Opioid Crisis in Veterans

The opioid crisis has become one of the most overwhelming and relevant issue of our time. It is estimated that 13.5 million people take opioids globally (WHO, 2017). Nationally, ninety one American deaths per day, for the last fifteen years, are due to opioids (Centers for Disease Control [CDC], 2017). In our state of South Carolina, in 2016, five hundred and fifty people died as a result of opioid overdoses. (SCDHEC, 2017). The statistics of the opioid addiction are alarming and the rates are increasing due to opioid medications being over prescribed by pharmaceutical professionals. Behavioral and environmental risk factors also are playing a role in addiction taking over, which can include family, friends, school, living situation, the abuse of other drugs, and chronic pain.

Although this issue affects many age groups, and races, we have decided to focus on the target population of the military and veterans. When veterans return back home after serving our country they suffer from mental and physical chronic pain. Most veterans battle chronic post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) and seek medical help from professionals who prescribe opioid drugs. According to
Barbara Goldberg, fifteen percent of U.S. military rely on opioids following deployment, compared to four percent of the general population (Goldberg, 2017). Through our research we hope to provide a better understand of why veterans are a target population of the opioid epidemic, what the risk factors are contributing to their high statistics, and how we can begin to use best practices to overcome the problem at stake. Therefore our research question stands: Why is the opioid crisis so severe in veterans of the armed forces and how can we begin to start them on the road to recovery?

The opioid crisis has become a more prevalent issue just recently in the last 20 years when drugs such as oxycontin were approved as a safe pain pill to be taken when prescribed by doctors. Our question is aimed at why do opioids pose such a threat to veterans. We want to try and understand why doctors in veterans hospitals are continuing to prescribe these addictive medications knowing that the United States has an opioid crisis right now. The question we are answering is extremely important in finding a solution due to the fact that these veterans are fighting for our lives overseas and when they come back we are not fighting for them. They represent a population that is underserved when it comes to being treated for disorders like PTSD and injuries resulting from war. These veterans choose to take and become dependant on these drugs for many reasons. Boulder Crest Retreat is a place veterans of war can attend at no cost to start a road to recovery, the Institute was formed to develop, deliver, study and scale Posttraumatic Growth-based solutions to struggle “ including trauma, PTSD, anxiety, depression and suicidality (Press Release Newswire, 2018).

By attending these retreats they can start bettering themselves before they turn to prescription drugs for help. According to a publication written by the National Institute on Drug Abuse, there has been a zero tolerance policy that has been enforced since 1982. This policy can become a problem once they are finished with their time in the armed forces because they have no tolerance for any drugs being prescribed, meaning any drug can become addictive. We feel that by implementing a change invoking solution to the care of these veterans, it will lower the statistics of using prescription drugs. There are many other sources that mention opioid issues in the military or even after, and some even speak about changes and steps to recovering properly for these veterans. However, by approaching this question of Why is the opioid crisis so severe in veterans of the armed forces and how can we begin to start them on the road to recovery? we can try to combine all of the knowledge we have found and address the question using many different areas of the crisis, including business, mental issues, physical issues, health care accessibility and overall adequate care.

The length that the opioid crisis has stretched is far beyond what most of us realize. After veterans have spent so many years fighting for our country, they come back home to fight another issue: the opioid crisis. Everyday, the opioid crisis kills roughly one hundred Americans and veterans are twice as likely to die from an overdose than civilians, a Department of Veterans Affairs study showed (Centerstone). A large amount of prescribed medications for the military are opioids and for any pain management opioids are the first go to. A study performed in 2014 concluded that 40% of the American military has chronic pain and 15% of those individuals use opioids to combat it (Providers Clinical Support System, 2017).

Unfortunately, these numbers continue to rise. Research done at the University of Texas provided interesting information into the trends of the opioid crisis (Kazanis et al., 2018). In 2011, there was a decrease in both civilian and veterans populations, but more so among veterans. Between 2011 and 2013 there were continuous declines and largely in part due to policies put in place by the Department of Defense (DoD). A minor part of the decline can be attributed to changes in the veteran population and amount of opioids prescribed. The DoD has been working to lower the rate of opioid prescriptions and when the prescriptions are necessary, they are trying to prevent the misuse. According to the Army Times, many are working diligently to combat pain that soldiers experience early on (Curthoys, 2018).

Through being proactive, they can reduce the amount of opioid misuse and at the same time address issues that soldiers experience. Majority of soldiers return home with a whole host of issues. Cpl. Darin Adams returned home with back pain, an injury that had never been addressed when it occurred (Schumaker & Almendrala). Now, back in America he has to deal with the pain every day and uses opioids to combat it. Another study was performed after 9/11 in 2013 showed how vicious the opioid cycle has become. Joel, injured by a bomb, was prescribed any pill that he asked for even though he showed signs of addiction. He stated that he could get almost 500 pills at a time without anyone questioning it. This was standard protocol for many years until officials started looking into the doctors. More education was put in place and other measures were considered before going straight to pills. While the DoD is aware of the dangers that this crisis is inflicting upon the military population, much still has to be done to completely eradicate this problem.

The opioid crisis in our military and veterans is too large to be ignored. These men and women are fighting to keep us safe and ensure our rights, but the fight for them is far from over once they return home. Our project is geared to find the source of the opioid problem in the military and offer alternatives. One alternative to opioids that has been introduced has been the use of acupuncture for pain. According to a study conducted by the Military Healthcare System, findings of this study were consistent with physician-provided efforts to control pain, and top diagnoses were similar between active- and nonactive-duty beneficiaries. These data are in line with meta-analyses showing that acupuncture was more effective than placebo for addressing pain conditions, including headache, knee and back pain, neck disorders, and peripheral osteoarthritis (Madsen, 2018).

This study is just one example that there are alternatives to opioids that we are simply ignoring. Other alternatives, according to Military Medicine, include prescription monitoring programs, sole provider programs, and quality of care metrics (Sharpe, 2014). These alternatives provide a multitude of benefits. While monetary benefits are important to the success of a project, we are more focused on the social benefits. Military members struggle to live normal lives when they come home due to an addiction that they were prescribed. With the alternatives to opioids described above, we believe that current military members and veterans have a chance to end their addictions to opioids. The benefits of reducing opioid use range from quality time with family and friends, increased overall health, and even financial benefits.

While our alternatives are not free, they are a much healthier and safer option. We hope that, with the reduction in opioid use, that service members and veterans will be able to return to who they were before they were addicted. These benefits will not be immediate, but with support and time, will be worth it.

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