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Tuesday, Oct. 04, 2011

Prescription abuse down, but challenges face wounded warriors

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Prescription drug abuse among wounded warriors has decreased since the Army Pain Management Task Force was founded two years ago, the Army’s vice chief of staff said.

A drop in narcotics use was the good news Gen. Peter Chiarelli said as he discussed the high number of Soldiers suffering from post-traumatic stress disorder and traumatic brain injury during his speech Sept. 26 at the 2011 Defense Forum Washington seminar “The Journey Back: Helping Wounded Warriors and their Families Transition.”

As of Sept. 1, just more than 8,900 Soldiers were part of the Wounded Warrior Program, he said. Of those, just under 4,500 suffered from PTSD, and just under 1,500 suffered from TBI.

These are “the signature wounds of this war," Chiarelli said. And he added that more Soldiers are likely suffering, but have not yet been diagnosed. “We must get a handle on this,” he said.

Advancements have been made, though, he said, in dealing with one problem facing wounded warriors: prescription drug abuse. The Army Pain Management Task Force has created new guidelines, he said, to ensure fewer Soldiers are able to become addicted to prescription drugs.

“These important changes have led to a decreased use of prescription medications,” he said. Specifically, there have been reductions in the use of narcotics and psychotropic drugs.

At Walter Reed’s Warrior Transition Unit, narcotics use went down from 80 percent to 8.5 percent among wounded warriors, he said. The general said the Army would like to replicate that success at all Army installations, but there is a shortage of those trained in alternative pain management.

The Army Pain Management Task Force was chartered in 2009 to look at alternative ways to treat pain, including such things as yoga, meditation and acupuncture. Prescription records for Soldiers are also now tracked by Defense electronic databases.

“My number-one priority is the health and well-being of the force,” Chiarelli said. While issues such as cost savings and the Army’s network are also important, he said that unlike the Air Force and Navy, where platforms such as aircraft and naval vessels are critical — the Army is “people-centric. The rest simply won’t matter if our people aren’t cared for properly.”

Chiarelli also expressed concern to seminar attendees about the complexity of and the speed at which Soldiers move through the Integrated Disability Evaluation System. After a decade of war, he said, there are about 20,000 Soldiers in the system. Those are Soldiers who are not able to deploy, he said, adding that the number of Soldiers in the system has increased about 169 percent since January 2008.

“The reality is that number is probably closer to double that factor if you figure in the number of Soldiers who are not yet enrolled in DES, but are nonetheless non-deployable, with either temporary or permanent medical profiles.”

Some of those, he said, will get a permanent profile, for up to six months, and they will heal and be able to go back into a deployable status. Others, he said, will remain un-deployable, and enter the DES. “When you take 40,000 Soldiers out of the end strength of the U.S. Army — that is one of the effects of 10 years of war.” Getting an active-duty Soldier though the system takes about 373 days now, he said. “Needless to stay, this is too long.”

Inside the Army”s Wounded Warrior Program, about two-thirds of Soldiers are suffering from either post-traumatic stress disorder or traumatic brain injury, Chiarelli said.

Chiarelli reported a statistic from the National Institute of Health that the average time between injury and first treatment is 12 years.

With the drawdown in Iraq and Afghanistan, more Soldiers will be coming home, and some will stay home 12-14 months. Many of those, he said, will be dealing with physical and behavioral health issues — including depression, anxiety, TBI and PTSD.

Of particular concern are Soldiers in the Army Reserve and the Army National Guard. Unlike their active-duty counterparts, those Soldiers do not stay on a military installation or a military community after they return from overseas.

“We are not going to rest until we figure out how to bridge the divide of the Reserve component,” he said.

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