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Monday, February 21, 2011

Overprescribing prescription drugs to Veterans - Huffington Post

Good article in Huffington Post about the problem of overprescribing drugs to our veterans by Leila Levinson, author of Gated Grief: The Daughter of a Concentration Camp Liberator Discovers a Legacy of Trauma:

The figures have become familiar: the number of veterans and troops in the wars in Iraq and Afghanistan who suffer from post-traumatic stress disorder are at record levels: 300,000 men and women. What isn't so well known is what most of these people experience when they turn to the military for help. They get prescriptions for serious drugs. Multiple prescriptions.
Prozac, Effexor, Elavil or Trazodone for depression. Paxil for depression, obsessive-compulsive disorder or anxiety. Zoloft for depression, obsessive-compulsive disorder, anxiety. Wellbutrin for depression, anxiety, attention deficit disorder. Celexa for anxiety, panic attacks, ADHD. Valium for anxiety and insomnia. Klonopin, Ativan, or Xanax for anxiety and panic attacks. Topamax for migraines. Percocet, Lyrica, or OxyContin for pain. Adderall or Ritalin for ADD, or ADHD. Haldol, Risperdal or Seroquel for psychosis. Ambien, Lunesta, or Restoril for insomnia.

A group of veterans I had the honor and privilege of meeting with recently shared how this pharmaceutical approach to their physical and emotional pain and inability to sleep -- which I discovered is a universally disabling consequence of combat -- quickly alienates them, producing cynicism towards the VA. "They just push pills," one man told me. "They act as if there's a quick fix: just pop these pills."

The veterans know on a gut level that the remedy to their intolerable memories and nightmares -- both waking and asleep -- will not come through a pill. So they find themselves in the all but laughable situation of finding a way to get rid of the pills they are obligated to get -- once they sign on for help from the VA.
"You can't just flush them down the toilet, because then you're putting this crap in the water system." One veteran throws his in the trash, after spray painting all identifying information on the bottle. When another tried dumping the contents into a plastic baggie, the contents heated up and melted the bag. "So what the hell is that stuff doing to my insides?"

It is difficult enough for pharmaceutical companies to know the long term consequences of taking any one of the many drugs listed above, but what about when they are taken in combination? What are the synergistic effects of these powerful brain altering chemicals?

I have personally observed how psychiatrists cannot say with any certainty whether a drug will mitigate certain behavior or moods. Prescribing drugs is a crap shoot. And that only becomes more the case when multiple drugs are prescribed. The absurdity increases when we recognize that psychiatrists often prescribe drugs to address side effects of another drug. Adderall can make people insomniacs or create tics, and so drugs are given to induce sleep or stop the tics. Or stimulants are given when a drug is overly sedative.

Just getting a prescription filled can make a veteran wish they hadn't ever sought help. Many vets report that when they pick up their prescriptions, the pharmacists give them weird looks, as if to say, "What's your story, that you need all these drugs?" This only adds to the stigma our veterans and troops already feel.

Last week two excellent articles reported the military's reliance on pharmaceuticals to address the burgeoning mental health care crisis in our troops. The Feb. 14th issue of New York Magazine carried an article "The Prozac, Paxil, Zoloft, Wellbutrin, Celexa, Effexor, Valium, Klonopin, Ativan, Restoril, Xanax, Adderall, Ritalin, Haldol, Risperdal, Seroquel, Ambien, Lunesta, Elavil, Trazodone War" that describes in detail how the mental health crisis within the Army and how medications are central to its response. "Nearly one-third of all active duty Army suicides in 2009 involved prescription drugs."

James Dao of the New York Times reported on Feb. 12 in "For some Troops, Powerful Drug Cocktails Have Deadly Results" that the military is using psychiatric drugs more than it ever has before, while at the same time experiencing a remarkable increase in drug dependency, suicide and fatal accidents, many the result of a fatal combination of drugs.

The Department of Defense is paying attention, demanding increased monitoring of prescription drugs, restricting their use, offering more treatments like acupuncture, yoga, and exposure therapy, but "shortages of mental health professionals have hampered those efforts." The article goes on to say, "Given the depth of medical problems facing combat veterans, as well as the medical system's heavy reliance on drugs, few experts expect the widespread use of multiple medications to decline significantly anytime soon."
Why is the Department of Defense not issuing a public call of action to all mental health therapists to help in this crisis? Why are the mainstream media and the Department of Defense ignoring efficacious and inexpensive approaches such as those offered by Soldier's Heart and Operation Warrior Wellness? The veterans of Iraq and Afghanistan whom I met at a Soldier's Heart retreat last month began the retreat exhausted, strung out, anxious, hopeless. Four days later they had had the first nights of sleep that they could remember; their bodies showed looseness and energy; light had entered their eyes, and they expressed hope and confidence in their ability to reassemble their lives and those of their families.

The irony of the military's predicament is that the solution is the cheapest: connect our veterans to the love and caring so many of us civilians want to give them. Let's create networks of communities for them, their families. What is essential to this is to acknowledge that combat trauma is a wound to the soul, not some neurological aberration that pills can fix.


Anonymous said...

yes, i am especially personally familiar with the way in which the VA "treats" their mental patients with drugs. It would be very interesting and telling for all to know exactly the statistics of just how many mental patients the VA has "put to sleep with their drugs."

Carol said...

Not to mention the insulin comas, electric shock and lobotomies which were used as psychiatric "treatments" after WWII and Korea.