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DOD watchdog: Medication management policy puts wounded warriors at risk for overdose

- The Washington Times - Saturday, February 22, 2014

A new report from a Department of Defense watchdog concludes that wounded warriors may be at risk for accidental prescription drug over dosage.

The Department's office of inspector general found in its audit that the Wounded Warriors program did not have streamlined overarching policies to ensure consistent medication management for soldiers. While there are various policies at different levels of DoD hospitals, the lack of one umbrella standard left gaps in the system where accidental over-dosage from mismanaged prescriptions was possible.

The watchdog also found that military pharmacies did not have capabilities to properly collect and dispose of extra, unneeded medicines, leaving them available to the public and vulnerable to abuse.

The Armed Forces Health Surveillance Center reported that the military had almost 13,000 pharmaceutical-related hospitalizations for overdose/poisoning between 2001 and 2012. Prescription medication overdose happened almost five times more than alcohol or illegal drug overdose with pain and psychotropic4 medications accounting for more than 65 percent of the hospitalizations.

The absence of a supreme DoD establishment of minimum requirements for prescription management creates opportunities for accidental over dosage when soldiers require multiple medications for recovery.

Surgeons General from each branch of the military agreed with the IG's recommendations and are taking steps to create new policies. The Air Force Surgeon General did not respond before the final publication of the report.

In addition, while civilian hospitals may host re-collection events and establish drop-off locations for extra, unneeded prescription drugs, military hospitals have not been granted the authority to receive excess medication from Wounded Warriors and DoD clinics had to rely on patients to discard of these medications on their own.

The Army Times reported that there were 32 prescription overdose deaths between 2007 and 2009 in Army and Marine Corps Wounded Warriors units. The Army's January 2012 Gold Book, 17 reported that prescription medications accounted for 142, or 72 percent, of the Army's 197 drug-related accidental deaths between FY 2009 and 2011. In a sample of 63 cases, 30.2 percent involved ingestion of a medication that was not prescribed to that Soldier and approximately 50 percent of the cases involved polypharmacy with multi-drug toxicities or overdoses.

The National Institute on Drug Abuse reported that prescription drug abuse by service members doubled from 2002 to 2005 and almost tripled from 2005 to 2008.

Currently, there are federal restrictions on "drug-take-back" programs to law enforcement entities. As a result, Wounded Warriors are left without a safe, reliable, accessible and accountable method to dispose of extra drugs, which increases the risk for abuse.

In response to the IG's recommendations, the Secretary of Defense made a formal request with U.S. Attorney General Eric Holder to grant the DoD authority to collect and dispose of leftover medications.

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