Opioid addiction represents a nationwide epidemic responsible for tens of thousands of deaths each year. And while no group–be it men or women, young or old–are spared, few groups have felt the effects of the rising tide of the epidemic like veterans.
According to a 2011 study, patients of the Veterans Health Administration are twice as likely to die from accidental overdose than non-veterans.1 The reason goes back to the very ailment opioids were designed to treat: pain. A 2014 report in JAMA Internal Medicine suggests nearly half of those returning from the battlefield struggle with chronic pain, versus a quarter of the general public. This in turn has led to higher rates of prescriptions. All told, 15 percent of U.S. military rely on opioids following deployment, compared to 4 percent of the general population.2
Sabrina Franks is a recovery assistant at a Volunteers of America Adult Detox center in Salt Lake City, Utah. The residential program, which targets homeless and low-income men and women, recently began working with Veteran Affairs to prioritize vets in need. The change has given Franks a unique–albeit limited–perspective on the differences between servicemen and women seeking treatment, and the rest of the program’s client base.
“I’ve noticed they are more closed off about what they’re going through,” Franks told Talbott Recovery in this exclusive interview. “Our clients come in, and they’re very open about their symptoms. Whereas, veterans come in and they just lie in bed. They’re clearly miserable, but they won’t come to staff or really engage with a lot of other clients.”
Franks attributes it in part to post-traumatic stress syndrome, which she said is common among the veterans at the center. “Also, there’s the idea that you have to be ‘army strong.'”
When it comes to the substances that drive veterans to their door, Franks said it depends on the client’s age. “With the older veterans, I’ve noticed it’s more alcohol. The younger veterans that have come in I’ve noticed it’s more opiates that are a problem.” For those in the latter group, she said many cite injury as the pathway to abuse. “I’ve heard that a few times from them and from other people–that injury is what led them to addiction.”
Sean M. experienced all of this first hand as an Airborne Ranger in Afghanistan.
“I did not realize the toll that multiple deployments took on my mental health,” he wrote in the story he posted on the Heroes in Recovery website. Rather than opioids, however, Sean turned to alcohol. “With every deployment, I came back and drank a little bit more.” This continued until he was admitted into the Army Substance Abuse Program (ASAP). “I was an ASAP rehab failure.”3
Forced out of the Army, PTSD and alcoholism took over. “My life fell apart…PTSD and alcohol dependence were killing me physically, mentally, socially and spiritually.” Several stints in rehab followed until finally, in 2012, something changed. “That was when I finally got it. I finally did it for myself.”
This tenacity to see recovery through multiple relapses is a trait Franks said is one she’s witnessed in her own program’s veteran clientele.
“I think they go through the same things with addiction that other people go through in terms of it taking them a few times to commit to going into treatment.” But, she said, “I do feel like when they do commit to recovery, they do tend to be stubborn about it.”
Fortunately for individuals like Sean, Veteran Affairs is getting smarter in not only treating, but also preventing addiction in its servicemen and women. This is particularly true when it comes to opioid prescriptions. More and more VA centers are introducing non-drug forms of therapies for managing chronic pain, including yoga, acupuncture, physical therapy and mindfulness. In 2013, the organization launched the Opioid Safety Initiative to better track opioid use among veterans in its health care system. Finally, the VA has cut back on supply, reducing the number of veterans receiving opioids by 20 percent and dosage sizes for about 17,000 patients.4
But the picture is still far from rosy. The years 2010 to 2015 alone saw a 55 percent growth in the number of veterans with opioid-use disorders. But Dr. Carolyn Clancy, the VA’s deputy under secretary for health and organizational excellence, is optimistic. “I’m very pleased to say that we have made substantial progress across the system,” she said in an interview with Frontline. “We’re not done, but it is literally a priority that is part of the fabric across our system, and we monitor this on a regular basis.”5
Written by Tamarra Kemsley