Military Allows Addictive Drugs in Treatment

     WASHINGTON (CN) – Drug maintenance programs that include the use of potentially addictive drugs to treat individuals addicted to painkillers are now covered by TRICARE, the military’s health provider, the Department of Defense has announced.
     Under the previous regulation, TRICARE and its predecessor, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), did not cover drug maintenance programs that substituted a therapeutic drug with one that is potentially addictive.
     The DoD’s policies for drugs used in treatment programs had not been changed since 1977 and did not reflect modern standards that include the use of addictive drugs, according to the agency.
     “Evidence-based modalities of care in the treatment of substance use disorders include the use of agonist and antagonist medications that help to reduce cravings, maintain functioning and support long-term recovery,” the DoD explained in its action.
     The new regulation brings treatment programs covered by TRICARE up to date with current standards, the action says.
     “This final rule changes TRICARE’s coverage policy based on the acceptance of drug maintenance as an integral part of opioid treatment services when medically necessary and as part of a comprehensive treatment plan for an individual with substance use disorder,” the DoD said.
     Prescriptions for pain medication issued by military doctors have more than quadrupled since 2001, reaching 3.8 million in 2009, according to a study completed by the Institute of Medicine (IOM) of the National Academies of Science.
     “Some attributed these trends to combat-related injuries and strains from carrying heavy packs, body armor and weapons over mountainous terrain during multiple deployments,” the IOM said in its study.
     The American Psychiatric Association (APA), representing 36,000 psychiatric physicians, says it strongly supports the new regulation.
     “The current rule fails to recognize a wealth of medical evidence which supports certain maintenance programs as only one component of the continuum of care necessary for the effective treatment of substance dependence. While advances in medical science have greatly reduced the number of American deaths on the battlefield, many American soldiers continue to sustain injuries. Over the course of the last ten years, numerous injured soldiers have returned home from battle in Iraq and Afghanistan in need of prolonged treatment. Long-term use of pain medications heightens some injured soldiers’ risk of pain medication dependence. Knowing this, it is critically important that all safe and effective treatments for substance dependence be available to America’s military personnel,” the APA said in a 2012 letter to the DoD.
     The regulation goes into effect Nov. 23.

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