Pubdate: Wed, 11 Nov 2009
Source: Army Times (US)
Copyright: 2009 Army Times Publishing Company
Author: William H. McMichael, Staff writer
Referenced: The Report


Treatment, not incarceration, should be the first option for veterans 
who commit nonviolent drug-related offenses, a group advocating 
alternatives to the nation's "war on drugs" said Wednesday in a new report.

The Drug Policy Alliance report also called on government agencies to 
adopt overdose prevention programs and policies for vets who misuse 
substances or take prescription medicines, and urged "significantly 
expanded" access to medication-assisted therapies, such as methadone 
and buprenorphine, for the treatment of dependence on opioid drugs 
used to treat pain and mood disorders.

During a conference call with a Drug Policy Alliance representative 
and seven other advocates for change in the treatment of veterans, 
the military's Tricare health benefits program came under fire for 
what a New York-based physician and specialist in drug addiction 
treatment called its failure to pay for veterans' and family members' 
opioid dependence treatments.

The treatments, said Robert Newman of the Rothschild Chemical 
Dependency Institute, are endorsed by the National Institute on Drug 
Abuse and the Institute of Medicine.

Newman cited a 2008 speech by U.S. Ambassador to Vietnam Michael 
Michalak in Hanoi, in which he acknowledged that U.S. dollars were 
being spent on methadone treatment for Vietnamese drug addicts.

"And yet, our government, our Department of Defense, has an insurance 
plan that simply excludes maintenance treatment," Newman said. "I 
find that outrageous."

According to the Tricare manual, "drug maintenance programs when one 
addictive drug is substituted for another on a maintenance basis 
[such as methadone substituted for heroin] are not covered." Tricare 
spokesman Austin Camacho said this applies to all Tricare 
beneficiaries, including veterans and family members.

There are no solid numbers on how many veterans suffer from drug 
addiction -- just as there are none that nail down the number of 
veterans currently in prison and county jails.

The Drug Policy Alliance says that substance abuse is the "single 
greatest predictive factor for the incarceration of veterans" and 
that without more effective treatment programs, veteran incarceration 
is likely to increase.

"The bottom line is, we don't have accurate numbers," said Dan 
Abrahamson, director of legal affairs for the Drug Policy Alliance 
and the report's co-author. "The data that we do have are outdated. 
Veterans are actually just getting lost as they come back home. 
They're lost in the data sets, they're lost in the reporting, they're 
lost when agencies don't ask them whether they're veterans."

Those close to the issue point out that about 30 percent of Iraq and 
Afghanistan war vets report symptoms of post-traumatic stress 
disorder, traumatic brain injury, depression or other mental illness 
or cognitive disability, and that 19 percent of veterans who have 
received care from the Veterans Affairs Department have been 
diagnosed with substance abuse or dependence.

Guy Gambill, an Army veteran and advocate for veterans' rights who 
took part in the conference call, noted that one of the hallmarks of 
PTSD "is a tendency to self-medicate. People do that with drugs, 
people do that with alcohol."

USA Today reported in June that the rate of Army soldiers diagnosed 
with alcoholism or alcohol abuse increased from 6.1 per thousand in 
2003 to an estimated 11.4 as of March.

The Pentagon says that from Sept. 11, 2001, through August 2009, some 
1,991,578 individual service members have been deployed in support of 
Operations Enduring Freedom and Iraqi Freedom. It does not track how 
many of those served in the actual combat zones.

Gambill called for a dialogue between veterans service organizations, 
justice reform groups and the military to "formulate policy based on 
research" in an effort to avoid the widespread problems with drugs 
and incarceration experienced by many Vietnam-era veterans.

"If I could do anything here, it would be to exhort Congress to have 
the political courage to be smarter than the problem this time," he said. 
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