on the streets than prescription pills—but price is not as much of a prevalent factor among veterans. It’s a matter of availability and ease.

Corporate Director of Behavioral Health and Sleep Center at Cape Fear Valley Medical Center in North Carolina, John T. Bigger, noted a trend among veteran anecdotes and described to, “The description that I’ve been given, they get injured somehow—most of the injuries come from training, not actually deployment—they’ll get prescribed a painkiller, then when they become discharged, they’ve become addicted. Then suddenly, they’re away from military service, don’t get prescriptions anymore, so they go to the streets to get heroin.”

Creating several obstacles to legally obtain prescription painkillers have forced veterans to take desperate means, but as to how many soldiers are turning to heroin is slightly uncertain. There are no concrete statistics on the transition from prescription opioids to heroin for veterans—at least, not from the VA.

Psychiatrist Dr. Eugene Kim, who specializes in addiction in Fort Bragg, NC, and is affiliated with the Womack Army Medical Center, presents one reason in the article as to why there might be a lack of data on this issue: drug testing. According to test results from the Department of Defense, only “two percent of active-duty soldiers test positive for drug use.”

“In the civilian world, if the doctor cuts you off [from prescription painkillers], you don’t have the money, then you might go to heroin,” said Kim. “We’re not seeing it in the same magnitude in the military world. We haven’t seen that conversion to heroin.”

The issue with this conclusion, however, is that two percent of active-duty soldiers do not reflect veterans who aren’t active-duty. Nor does it detect all forms of addiction. Drug tests detect abuse of illegal substances, which do not include prescription painkillers. And while it is possible to detect whether misuse of opioids has occurred, it is only a concern if the dosage prescribed by a doctor isn’t high already. With the right under-informed or morally questionable doctor willing to fill out the appropriate paperwork, it is possible to have the VA’s radar skim right over you.

Though there may not be many numbers covering the spectrum of veteran addiction, that doesn’t mean it isn’t occurring. In a healthcare system that leaves some veterans feeling abandoned and stigmatized, not everyone will cry out for help before it’s too late.

Tragedy Spikes as Veteran Addiction Leads to More Overdoses and Suicide

Data that does exist cover the alarming rate of veteran suicides due to drug abuse in the United States. Megan McLemore, senior health researcher at Human Rights Watch, published a 39-page report that found that “drugs or alcohol are involved in 1 of 3 Army suicides, and the VA estimates that 22 veterans commit suicide each day.”

The report, “No Time to Waste: Evidence-Based Treatment for Drug Dependence at the United States Department of Veterans Affairs,” asserts that prevalent issues among the veteran community—homelessness and mental illness—are “strongly associated” with alcohol and drug dependence, which includes prescription opioids.

“Hundreds of thousands of veterans are struggling with chronic pain, drug dependency, mental health conditions, and homelessness—conditions that are often deeply intertwined,” said McLemore. “The Department of Veterans Affairs has developed effective, evidence-based programs, but obstacles remain in policy and implementation to reach all veterans who need them.”

While the VA has taken great measures to keep the opiate abuse epidemic among veterans, overprescription habits among VA doctors remain in place, particularly when dealing with mental health problems among soldiers, such as post-traumatic stress disorder (PTSD) or severe chronic depression and anxiety.

“Too often we hear stories of veterans who are prescribed what seems like an assortment of antipsychotic drugs and opioids with very little oversight,” said Jacqueline Maffucci, research director for the Iraq and Afghanistan Veterans of America, to the House Veterans’ Affairs Committee, as covered by the Military Times. “On the flip side, there are some stories of veterans with enormous pain and doctors who won’t consider their request for stronger medication.”

The Government Accountability Office released a report that documented 30 cases of veterans diagnosed with a major depressive disorder and found that 86 percent of patients who were prescribed an antidepressant were not properly re-assessed within four to six weeks afterward.

Other trends, as reported by The American Conservative, showed that antipsychotic drugs were being used as quick fixes to mental health issues, even to problems they weren’t designed to treat. For example, quetiapine, otherwise known by its brand name Seroquel, is a medication commonly prescribed to people with schizophrenia or bipolar disorder, but it’s found to be prescribed to soldiers with stress-induced insomnia and other sleeping disorders—even though it is known to “cause an irregular heartbeat and a higher risk of heart attack.”

From 2005 to 2011, about 49,000 veterans (of all wars) committed suicide, twice the rate of the civilian population and which may have large ties with drug abuse and mental illnesses. As a reaction to overmedicating soldiers, Operation Speak Up, an effort launched by the International Society for Ethical Psychology and Psychiatry (ISEPP), formed in 2012 with their mission philosophy that medication may dull memories and emotions of soldiers, but does not properly teach them healthy coping methods to live with them.

Over the years, more effort to provide soldiers with complementary and alternative medicine became the agenda among veteran associations and military families. The VA, once again, had to find new solutions to tackle veteran addiction.

Stay tuned next Monday, Aug. 22, for Part 4, “Veteran Addiction: Hope for New Beginnings and Recovery,” and learn how veterans are seeking alternative therapies for their addiction.

Read more from this series:

Part 1– “Veteran Addiction: The Military’s Struggle in US Epidemic”

Part 2“Veteran Addiction: The Fight Against Opiate Addiction”

Part 3 “Veteran Addiction: How Soldiers Lose the Mental Battle”

Part 4 – “Veteran Addiction: Hope for New Beginnings and Recovery”

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