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Drug Use in the Military and the Need for Harm Reduction

The Huffington Post The Huffington Post 14/03/2016 Tessie Castillo

When Kevin Rumley joined the Marine Corps after 9/11 to fight for his county, he never dreamed it would set him on a path to heroin addiction. But then again, no one who has struggled with drug dependency ever imagined ending up in that place.
Rumley's story is one that is becoming increasingly common in the military. While serving in the Marine Corps during the years building up to the Iraq War, he witnessed a culture of heavy drinking, rampant prescription pill abuse, and a "don't ask don't tell" policy when it came to addiction. After being injured by an IED explosion in Iraq in 2004, he came home to multiple surgeries and a seeming unending supply of prescription painkillers. Like so many injured veterans, he got hooked.
"For years I fed my addiction with prescription pills from the Veteran's Administration, but as my tolerance grew, I needed more and more pills just to feel normal," Rumley explains. "Then the VA stopped filling my prescriptions, so I went out to the streets to look for a potent and cheaper alternative. I found heroin. All those lines I had drawn in the sand about no matter how bad things got I would never snort drugs or inject drugs - over the next five years I crossed them all."
For years Rumley struggled against a growing drug problem, even resorting to stealing syringes from local pharmacies when they wouldn't sell him any. But finally he sought help at an opioid detox program where he was put on suboxone, a medicine that reduces the cravings for illicit opioids. Thanks to successful suboxone treatment, he was able to give up heroin. Rumley went back to school for substance use counseling, graduated at the top of his class, and currently works as a certified addictions counselor helping other veterans who grapple with drug dependency.
Rumley has a few suggestions for how the military could better serve veterans and alleviate the drug and alcohol dependence that plague so many of our returning soldiers. First, the military can put more resources into viable discharge and reintegration plans for soldiers returning from a tour of duty.
"After being discharged, the pure shock of leaving the structure and support of your comrades can be overwhelming," he says. "Often veterans are isolated in rural communities because of PTSD issues that make them sensitive to noise and crowds. Sometimes the only support system they have is the VA, which gives out the pills that lead to addiction. It's no surprise that many turn to drugs or alcohol to cope."
Rumley is also a current advocate for syringe exchange programs, which he says would help veterans and other drug users avoid infections and connect with services that can help them address addiction. Syringe exchange programs provide sterile syringes while collecting used injection equipment and offering services such as HIV and hepatitis C testing, treatment and prevention education, drug treatment referrals, and other social service referrals.
"One thing about syringe exchange is that it not only promotes healthier choices when it comes to injection, but it serves as a conduit to provide other health services to people," Rumley explains. "People can come to the syringe exchange and have an opportunity to engage with other people who have been through the same experiences and can show tangible success."
Rumley would also like to see the military adopt an evidence-based harm reduction approach to dealing with addiction issues.
"We have this unfortunate assumption as a society that if you are using drugs, you are accepting all negative consequences and nothing can be done about it," he says. "But the harm reduction approach says a lot can be done. We can start getting people to think about healthier choices even before they are thinking about recovery."
Another fellow veteran, Brad West, who went through the same injury-pills-opioid addiction-suboxone-substance use counselor trajectory as Rumley, says that harm reduction would be helpful in the military because it rejects that mindset that you need to wait to address an addiction problem until it is so bad you need professional treatment. West currently volunteers at a treatment facility for Marines and he sees the same story over and over again.
"The common thread is that they come back injured after a tour of duty, start taking pain pills, get addicted, and then their supply is cut off abruptly," he says. "When military doctors recognize drug dependency, they don't taper off the medication, they just cut the person loose. Then of course the person will start looking for drugs in other places because the withdrawal symptoms from opiates are really unpleasant. Most get discharged for a drug problem, even if they go through treatment, especially now as the military is downsizing and looking for reasons to let people go. But when they are let go they still have those addiction issues."
West would like to see the military set up a system where soldiers can go if they have a problem to seek treatment instead of living in fear that admitting to an addiction will only lead to discharge.
"There is this culture that if you have an addiction you need to hide it," says West. "We need to remember that most of these veterans were legitimately injured in the line of duty serving their country. We need to stop treating people addicted to drugs as lepers and recognize that they are people who may need help."
There are some signs of hope in recent years that the military is starting to recognize the need to address addiction problems. Some bases and military hospitals have recently approved suboxone treatment for veterans and are making more efforts to ready returning soldiers for civilian life. As the national culture towards drug use as a whole shifts towards a more evidence-based, health centered approach, the military just might change too.

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