Veterans Incarcerated and Ignored from Drug War Chronicle

Veterans Incarcerated and Ignored When They Could Be Getting Help, Report Finds
from Drug War Chronicle, Issue #607, 11/6/09
Roughly 200,000 US veterans are in prison or jail, many of them there because of substance abuse or mental health issues, according to a new report released Wednesday. The report outlines the problem and suggests reforms that could ease the plight of American soldiers returning from the war zone and trying to make the transition back to civilian society.
VA Medical Center, Columbia, MOAccording to the report, 140,000 vets were in prison in 2004, with tens of thousands more serving time in jails. Nearly half (46%) of vets doing time in federal prison were incarcerated for drug offenses, while 15% of those in state prison were, including 5.6% doing time for simple possession. Three out five (61%) of incarcerated vets met the criteria for substance dependence or abuse.
The report, Healing a Broken System: Veterans Battling Addiction and Incarceration, comes at a critical time. With hundreds of thousands of soldiers currently deployed in Iraq and Afghanistan, the US faces a mounting challenge in caring for returning vets.
Many are returning home damaged by their experiences. According to the report, 30% of Iraq and Afghanistan veterans report symptoms of Post-Traumatic Stress Disorder (PTSD), traumatic brain injury, depression, mental illness, or other cognitive disability. These medical conditions, if left untreated, can contribute to problematic drug use, addiction, and fatal overdoses, as well as homelessness, suicide, and criminality, particular violations of the drug laws.
While the study mentions 200,000 vets behind bars, the number is most likely much higher. That's because owing to problems in data collection -- a problem in itself -- the last year for which hard numbers on vets behind bars is available was 2004. Since then, more than a million more vets have returned from their deployments and mustered out.
The report had its genesis about a year and a half ago, when the Drug Policy Alliance (DPA) teamed up with a classroom of law students at Northeastern University in Boston to investigate the obstacles veterans were facing in obtaining adequate access to mental health and substance abuse services. In addition to a series of surprising and dramatic findings, the report also includes a list of specific recommendations about how to improve services for vets suffering mental health and substance abuse issues.
"We learned that far too many returning vets are falling victim to the war on drugs because of barriers to effective treatment," said DPA's Dan Abrahamson at a Wednesday press conference. "There are nearly a quarter million vets behind bars right now for crimes motivated in part by mental health or drug addiction problems. One third of returning vets report symptoms of Post-Traumatic Stress Disorder (PTSD). Also, vets suffer from traumatic brain injury, depression, and mental illness at higher rates than normal. All of those are contributory factors to substance abuse and drug addiction, as well as overdose, homelessness, suicide, and being arrested for a non-violent drug offense."
In the battle theater, soldiers are supposed to function despite high stress, and the military is more than willing to prescribe them whatever it takes to keep them fighting. But it's a different story when the vets come home.
"Service-related drug dependency is being talked about quite a bit in the veterans community, but is not well understood outside the military," said Tom Tarantino, an Iraq war veteran and now legislative associate for Iraq and Afghanistan Veterans of America. "The ease of obtaining prescriptions in theater is staggering," he explained. "I know crack dealers who are more discriminating about issuing drugs than some of the medics I saw in Iraq. It's alarming how many people were just given anti-depressants instead of asking whether they were really fit for duty," said the veterans' lobbyist.
"Sometimes, it's just a matter of expediency and life in a combat zone, but then you have vets coming back from an environment where meds are very loosely prescribed and they are confronted with a medical system much more stringent about issuing drugs," Tarantino explained. "And that can cause problems."
"Let's be smarter than the problem," said veterans' advocate Guy Gambill. "We can't afford not to be. We arrest too many people and incarcerate them for too long. Then the mark of a criminal record keeps them from getting jobs, housing, and other services, and then the recidivism rate goes up."
There are things that can be done, Gambill said. States can change their incarceration policies. Localities can be more proactive.
"Chicago police and the LAPD are doing front-end interventions," Gambill noted. "In LA, trained peer specialists are doing ride-alongs with the LAPD so the officers will recognize Iraq and Afghanistan war vets. In Chicago, police are doing crisis intervention training, and the first hundred of them are all Iraq and Afghanistan vets. They'll try to grab these guys at first contact and get them into treatment instead of jail. These sorts of peer-led interventions work very well. We need to catch this on the front end, so we don't have 200,000 homeless vets on the streets like we do now."
Another stumbling block is the Department of Veterans Affairs current policy on drug treatment for vets. The VA is willing to offer treatment, but not for vets behind bars.
"We need the Department of Veterans Affairs to lift their ban on drug treatment of incarcerated vets," said Tarantino. "We're pleased that the department now has a justice coordinator at every VA hospital, but they're waiting outside the prison door, not inside, when the vets need it most. This is a regulation they can change with the stroke of a pen," he said.
Yet another problem for vets, especially those with substance abuse issues, is the lack of access to proven treatments. And because the insurance provided to soldiers by the armed forces also covers their families, lack of access to treatment affects them as well.
"Vets don't qualify for substance abuse treatment unless they are diagnosed with PTSD," said Abel Moreno, a former Army sergeant who saw service in both theaters and who now works with veterans through his organization Vets 4 Vets. "We are fighting two wars at once. It's obvious PTSD exists, and it's clear there are going to be substance abuse issues. We've created a subgenre among today's vets where there is a pain pill-popping mitigation ideal. We need quantified data so we can attack this situation head on," he said.
It's not only in failing to provide drug treatment absent a PTSD diagnosis where the DOD falls down, said Dr. Bob Newman, MD, director of the Rothschild Chemical Dependency Institute at Beth Israel Medical Center in New York City. "Tricare, the Department of Defense insurance plan refuses to pay for maintenance treatment of addiction with methadone or buprenorphine," he noted. "Maintenance therapy is not a new idea. It's endorsed by agencies such as NIDA, SAMHSA, the Institute of Medicine, and the World Health Organization. The US government supports this, yet DOD has an insurance plan that excludes maintenance treatment without explanation. That's outrageous," he said.
Tricare insures not only military personnel, but also their families. Tricare's refusal to pay for maintenance therapy nearly cost Teresa Bridges her daughter. Teresa's daughter, Amanda, married a soldier, Sgt. Shawn Dressler. Dressler was killed in combat shortly after the couple were wed, and Amanda retreated into a haze of Lortab and Tramitol. Tricare paid for her treatment, but after a year, her doctor noted on her records that she was being subscribed maintenance doses of Suboxone.
"Suddenly, Tricare dropped her like a hot potato," Bridges said. "Tricare believes taking Suboxone is just substituting one addictive drug for another -- at least that's what they told me. Amanda has done well on Suboxone, and if she stops taking it, she will eventually relapse. Fortunately, she is now in a temporary assistance program, but that will end after a year."
There are potential reforms that could ease the plight of returning vets, the report said. Among them are:
Changes in state and federal statutes to focus on treatment instead of incarceration for veterans who commit nonviolent drug-related offenses.
Adoption by government agencies of overdose prevention programs and policies targeting veterans who misuse substances or take prescription medications.
Significantly expanded access for veterans to medication-assisted therapies such as methadone and buprenorphine to treat opioid dependence.
"The care and feeding and support of vets is a national concern and responsibility," said Gen. Stephen Xenakis, MD, Special Adviser to the Chairman of the Joint Chiefs for Staff, Warrior & Family Support . "We are looking to knit together all the various services and institutions so that the soldier who has served and come home and ends up having problems or maybe ended up incarcerated gets treatment from all the sources available."
One of the big problems, said Tarantino, is lack of hard information. He noted that the Justice Department numbers in the report are from 2004. "In 2004, there were over one million fewer vets than there are today," he said. "We don't know how many vets are behind bars right now. We have no method for tracking vets unless they interact with some social services. We need to have DOD and DOJ compare lists. We need data," he said.
Lack of coordination among agencies dealing with vets is part of the problem, said Xenakis. "We need to better configure what we're doing," he said. "Records are not shared. The Department of Justice doesn't have access to Department of Defense records. We need to get organized so we can track people over time."
That effort has the support of the Pentagon, Xenakis said. "Our leadership heartily endorses this," he said. "It is really important that this information that this information is out there now, and that we follow it with the best action plans we can create. As a country, we have a responsibility to support our vets."
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It's not just Iraq and Afghanistan vetsComment posted by War Widow on Fri, 11/06/2009 - 6:23pm
My husband, Jeffrey J. McCrea, came home from Vietnam in 1971 with one helluva drug problem (which he didn't have when he went over there). He immersed himself in the drug and alcohol lifestyle, because that was the only thing that numbed the pain. He woke up IN VIETNAM, EVERY NIGHT. In 1989, he was finally persuaded to get help. From the VA? Not on your life. He went through a former Marine combat vet's treatment center. The VA was more than willing to prescribe an endless list of medications, including methadone pills for his chronic pain following 32 surgeries on his right leg alone, not to mention at least 10 operations on other parts of his body. He was given antipsychotic drugs, antidepressants, muscle relaxants, pain medications...but nobody actually helped him process the things he'd seen over there that haunted him permanently, endlessly. He then developed epilepsy. The VA prescribed Dilantin but never checked his blood levels. On June 17, 1992, Jeff decided he couldn't face one more day in his own personal living hell; he put his .41 magnum to his head and pulled the trigger. The VA might just as well have bought him the ammo and handed him the gun. As far as I'm concerned, he died in Vietnam; it just took his body 21 years to catch up. Nobody back then acknowledged PTSD. Although it is now recognized, from what I've seen, they're not really doing a damn thing to help these vets. You'd think that with several decades of experience, somebody, somewhere would have figured out that PTSD is a lifelong sentence; these poor vets do whatever they can to cope with things in their heads that the rest of us will NEVER understand. Locking them up is NOT a solution.
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helpComment posted by sunny ranck on Sat, 11/07/2009 - 10:04am
God help us all
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VeteransforMedicalMarijuana.org V.M.M.A.Comment posted by disgruntled veteran for peace on Sat, 11/07/2009 - 4:45pm
Real help for veterans and loved ones from people who care and understand what you are going through.For goodness sake give Veterans for Medical Marijuana access a chance to really help . Strong support along with cannabis natural health is effective for pain,p.t.s.d.,cancer,you name it. Special thanks and great appreciation to all who serve and to all supporting family and friends as well. Love and peace to all.
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Israelis Have It RightComment posted by 11BravoRTOVN on Sat, 11/07/2009 - 7:00pm
While the Univ. of Haifa just came out with their "Cannabis for PTSD" study, the Israeli Army has been giving cannabis to their PTSD soldiers for some time now. Reading their stories led me to give it a try and WOW. Now, I don't "smoke." I vaporize and take only one hit during a session. Without getting high, I no longer have those "sticky," anger building thoughts. They're turned "slippery" and vanish. When my wife sees me getting edgy, she simply says, "Go to the bathroom." That's my cue that she sees it surfacing again and for me to go take a hit to calm down. And as fast as you can walk up stairs and back down stairs, the PTSD episode has passed.
We know that the VA will NEVER allow us to have medical marijuana as long as the US prescribes to the age old draconian drug laws we now have. That's why it behoves you to join the reform movement in your state as changing the states is how we change the feds. We were all children once. Now, do it for the VETS!