Fifteen years of war in the Middle East has resulted in the highest number of veterans of foreign wars since the Vietnam era. These men and women who have made great sacrifices on behalf of our country come home and face a variety of problems, including:
- Lack of job opportunities
- Financial problems
- Mental health disorders
Mental health issues – such as post-traumatic stress disorder (PTSD), anxiety disorders and other stress-related disorders – are especially common due to traumatic wartime experiences. According to a 2012 VA report, around 20 percent of veterans returning from the Iraq and Afghanistan wars suffer from PTSD.
Sadly, the VA system is woefully inadequate to properly serve the needs of our veterans. Even after a $10 billion program was instituted to reduce wait times and get vets faster care, the bureaucratic inefficiency of the system has had the opposite effect.
Not only do vets face long wait times, but when they finally see a doctor they are often simply given prescription medications that have a host of potential side effects, including addiction.
Help for Vets with PTSD: Are We Too Reliant on Prescription Meds?
Trauma-related mental disorders are complicated to treat because each individual has different circumstances and varied responses to medication. Doctors need to be able to carefully diagnose the needs of each individual and try different treatment regimens to see what each patient responds best to, while minimizing harmful side effects.
But if it takes months for a vet to get one doctor’s appointment, and months more before the doctor gets paid, then it’s very difficult for vets to get the individualized care they need. Simply giving them a prescription and then hoping for the best opens up vets to the very real risks of drug abuse and addiction, which only adds to the problems our vets face when they return home after serving our country.
The list of medications that can be used to treat mental illness in vets is extremely long (see below). What are the odds that the doctor is going to get it just right the first time when the patient is finally able to get an appointment?
Drugs that vets can be prescribed to treat PTSD-related symptoms fall into the following five categories. Click on any of the following classes of drugs to see the full list.
- Amitriptyline (sold under brand names Elavil, Endep, Levate, others)
- Amoxapine (Asendis, Defanyl, Demolox, others)
- Bupropion or bupropion hydrochloride (Wellbutrin)
- Citalopram (Celexa, Cipramil)
- Clomipramine (Anafranil, Clofranil)
- Desvenlafaxine (Pristiq)
- Desipramine (Norpramin, Pertofrane)
- Doxepin (Deptran, Sinequan)
- Duloxetine (Cymbalta)
- Escitalopram (Lexapro, Cipralex)
- Fluoxetine (Prozac, Sarafem, others)
- Flurazepam (Dalmane, Dalmadorm)
- Fluvoxamine (Faverin, Fevarin, others)
- Imipramine (Tofranil)
- Maprotiline (Deprilept, Ludiomil, Psymion)
- Mirtazapine (Avanza, Mirtaz, Zispin, others)
- Nortriptyline (Sensoval, Aventyl, Norpress, others)
- Paroxetine (Paxil, Pexeva)
- Phenelzine (Nardil, Nardelzine)
- Protriptyline (Vivactil)
- Sertraline (Zoloft, Lustral)
- Trazodone (Oleptro, Trialodine)
- Trimipramine (Surmontil, Rhotrimine, Stangyl)
- Vilazodone (Viibryd)
- Vortioxetine (Brintellix)
- Buspirone (Buspar)
- Chlordiazepoxide (Librium)
- Clonazepam (Klonopin)
- Diazepam (Valium)
- Estazolam (ProSom, Eurodin)
- Hydroxyzine (many names)
- Lorazepam (Ativan, Orfidal)
- Midazolam (Dormicum, Hypnovel, Versed)
- Oxazepam (Serax, many others)
- Temazepam (Restoril)
- Triazolam (Halcion, Trilam, others)
- Asenapine (Saphris)
- Fluphenazine (Prolixin, Modecate)
- Haloperidol (Haldol, others)
- Iloperidone (Fanapt)
- Loxapine (Loxapac, Loxitane)
- Lurasidone (Latuda)
- Olanzapine, sometimes in combination with fluoxetine (Zyprexa, Zypadhera or Symbyax)
- Perphenazine (Trilafon)
- Pimozide (Orap)
- Prochlorperazine (Compazine, Phenotil, others)
- Quetiapine (Seroquel)
- Risperidone (Risperdal)
- Thiothixene (Navane)
- Ziprasidone (Geodon, Zeldox, Zipwell)
- Carbamazepine(Tegretol, Carbatrol, others)
- Divalproex sodium(Depakote)
- Valproic acid(Depakene, Valproate)
- Butabarbital (Butisol)
- Eszopiclone (Lunesta)
- Prazosin hydrochloride (Minipress, Vasoflex, others)
- Ramelteon (Rozerem)
- Zaleplon (Sonata)
- Zolpidem (Ambien)
Bottom line: Simply medicating our vets, especially without giving them adequate follow-up care with their physicians, puts them at greater risk for problems stemming from prescription medication.
PTSD and Substance Abuse
Vets with PTSD are at greater risk for substance abuse in two ways:
- Some prescription drugs used to treat PTSD symptoms can be addictive.
- Vets who don’t get proper treatment for their symptoms may turn to alcohol and/or drugs to ease their symptoms on their own.
While improper treatment can lead to addiction, many vets simply don’t get any care for their trauma-related illness, which can lead to:
- Job loss
- Financial difficulties
The suicide rate for veterans with PTSD is 50 percent higher than the national average. Overdoses are more likely to occur when substances are mixed (like prescription meds and alcohol), which is more likely to happen without proper doctor supervision.
Vets who have already developed a substance use disorder need treatment for both the addiction and their PTSD. This requires timely access to dual diagnosis professionals who can properly assess the individual’s needs and provide appropriate treatment.
Healthcare organizations that help vets with PTSD and addiction need to use a combination of therapy, medication and other proven treatment methods. The important thing is to ensure that each veteran gets the care he or she needs in a timely manner and with appropriate ongoing treatment.
How Can I Help Veterans with PTSD?
Just as our servicemen and women have fought for freedom abroad, it is up to us to help fight for their well-being here at home. While there’s not a single solution to the problems that plague the VA medical system, our country can find solutions when concerned citizens take an interest.
The first step is engaging in open conversation about the issues and ways to solve them. We invite you to join the discussion online and share your thoughts on how we can better care for our soldiers when they return home.