Improving Treatment and Preventing Drug-Related Harms Among Returning Veterans of the United States Armed Forces
Adopted at the 78th Annual Meeting in 2010
WHEREAS, the wars in Iraq and Afghanistan are in their seventh and eighth years respectively, and nearly two million American troops have served in either conflict, thousands of whom have been deployed multiple times; and
WHEREAS, the men and women of the armed services have made sacrifices to preserve the freedom of the American people and we have an obligation to care for them; and
WHEREAS, according to a 2008 report by the RAND corporation, nearly one-third of current conflict veterans will report symptoms of Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), major depression, or other cognitive disorder or disability; and
WHEREAS, these psychological wounds of war, if left untreated, often contribute to substance abuse and addiction, fatal overdose, homelessness, suicide; and violations of the law, especially nonviolent drug offenses; and
WHEREAS, in 2004, the United States Department of Justice, Bureau of Justice Statistics reported that 140,000 veterans were incarcerated in state and federal prisons, with tens of thousands more in county jails; and
WHEREAS, experts believe the number of incarcerated veterans will dramatically increase as more service men and women return from Iraq and Afghanistan; and
WHEREAS, research shows that the single greatest predictive factor for the incarceration of veterans is substance abuse; and
WHEREAS, veterans incarcerated for drug offenses received average sentences that were one year longer than those of non-veterans incarcerated for the same offenses; and
WHEREAS, The United States Conference of Mayors adopted a resolution at its 75th Annual Meeting declaring the war on drugs a failure and calling for a public health approach to drug problems, which includes community-based treatment instead of incarceration for nonviolent drug offenders; overdose prevention policies, and greatly increased access to medication-assisted therapies like methadone and buprenorphine; and
WHEREAS, diverting veterans from jail and prison through the training of first responders and through the implementation of veterans diversion programs can help returning veterans struggling with substance abuse and mental health conditions; and
WHEREAS, The United States Conference of Mayors adopted a resolution at its 77th Annual Meeting calling for the implementation of strategies to prevent homelessness among returning veterans, including local efforts to divert veterans into treatment instead of arresting and jailing them, and outreach and reentry services for veterans being discharged form correctional facilities; and
WHEREAS, many communities are beginning to adopt these strategies, including Buffalo, New York; Orange, Santa Clara, and San Bernardino counties, California; Tulsa, Oklahoma; Anchorage, Alaska; Chicago, Illinois; King County, Washington; Madison, Wisconsin; Phoenix, Arizona; Minneapolis, Minnesota; Rochester, New York; and Allegheny County, Pennsylvania; and
WHEREAS, California and Minnesota have passed laws providing that veterans who suffer from PTSD, substance abuse, or psychological problems as a result of their service and who commit certain nonviolent offenses may be diverted to treatment instead of jail or prison; and
WHEREAS, these positive first steps must be improved and expanded; and
WHEREAS, the United States Department of Veterans Affairs (VA) recently adopted a policy prohibiting VA physicians from recommending medical marijuana to their patients, even in jurisdictions that have legalized marijuana for medical use, and even when marijuana is the safest and most effective medicine to treat PTSD and other service-related conditions; and
WHEREAS, patient reports and published research indicate that medical marijuana can be a highly effective treatment for PTSD, and overwhelming scientific evidence has already proven marijuana's safety and efficacy for treating conditions like chronic pain, which affects many combat-injured veterans; and
WHEREAS, medical marijuana carries none of the risks associated with prescription drugs used to treat PTSD, which have been implicated in the tragic overdose deaths of several current conflict veterans; and
WHEREAS, PTSD is the leading medical condition qualifying for the medical use of marijuana in the State of New Mexico; and
WHEREAS, veterans should not be deprived of the same rights as nonveteran patients in the jurisdictions that permit medical marijuana use; and
WHEREAS, research and news reports suggest that veterans are at high risk of overdose given the widespread use of prescription medications, especially opioid analgesics for relief of pain from combat injuries and antidepressants for mental health treatments; and
WHEREAS, military surveys have found prescription opioid medications to be the most widely misused class of drug among members of the armed forces; and in May it was reported that the number of U.S. Army soldiers enrolling in treatment for opiate addiction rose 500 percent between 2004 and 2009; and
WHEREAS, the Department of Defense's TRICARE insurance system explicitly prohibits coverage of methadone and buprenorphine treatment for active duty personnel or for veterans in the process of transitioning from DoD care, and as a result, active and recently active military personnel are denied effective treatment for opioid dependence, often at a critical, early juncture when full-blown addiction could still be avoided; and
WHEREAS, The United States Conference of Mayors adopted a resolution at its 76th Annual Meeting urging cities to take actions to prevent overdose fatalities, such as the distribution of Naloxone -an opioid antagonist medication that reverses the respiratory failure that commonly causes death from opioid overdose - directly to lay people; and the adoption of medical amnesty laws for witnesses of a drug overdose, such as the State of New Mexico adopted in 2007; and
WHEREAS, The United States Conference of Mayors adopted a resolution at its 77th Annual Meeting advocating greatly expanded access to addiction treatment, including alternatives to incarceration, specially tailored treatment, recovery support to veterans returning from active duty - particularly veterans who are suffering from or are at high risk for PTSD and/or alcohol and other drug problems, NOW, THEREFORE, BE IT RESOLVED that the United Conference of Mayors urge immediate policy changes to improve the health, reduce the likelihood of accidental death, and preserve the freedom of those who have served in our armed forces; and BE IT FURTHER RESOLVED The United States Conference of Mayors urge state and federal governments to modify sentencing statutes and improve court-ordered drug diversion programs to better treat - rather than criminalize and incarcerate - veterans who commit nonviolent drug- related crimes; and BE IT FURTHER RESOLVED that such diversion programs allow veterans to access treatment without first pleading guilty; expand their treatment options and quality; embrace medication-assisted therapies like methadone and buprenorphine; prohibit jail sanctions, which would likely exacerbate veterans' mental and physical injuries or illnesses; and empower treatment professionals to make treatment decisions; and BE IT FURTHER RESOLVED that The United States Conference of Mayors urge cities to direct and train local law enforcement agencies to divert veterans to appropriate VA care instead of booking and arresting them, when such a disposition is in the interest of the veteran and public safety; and
BE IT FURTHER RESOLVED, that The United States Conference of Mayors urge the VA to allow physicians to make recommendations related in medical marijuana to their veteran- patients in jurisdictions where marijuana is legal for medical use; and BE IT FURTHER RESOLVED that The United States Conference of Mayors urge the VA and Department of Defense (DoD) to immediately adopt overdose prevention programs and policies targeting veterans and service members who misuse alcohol and other drugs, or who take prescription medications, especially opioid analgesic, and that such policies include improved patient screening, monitoring, supervision, and education, and physician training; and the prescription of Naloxone to all veterans who are taking opioid pain medications; and BE IT FURTHER RESOLVED that The United States Conference of Mayors urge states - and even military bases - to follow the lead of New Mexico and enact laws that provide legal amnesty to persons who report an overdose to emergency medical services; and BE IT FURTHER RESOLVED that the VA increase access to methadone, buprenorphine and other medication-assisted therapies among opioid-dependent veterans; and the DoD eliminate restrictions preventing TRICARE from covering buprenorphine and methadone for active military, veterans, and their families.