After returning from Iraq and Afghanistan, U.S. veterans are increasingly become casualties of the country's longest war: the war on drugs.
Last Friday, the Drug Policy Alliance released an updated and revised edition of its seminal 2009 report, "Healing a Broken System." The report examines the plight of veterans struggling with incarceration and psychological wounds of war, such as addiction and post-traumatic stress disorder, and suggests reforms that could improve the health and preserve the freedom of American soldiers transitioning back to civilian life.
After a decade, the wars in Iraq and Afghanistan have taken an unimaginable toll on U.S. service personnel. Information obtained by Veterans for Common Sense reveals that, among veterans receiving care through the Department of Veterans Affairs (VA), 50 percent are diagnosed with PTSD or another mental illness. According to the VA, nearly one in five Iraq and Afghanistan veterans have a substance misuse condition. Left untreated, these conditions often contribute to fatal overdose, homelessness and suicide, as well as violations of the law, particularly nonviolent drug offenses.
After a thorough review of new research, our report found that these grave problems have only grown worse since 2009 -- and these problems are only made worse by entrenched drug war policies at the state and federal levels.
We arrest far too many veterans for drug law violations. A criminal record makes it all but impossible to get a job, housing, education, and other services -- often creating a vicious cycle of addiction and incarceration. The latest data -- from 2004 -- shows that more than 140,000 veterans were in state or federal prisons with another 60,000 or more in local jails. As more veterans return from combat and separate from the military, experts predict that the number of incarcerated veterans will almost certainly increase.
We also fail to take simple measures to prevent overdose, which are claiming unacceptable numbers of veterans and military personnel. One study found that patients in VA care had twice the rate of fatal accidental poisoning as the general public, with opioid pain medications the leading cause. Another study in the Journal of the American Medical Association this year reported that veterans with PTSD were significantly more likely to be prescribed at least one opioid -- and to experience an overdose.
In 2010, the Military Times found that on average, one active duty service member dies each week from an overdose. In August, the Austin American Statesman found that overdose was a leading cause of death among Texas veterans, rivaling accidents and suicides. Unlike national campaigns to prevent suicide, however, overdose has been largely unaddressed.
In spite of these alarming signs, we routinely ignore the best available treatments for opioid dependence: methadone and buprenorphine. These treatments are not available for the majority of veterans and military personnel who need them. In fact, the insurance systems of the Department of Defense and the VA specifically refuse to cover these effective medications.
The government response to this crisis has not only been too late; it's also been too little. One popular "solution" has been to expand drug courts to serve veterans. While well-meaning, such courts are costly to operate, unproven by research, cover only a fraction of those veterans who come into contact with the justice system, and deny evidence-based treatment modalities, including methadone and buprenorphine. These programs often send veterans to jail for relapse -- a common occurrence during treatment -- which may only exacerbate veterans' physical and mental health conditions. Perhaps worst of all, drug courts typically require an arrest and a conviction. Veterans should not have to get arrested or convicted to access treatment. Courts should be reserved for veterans charged with more serious offenses, not for those busted for drug possession. Such courts should be a last resort, not the first. Our veterans deserve better.
There are many other ways in which veterans are affected by the drug war that are not covered by our report. These include: how our dubious supply reduction efforts undermine U.S. objectives in Afghanistan; how members of the military are involved (or may be involved) in futile militarized anti-drug strategies in Mexico, Colombia and Central America; or how the same wounds of war are also affecting civilian populations in different theaters of war. As world leaders are increasingly calling for a fundamental debate about alternatives to drug prohibition, these issues are ripe for exploration.
But that is a conversation for another day. For today -- Veterans Day -- we must redouble our efforts to care for the men and women who have worn the uniform, and do everything we can to prevent them from joining the growing list of the drug war's casualties.
Daniel Robelo is a research coordinator for the Drug Policy Alliance.