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According to a new report released by Human Rights Watch, more than one million veterans enrolled within the VA primary care system are taking prescription opioids for chronic pain. At the same time, an unprecedented number of veterans are dying as a result of both accidental and intentional drug overdoses. The report, which was released earlier this month, brings to light the growing concern that veterans of all ages are struggling with pain, which results in chronic use of prescription opioids. It argues that the VA “should remove barriers to ensure access to evidence-based drug dependency treatment and make overdose prevention programs available to veterans in the community.”
One of the primary recommendations of the Human Rights Watch report is a push the availability of naloxone, a prescription medication that reverses the effect of an opioid overdose. This past year naloxone injections were brought to market in an auto-injector under the brand name EVZIO. The pen was designed for individuals without medical training who may need to inject a patient during an opioid overdose situation. This medication can save someone’s life when his/her respiration system is shutting down due to an opioid overdose. from substances such as hydrocodone or heroin. However, the injection must be administered by someone other than the individual having the overdose. It also causes a violent reaction in the body of the receiver because it puts the body into a state of instant detox, resulting in nausea, vomiting, and at times, violent anger due to the sudden pain of detox. While naloxone is a temporary solution in the life-and-death moments of an overdose, it is not long-term solution for anyone with a drug addiction. If veterans receive access to EVZIO/naloxone pens, they also need to be receiving access to programs that provide long-term solutions to drug dependence, as well as prevention, yet, these recommendations are largely absent from the report.
The second concern is the HRW’s recommendation to increase veteran access to methadone and buprenorphine for long-term treatment of drug dependency. According to HRW senior health researcher and author of the report Megan McLemore, “Only one of three patients at the VA who need methadone or buprenorphine is getting it.” From a medical standpoint, switching from one medication to another is not a realistic solution to treat most drug dependent individuals. These medications must be prescribed and monitored under specialized programs through certified doctors and pharmacists due to the high risk of accidental death. Methadone precautions include central nervous system depression, hypotension, QT prolongation, and respiratory depression. This means that methadone patients can experience changes in their heart rate that can lead to the heart no longer beat in rhythm, which is a medical emergency. Methadone, can also contribute to severe depression in addition to respiratory depression, which can be fatal.
The population of veterans most impacted by drug dependence, illegal or legal, is the chronically homeless who often struggle with mental health conditions, post-traumatic stress, and depression. These veterans should not be placed on medications to treat their addictions since these treatments require extensive stability and regulation. Rather, these veterans need programs like HUD-VASH, which provides permanent housing to chronically homeless veterans. In previous years, HUD-VASH required veterans to prove their abstinence from drugs or alcohol before receiving housing; now it “provides housing as the first step and then surrounds the individual with a range of supportive services.” While this shift allows the VA to reach those who are “most vulnerable” to drug and alcohol abuse, the risks of replacing one dangerous medication --- for instance, methadone --- with another still remains. Currently, there are four VA pilot programs that are pushing medical treatments such as acupuncture, aqua therapy, pool therapy, and physical therapy as alternative ways of treating pain.
One additional concern with doctors prescribing medication to treat drug addiction among veterans is that within the VA healthcare system, doctors are not held to the same level of reporting for prescribing and dispensing controlled substances. When any doctor in the private sector writes a prescription for a controlled substance, the pharmacy must check that substance against a state database, and report any other controlled substances dispensed to the patient. Currently, the VA and military pharmacies do not report to these prescription-controlled medication monitoring programs; therefore, providers have no idea what the patient might already be taking, and if the interaction with drugs will cause harm to the patient. Without this checks-and-balance system, doctors run the risk of harming patients, or providing them with access to an unlimited supply of controlled substances.
In the end, there is no magic pill to treat drug abuse and dependence. Just because a drug is a prescription medication, does not make it safe. Treatment needs to start with a societal change in how we view and take prescription pain medication, and start broadening our list of possible solutions to include alternative therapies and behavioral treatment. Additionally, patients and providers need to establish realistic benchmarks in the reduction of pain from the start. Patients and family members should both be informed of what signs to look for when pain treatment is not effective, and when dependence and addiction are becoming a risk. Finally, the veterans community need to remember our greatest strength that was ingrained in us throughout our military service: We were trained to work as a team, and leave no one behind.
L. Joy Ohnstad, is an Army and Air Force veteran. She is a graduate of University of Wyoming’s College of Business, and is currently completing a dual Doctorate of Pharmacy and a MBA at the University of Wyoming. She is also a Tillman Military Scholar and is implementing a program on the University of Wyoming campus to improve the academic success of women veterans.
A Minnesota Army National Guard UH-60 Black Hawk helicopter with three Guardsmen aboard crashed south of St. Cloud on Thursday, said National Guard spokeswoman Army Master Sgt. Blair Heusdens.
At this time, the National Guard is not releasing any information about the status of the three people aboard the helicopter, Heusdens told Task & Purpose on Thursday.
The Pentagon's latest attempt to twist itself in knots to deny that it is considering sending up to 14,000 troops to the Middle East has a big caveat.
Pentagon spokeswoman Alyssa Farah said there are no plans to send that many troops to the region "at this time."
Farah's statement does not rule out the possibility that the Defense Department could initially announce a smaller deployment to the region and subsequently announce that more troops are headed downrange.
The Navy could deploy a second carrier to the Middle East if Trump orders an Iran surge, top admiral says
The Navy could send a second aircraft carrier to the Middle East if President Donald Trump orders a surge of forces to the region, Chief of Naval Operations Adm. Mike Gilday said on Thursday.
Gordon Lubold and Nancy Youssef of the Wall Street Journal first reported the United States is considering sending up to 14,000 troops to the Middle East to deter Iran from attacking U.S. forces and regional allies. The surge forces could include several ships.
I didn't think a movie about World War I would, or even could, remind me of Afghanistan.
Somehow 1917 did, and that's probably the highest praise I can give Sam Mendes' newest war drama: It took a century-old conflict and made it relatable.
An internal investigation spurred by a nude photo scandal shows just how deep sexism runs in the Marine Corps
"I will still have to work harder to get the perception away from peers and seniors that women can't do the job."
Some years ago, a 20-year-old female Marine, a military police officer, was working at a guard shack screening service members and civilians before they entered the base. As a lance corporal, she was new to the job and the duty station, her first in the Marine Corps.
At some point during her shift, a male sergeant on duty drove up. Get in the car, he said, the platoon sergeant needs to see you. She opened the door and got in, believing she was headed to see the enlisted supervisor of her platoon.
Instead, the sergeant drove her to a dark, wooded area on base. It was deserted, no other Marines were around. "Hey, I want a blowjob," the sergeant told her.
"What am I supposed, what do you do as a lance corporal?" she would later recall. "I'm 20 years old ... I'm new at this. You're the only leadership I've ever known, and this is what happens."
She looked at him, then got out of the car and walked away. The sergeant drove up next to her and tried to play it off as a prank. "I'm just fucking with you," he said. "It's not a big deal."
It was one story among hundreds of others shared by Marines for a study initiated in July 2017 by the Marine Corps Center for Advanced Operational Culture Learning (CAOCL). Finalized in March 2018, the center's report was quietly published to its website in September 2019 with little fanfare.
The culture of the Marine Corps is ripe for analysis. A 2015 Rand Corporation study found that women felt far more isolated among men in the Corps, while the Pentagon's Office of People Analytics noted in 2018 that female Marines rated hostility toward them as "significantly higher" than their male counterparts.
But the center's report, Marines' Perspectives on Various Aspects of Marine Corps Organizational Culture, offers a proverbial wakeup call to leaders, particularly when paired alongside previous studies, since it was commissioned by the Marine Corps itself in the wake of a nude photo sharing scandal that rocked the service in 2017.
The scandal, researchers found, was merely a symptom of a much larger problem.