WASHINGTON -- The military is seeing significantly lower levels of opioid abuse and use as it installs a series of reforms in the midst of a drug epidemic that has gripped the nation, two service health officials told lawmakers.
Less than 1 percent of active-duty service members are abusing or addicted to opioids and its rate of deadly overdoses is a quarter of the national average, Vice Adm. Raquel C. Bono, director of the Defense Health Agency, told a House panel Wednesday.
This, as military prescriptions for opioids has fallen 15 percent as alternative forms of treatment are increasingly explored, said Capt. Mike Colston, director of mental health policy and oversight for the Office of the Assistant Secretary of Defense for Health Affairs. Opioids use by active-duty service members has declined from 3.2 percent to 2.7 percent during the last year, he said.
"This crisis is touching the lives of so many of our fellow citizens and the department is committed to playing its part to help combat the epidemic and ensure our patients receive the finest care we can provide," Bono told the House Armed Services Committee on military personnel issues. The Defense Department "is making headway, but there is more to be done."
In recent years, the military has installed a series of reforms to address the epidemic within its ranks, but it continues to see concerns. Bono said work remains in educating service members and veterans on opioid addiction threats and implementing new strategies to reduce abuse.
For example, there are specific groups that need increased attention, such as service members transitioning to civilian life, veterans and retirees, military officials and lawmakers said. In those cases, there's more likelihood of a patient falling through the cracks or higher incidents of concern.
"There has to be a system in place that ensures separating service members who are eligible for VA care and need VA care have an appointment scheduled before they separate from DoD," said Rep. Carol Shea-Porter, D-N.H. "The command responsible for a soldier when he or she is separating should also be held responsible for making sure that soldier is receiving the healthcare they need when separating... many service members are left to navigate that system themselves."
Shea-Porter referenced meeting with the mother of Army soldier Daniel Keegan, who saw numerous, months-long delays in seeking treatment after he got hooked on heroin as he battled post-traumatic stress disorder following a tour in Afghanistan. Keegan was unable to navigate the system as he battled addiction, and died in 2016, just two weeks before his treatment was finally slated to start.
"In Dan's word, he was a disposable soldier we spent a fortune training," Shea-Porter said, recalling a conversation with Keegan's mother, Stephanie. "But when he got sick, we dropped him."
Nationally, the opioid epidemic claims an estimated 116 people from drug overdoses each day. In 2016, 42,249 people died and the crisis has cost more than $504 billion, said Rep. Mike Coffman, R-Colo., chairman of the House subpanel.
By comparison, the military is doing very well, said Rep. Ralph Abraham, R-La.
"If you guys have only 1 percent rate, you guys are doing phenomenal," Abraham told the military officials. "Kudos to what you are doing."
But military retirees who use opioids remain a concern, Bono noted.
The majority of long-term opioid patients -- 83 percent -- are older than 45 years old, most likely to be a retiree or a relative of one and they seek care outside military hospitals and clinics, Bono said.
Reforms yet to be implemented will help address the continuing crisis, she added.
For example, in December, the Defense Department will enter into a new phase of transparency regarding opioid use among its ranks through a joint reporting effort with state Prescription Drug Monitoring Programs, or PDMPs. That will create new, additional safeguards for catching people who might be abusing or are addicted to the drug.
"It is a crisis in our country when we have over 2 million people over the age of 12 who are either dependent on opioids or are abusing them. It is time for us to take very seriously the impacts on everyone at the least our service members, their dependents and retirees," said Rep. Jackie Speier, D-Calif., ranking Democrat on the military personnel issues subpanel. "I think the military has the opportunity to lead the nation to reduce opioid abuse and develop alternate pain management therapies."