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Painkiller Abuse in Military

October 21, 2008
by Daniel Guarnera
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USA Today has an article today about the abuse of prescription painkillers by servicemembers and returning veterans. There's also a special online follow-up about the 509th Engineering Company, based in Missouri, where at least a quarter of the soliders have admitted to abusing narcotic pain-killers.

The articles note that in 2005 there were over 50,000 prescriptions written by military doctors for narcotic painkillers, and such a high rate of use carries the risk of misuse and addiction. An Army study in 2005 indicated that 4% of soldiers had abused prescription medicines in the last month, and 10% had done so at least once in the last year. The VA and military are starting to look more closely at their pain management techniques and investigating methods (such as new dispenser machines) to reduce abuse and addiction.

So far, media coverage about substance use disorders among returning veterans has focused primarily on co-occurring mental health problems (for example, the comorbidity of PTSD or TBI with drug use). This article calls attention to the relationship between addiction and orthopedic injuries that cause chronic pain, which is the number one complaint of all Iraq and Afghanistan vets receiving medical care through the VA. The emphasis that veterans' mental health issues have received in the last few years has been groundbreaking and very encouraging, but the Pentagon and VA can't forget that veterans taking prescriptions for muscle, joint, or skeletal pain are at heightened risk for substance use disorders as well.

The second article mentions this anecdote, from Spc. Jeremy Thompson:

Thompson knew it was wrong, he said, and asked his squad leader about enrolling in the Army Substance Abuse Program. The sergeant, he said, told him that admitting his dependence would ruin his career.

There's still a lot of work to be done ...

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Not only is this an increasing problem, but the VA has no facility for treating these addictions here. Also, Tri-Care will not pay for Suboxone/treatment, but WILL pay for continuing opiod medications. There appears to be minimal oversite of VA doctors who freely prescribe these drugs to returning OIF/OEF Veterans.

Treatment admission for abuse of prescription painkillers now accounts for 5 percent of all admissions for substance abuse, a substantial jump from 1 percent in 1997. The Department of Health and Human Services' Substance Abuse and Mental Health Services Administration reports that while alcohol-abuse-related admissions still makes up the bulk of the 1.8 million treatment admissions, that portion has inched down over the years to 40 percent from 50 percent in 1997. The statistics, found in the "Treatment Episode Data Set 2007 Highlights," also show treatment admissions for heroin at 14 percent, methamphetamine at 8 percent, and marijuana at 16 percent. SAMHSA Acting Administrator Eric Broderick says the report "provides valuable insight into the true nature and scope of the challenges confronting the substance abuse treatment community."


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Substance Abuse Center

Daniel Guarnera

Daniel Guarnera is the Director of Government Relations for NAADAC, The Association for...