Rural veterans a significant part of the opioid crisis
Rural voters flocked to the polls this past November, showing our discontent with the current structure of our government and the lack of attention being paid to our “flyover” communities. In rural communities across America, living conditions are deteriorating, jobs are scarce, and people are suffering. To make matters worse, the addiction epidemic has hit small towns particularly hard.
On a deployment to Sadr City, Iraq, in 2005, I injured my lower back while attempting to fix a blown tire on my team’s up-armored Humvee. This led to my first experience with opioid pain medication. In 2007 I received a prescription for OxyContin after undergoing surgery to repair the damaged vertebra. The surgery wasn’t successful, and I remained on painkillers for a few months until I could undergo a second surgery. After this surgery, I was again prescribed painkillers — this time, oxycodone and hydrocodone. This is when I started to feel the early signs of addiction.
Luckily, before I became too dependent, I was able to slowly wean myself off of opioids. Instead, I relied on anti-inflammatory medication and the personal choice to be in pain for the remainder of my time on active duty. I remember vividly the complete absence of any type of counseling at the time regarding the addictive qualities of opioid-based painkillers. Looking back, like while I was deployed, I realized that I dodged a proverbial bullet.
My enlistment contract expired at the end of 2008 and I was transferred to the Department of Veterans Affairs health care system. After a brief meeting with a primary care physician, I left the clinic with more painkillers, muscle relaxers, sleeping pills and anti-anxiety medication than I knew what to do with. But, like a good troop, I followed the doctor’s orders and took every pill according to the dosage recommendations on the bottle.
Although I was excited to use my GI Bill benefits and begin the next phase of my life, the daily concoction of drugs was causing me to fall back into a state of chemical dependency that I experienced while on active duty. I couldn’t concentrate in class or at home; all I could think about was my next mouthful of pills. As a former forward observer trained to always be alert and aware of my surroundings, I found myself in a constant internal battle with my new hazy state of existence.
At that time, there existed a stigma associated with admitting that I may once again be going down the path of addiction. In my mind, the pain was better than the alternative. Unannounced to my primary care physician for a fear of some type of backlash for “challenging” the authority (probably a remnant of my indoctrination into the military), I made the choice to once again quit taking painkillers.
As a veteran, I’m concerned about the ability for me and my fellow veterans to choose the medication and treatment that works best for us. From my personal experience, each VA treatment center is different in how it approachs pain management. But in my case, almost all have involved some sort of opioid painkiller.
Although these issues of addiction and abuse have been getting more attention as of late, particularly at the Tomah VA in Wisconsin, I know many veterans and family members of veterans who still struggle daily. This epidemic is hitting my home state of Wisconsin particularly hard — both in civilian and veteran populations. Billboards advertising drug and addiction treatment now line the interstate — oddly, in the most rural of areas, where roughly 70 percent of Wisconsin veterans reside. The writing is literally on the wall.
Wisconsin has seen a 600 percent increase in opiate and heroin overdose fatalities in the last decade, part of a larger Midwest-region problem where there are 4.3 heroin overdose deaths per 100,000 people.
Rural men are dying faster because of, plain and simple, “an uptick in suicides and deaths due to poisonings and substance abuse,” according to a February 2016 Time magazine article. Former Agriculture Secretary Tom Vilsack cited the reason for this as “a consequence of a rural economy that’s been struggling historically quite some time,” and pointed at opportunities to change this tide, including congressional funds to fight the opioid epidemic.
For example, Congress recently passed legislation, with overwhelming bipartisan support, that reserves $1 billion in grants over the next 10 years for states to fight opioid abuse — a necessary step forward. If we don’t start aggressively seeking better addiction treatment now, these numbers will continue to grow, affecting families in every corner of the state.
Effective and affordable treatment must also be available to recovering addicts — in the form of medication and counseling. There’s been a lot of success in rural areas with treating drug addiction with buprenorphine, a prescription that reduces withdrawal cravings and symptoms, but unfortunately, the pharmaceutical company behind the most common treatment has been accused of price gouging.
Forty-two attorneys general, including Wisconsin’s, have shown some real leadership by creating a bipartisan coalition to sue the makers of Suboxone, used in opioid recovery, for price inflation and related issues. Concerningly, Medicare spent almost $165 million on Suboxone in 2015 nationwide. This is a status quo that just doesn’t work if we’re hoping for real progress and solutions.
Fighting this crisis is difficult and demands action on numerous fronts — we need to focus on prioritizing and empowering the VA so that veterans have quality, affordable physical and mental health care. Our community leaders must take the steps necessary to pursue real solutions to opioid abuse.
Steve Acheson served in the Iraq War. After his honorable discharge from the Army in 2008, he served as a veteran adviser for Steve Kagen, a Democrat, when Kagen represented Wisconsin’s 8th Congressional District in the House of Representatives. He is director of High Ground Veterans Advocacy and lives in Campbellsport, Wis.