Problem Increasing

Misuse of pain medicine has been increasing in recent years. The latest Department of Defense Health Behaviors Survey showed that self-reported misuse of pain medications for non-medical purposes by all military servicemembers increased from 2% in 2002, to 7% in 2005 to 17% in 2008.

According to the Army’s “Generating Health and Discipline in the Force, Report 2012,” also called the “Gold Book,” between October 2006 and October 2011, of 312 deaths caused by drug toxicity, 68% (214) involved prescription medication (primarily opioids). Of these 214, 48% (103) were not prescribed to the victim at the time of death. In addition, drug-toxicity deaths have shown an upward trend, from 22 in fiscal year 2006 to 56 in fiscal year 2010.

Reducing substance abuse is not something Bailey approaches with modest expectations. “I believe we should have a big, hairy, audacious goal, and I talked about dropping abuse by 6% in five years,” he said, stressing that this is his personal goal, not an official Army goal. “This gives us a frame of reference for everything we talk about and everything we do.”

History proves that the Army is capable of sustaining and maintaining reductions in substance abuse, he pointed out, noting significant declines in drug-test positives for cocaine and the active ingredient in marijuana from 2010 to 2011. During the same time period, however, drug-test positives increased for oxycodone and oxymorphone, leading to the enhanced testing program.

“We already knew prescription drugs were a problem,” Bailey said, “But once we identify a problem and get the word out combining education with detection, we’re able to stamp it out. I say this with confidence.” The Army is affected by the increase in prescription drug abuse in society as a whole, he pointed out, but has the advantage of good teamwork to combat it.

“With more detection, the rate will initially go up, but then it will be followed by a drop,” he predicted.

Not In It Alone

This is not a solo effort for the Army Center for Substance Abuse Programs, Bailey pointed out. “We’re teamed up with U.S. Army MEDCOM — that’s the powerhouse of military medicine,” he said. “They run pharmacies, and they have them firmly in their sights as well.”

He noted that MEDCOM policies are designed to rein in substance abuse and support the center’s efforts. “Because we have a tight system, once we have our sights set on something, we’re able bring a lot of teamwork to bear; I think we will be the first among peers to turn around prescription drug use,” he suggested.

The education process will be extensive, Bailey said, explaining, “We just don’t mean passing out handouts and saying the soldiers are educated.” In fact, it will be more like a marketing campaign, with standard messaging across multiple media and target audiences that will include not only soldiers but their families and care providers.

“We have a campaign plan we’re kicking off; when people really learn is when the culture changes,” he added. “That’s the way ahead; when the culture changes, education is complete. You won’t need to tell anyone. The people who still [misuse drugs] will be criminals — and they’ll know it. We will definitely get to that point.”

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