U.S. Veterans with PTSD Face Risk of Opioid Addiction
President Obama has stated that American soldiers serving in Afghanistan will be coming home in 2014. Just how many of those troops will be coming home with physical or emotional scars remains to be seen. Stories of how returning soldiers shaken by the stress of combat are treated with pharmaceuticals by the Veteran’s Health Administration (VA) should serve as a warning.
Timothy Fazio, who served both in Afghanistan and Iraq before being honorably discharged in 2006, was the subject of an in-depth Wall Street Journal article. His initial Afghanistan tour was grueling and intense, but it was during his time in Iraq that Fazio’s hand was injured by a bomb. By the time he was home and attempting to reintegrate into American life, Fazio was struggling with the blackouts, angry outbursts and flashbacks that can accompany post-traumatic stress disorder (PTSD).
On top of his PTSD, Fazio was prescribed opioid painkillers for his hand injury. These powerful pain relievers didn’t only numb his hand pain but seemed to numb his emotional pain as well. The tragic story of opioid drug addiction, broken relationships, attempted suicides and multiple overdoses which ensued is enough to scare anyone away from a casual assessment of these medications.
In fact, VA research shows that soldiers with PTSD are almost two times more likely to be handed a prescription for opioid painkillers compared to soldiers without mental illness. They are also more often given several kinds of opioids and prescribed them in higher doses. The VA further found that veterans with PTSD who were prescribed opioid pain pills faced two times the risk for personal injury and overdose. The combination of prescription painkillers and mental illness means the risk for addiction skyrockets.
Fazio’s story is more of a cautionary horror story than a cautionary tale. The veteran was prescribed over 3,600 Oxycodone pain pills between 2008-2011. He overdosed six different times, tried to kill himself by jumping from his parent’s balcony, crashed the family car and threatened his parents with a knife.
In 2008 he checked himself into a VA hospital asking for help to beat his opioid addiction and checked himself out seven days later with a month’s supply (168 pills) of the very drug that sent him there in the first place. He was given another 168 pills the following day.
The VA would not comment on the case, but said that doctors follow standard care guidelines when it comes to pain management and that doctors receive continuing education about opioid use and prescribing. The spokesperson for the VA said they would be reviewing Fazio’s case records.
There is no clear figure on how many vets suffer with comorbid PTSD and chronic pain. We do know that 30 percent of the Afghanistan and Iraq veterans who are being treated through the VA have PTSD. The VA itself reports that over 50 percent of those vets are also struggling with ongoing pain. The addiction risk for these soldiers is severe.
Even the physician who wrote the VA’s clinical guidelines for prescribing now says that VA doctors are over-prescribing opioids and issuing refills too readily. The known statistics seem to confirm that opinion:
- In 2012 the VA cared for over 50,000 vets who were struggling with opioid-related problems, a figure which is almost twice the number of soldiers with the same problem than 10 years ago
- The number of patients treated by the VA has grown by 30 percent in 10 years
- The number of opioid prescriptions doled out through the VA has risen 287 percent from 1999 to 2012
- The number of veterans who accidentally overdose is two times that of the general population, and the number one cause is opioids.
Timothy Fazio continues to struggle to put his life back together. The VA says that it is looking to reduce the number of opioid prescriptions given out and find replacement pain relievers. Let’s hope a solution can be found before the next wave of soldiers come home.