The Center for Ethics and the Rule of Law (CERL) at the University of Pennsylvania has issued a new report highlighting the connection between two crises in the United States: the epidemic of widespread opioid abuse and the mental health challenges facing veterans of recent combat deployments.
The report, titled “The Intersection of Opioid Overuse and Veteran Mental Health Challenges,” provides an overview of the opioid crisis in the veteran population, examines the over-prescription of opioids in the Veteran’s Administration and other care providers, and identifies in particular the dangers of prescribing opioids to individuals with PTSD. The report provides recommendations for the reform of practice and policy to address the serious difficulties produced at the intersection of veterans’ mental health issues and the opioid addiction crisis.
“The opioid crisis has disproportionally affected veterans, who often suffer from chronic pain in combination with high levels of psychological distress due to undiagnosed and untreated combat trauma,” said Professor Claire Finkelstein, founder and director of CERL. “This report details the current state of affairs, which is both a public safety risk and a disservice to the men and women who served in the military.”
As a result of collaboration with veterans, mental health professionals, attorneys, and policymakers, the report recommends that opioid prescribing patterns and opioid use be restricted and time delimited by FDA mandatory action or by federal legislation.
In addition, the report recommends that extreme caution be used in prescribing opioids for use in vulnerable populations, such as veterans, and that care be taken to provide access to treatment for combat trauma in the case of veterans seeking to become first-responders.
Further, the report recommends that studies be conducted to assess the potential degree of unresolved trauma in veterans serving as first-responders.
Retired Brigadier General Dr. Stephen Xenakis, a psychiatrist and active member of CERL’s board, consulted on the report and helps direct the Center’s efforts on veteran mental health issues.
“As CERL’s work has consistently shown, the cost of psychological injury in war has historically been underestimated,” the report states. “Addiction to pain medication is yet another instance of the extended psychological costs of war, accounting for significant financial loss for society and personal loss for veterans and their families. It is essential that the full costs of combat trauma be assessed, including far-reaching effects on the economy and national security, and that appropriate non-medicinal treatments be pursued to lower the rates of PTSI (Post-Traumatic Stress Injury) in the veteran population in lieu of medication where possible.”
Finkelstein is the Algernon Biddle Professor of Law and Professor of Philosophy at the University of Pennsylvania. Her scholarship examines the intersection of moral and political philosophy and the law, particularly the law and the ethics of war.
The Center for Ethics and the Rule of Law is a non-partisan interdisciplinary institute dedicated to the preservation and promotion of the rule of law in twenty-first century national security. The only center of its kind housed within a law school, CERL draws from the study of law, philosophy, and ethics to answer the difficult questions that arise in times of war and contemporary transnational conflict. CERL has made addressing the legal and political impediments to healing veterans suffering combat trauma a major focus of its recent work. The Center partners with behavioral specialists, highly placed active duty and retired military, medical researchers, as well as attorneys across the country to seek solutions to the epidemic of veteran suicide and mental health problems among veterans.
To read this briefing paper in its entirety, go to: https://www.law.upenn.edu/live/files/6192-cerl-report-on-ptsd-and-opioid-addiction-final.