Abuse of pain pills concerns Pentagon

Senate eyes leap to 3.8M prescriptions

By Gregg Zoroya, USA Today

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.

The Army, which has done most of the fighting in Iraq and Afghanistan, is examining how it gives pain relief pills to its soldiers, says Assistant Army Secretary Thomas Lamont. A multiservice task force will outline how to limit prescription medication use and ensure that Army hospitals all use the same procedure for dispending medicine, he said.

"Our soldiers are coming back (from combat) wounded, sore, injured, in need of rehab," Lamont told a Senate subcommittee last week.

"We found every Army medical center was dealing with pain in altogether different ways, all individual ... but not an Army-wide program at all," Lamont says. "There was no consistency."

One in four soldiers admitted abusing prescribed drugs, mostly pain relievers, in the 12 months prior to a Pentagon survey in 2008, according to the results released this year. Fifteen percent said they had abused drugs in the 30 days before the survey.

"I think what we don't understand ... is what the motivation is," says Jack Smith, head of the clinical and program policy for the Pentagon's Health Affairs office.

More study is needed to understand why and how troops are abusing prescription medications, he says.

Pentagon records show the abuse of prescription drugs is higher in the military than among civilians. Five percent of civilians reported abusing prescription drugs in a 30-day period in 2007, compared to 11% of military personnel surveyed in 2008.

"The No. 1 thing we have to be focusing on here is the long-term well-being of the (troops)," Webb says. "They have no options in terms of deciding when, and how long, and how repeatedly they're deployed. And so it's up to the top (military) leadership and us over here (in Congress) to make sure we're taking care of their well-being."