Report: Vets need drug treatment, not jail

(MILITARY TIMES)   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 “The data that we do have are outdated.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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