Abuse of pain pills concerns Pentagon

[unhappycamper]

Abuse of pain pills concerns Pentagon
By Gregg Zoroya, USA Today
Online Edition, Wednesday, March 17, 2010

WASHINGTON — The military is trying to curb the volume of narcotics given to troops as the number of prescriptions for painkillers and instances of drug abuse continue to soar, according to Pentagon data and recent congressional testimony.

Military doctors wrote almost 3.8 million prescriptions for pain relief for servicemembers last year — more than four times the 866,773 doses handed out in 2001, according to data from the Pentagon health office.

"These are stunning statistics," says Sen. Jim Webb, D-Va., who intends to look into the issue next week during a Senate subcommittee hearing that he will chair. Surgeons general of the Army, Navy and Air Force will testify. "I would really like to dig down in the data here and get their thoughts about what is driving this."

Military officials and analysts say the increase in the use of narcotic pain medication reflects the continuing toll on ground troops fighting in Iraq and Afghanistan, often through more than one combat deployment. In addition to those who are wounded, larger numbers of soldiers and Marines develop aches and strains carrying heavy packs, body armor and weapons over rugged and mountainous terrain.

"Clearly the stress on the force, because of these continuous deployments, is a component (in the increasing of prescriptions)," says Webb, a member of the Senate Armed Services Committee and decorated Marine veteran of Vietnam.


Rest of article at: http://www.stripes.com/article.asp?section=104&article=68735

[MadHound]

1. War and drug abuse seem to walk hand in hand

It was there in Vietnam, Korea, and both World Wars. Hell, even back in the Civil War soldiers were getting doped up on laudenum. It is due to being in pain, not just physically, but mentally and spiritually as well. One cannot see so much horror without having to find escape in one way or another.

[nightrain]

2. there's almost nothing as effective in blocking out reality as opiates.

the amount of painkiller prescriptions mirrors the extent of the horror of these wars.

Webb is surprised?

[rasputin1952]

3. I have seen what soldiers are packing these days...

and I can feel pain at what I see. I can't recall too many times when I'd go off with TA-50, you took what yo*u needed for the mission at hand. When you are lugging a weapon, 50# pack, body armor, and a host of other gear, in the heat and dust, you're going to break down eventually. running w/a pack is bad enough, but even worse if it's filled w/gear unnecessary for the mission at hand. Knees, spines, shoulders and joints all suffer from the additional weight and stress. Add a wound, and the body just can't take it.

Here's the thing about pain relief w/narcotics; if they are used for the treatment of pain, there is no real is no real threat of addiction, as pain is alleviated and the meds decreased then stopped. It is when they are used for "pleasure" that trouble begins. Alleviating mental anguish through narcotics has been around since the inception or war, the psychological pain for many is just too much, and they seek the euphoria that come from narcotic use when used for other than pain management. Far worse, is the use of alcohol to "alleviate" psychological situations. Benzodiazapines and narcotics generally suppress aggression, alcohol, which is far more readily available actually increase aggression, and alcohol addiction is more difficult to treat than narcotic addiction.

The truly frightening thing in all of this though, is that those who need relief through narcotics will almost assuredly not get said relief, or have that relief severely diminished because the scrutiny will increase to the point where military docs will have to field questions about their prescribing techniques from individuals far distant from the patient and the Medic/PA/MD...all cases are individualized, there is no "one way fits all" in a case liike this.

[unhappycamper]

4. A former medic speaks.

Thank you, Brother.

[Lyric]

5. Everybody assumes that rising narcotic use is about "abuse" and "getting high".

Nobody even considers the simpler answer--that this is largely about PAIN. The pain people suffer when they have a chronic health condition that is not being properly treated because people lack access to healthcare. The pain people suffer because their bodies hurt, but they don't have a doctor (or specialist, or hospital) willing to do the expensive procedure that fixes the underlying problem. And the pain people suffer because our collective health is crapping out (thanks, in part, to our processed diets, exposure to god-only-knows-what chemicals, and our couch potato culture). Our weight is going up, spine pain is on the rise, and painful autoimmune conditions like fibromyalgia, multiple sclerosis, and lupus are becoming more and more common. Because the lack of health CARE is also becoming more common, many of these people go undiagnosed. All they know is that they hurt, and while ER doctors can help with the hurt via pain prescriptions, they aren't really equipped to diagnose a complex chronic medical condition like MS--and even if they were, who can afford to follow up? You take the pain pills and pray that the pain goes away, and all the while, you unknowingly become part of a stupid statistic about the "rising use of narcotics"--a statistic that dismisses your pain and implies that you're just looking for a buzz.

And soldiers and veterans have it as bad as anyone else--sometimes worse. VA care sucks for many people, and soldiers who are still enlisted are not being treated solely with their own health in mind--there's always a political aspect, like when soldiers with PTSD are falsely diagnosed with something else in order to avoid the political fallout of a HUGE increase in...PTSD. It's not hard to see how the same could apply to many other illnesses, too. We wouldn't want the media reporting on how many complex illnesses and conditions our soldiers are dealing with, after all. That might make the military look bad, and we can't have THAT. Much easier to just imply that they're all a bunch of "boys-will-be-boys" idiots looking for euphoria because they're "stressed." Well they're definitely stressed, but I don't believe for a second that the rising need for pain medicine is because of "stress". I think better of our soldiers than that.

http://www.druglibrary.org/schaffer/History/soldis.htm
http://lupus.webmd.com/news/20020502/deaths-from-lupus-on-rise
http://www.news-medical.net/news/20091223/Back-pain-problems-continue-to-rise-in-US.aspx

It infuriates me how little attention is given to the idea that Americans are just HURTING more, overall, which is the simplest, clearest, most obvious reason why more and more people are using PAIN medications. Why do the government and the media insist on tying this into the War on Drugs? Does that make it easier to avoid the obvious underlying problem? I suppose it's cheaper to paint us all as pill-popping frat kids looking to score a "high" than to actually address the complexities that underlie this issue.

[rasputin1952]

6. Pain is objective and subjective...

we're talking physical pain here for this post.

Not many people can deal with some pains that are "excruciating", a fractured femur, gall stones, kidney stones, fall into. the "excruciating" category. Other pain can be mild to moderate, sprains, strains, some headaches etc, and can often be treated with mild narcotics or NSAID's like aspirin or ibuprofen. Objectively, the injury or underlying cause of the pain can often be used in deciding the treatment. Subjectively, it is difficult for someone to ascertain just where the pain lies on a pain scale. What may be an "8" to you on a 1-10 pain scale, may be a "3" to me, or even a "0". While each of us are anatomically the same in many areas, we cannot fit everyone into the same category physiologically, things are different for different people.


I agree wholeheartedly with your statement that underlying causes need to be treated. Pain is the body's way of saying, "something is wrong", and the problem needs to be found and dealt with. In the meantime, no one should ever have to be in pain because some doc makes a decision based on outside scrutiny. The training one goes through to diagnose pain levels is actually minimal; experience has taught me to be a little wary, but i can assure you that my standing orders in the field were to treat the pain first, after the "ABC's", unless contraindicated, and you will get to the other problems soon enough, with a patient that is far easier to deal with. No one I ever heard of became addicted to morphine or dilaudid because of a shot or two of the stuff. Addiction comes from long term abuse, not proper use.