Back to Top Skip to main content

There is hope

Medically assisted treatment for opioid use can break the cycle of addiction. Medically assisted treatment for opioid use can break the cycle of addiction.

Recommended Content:

Mental Health Care | Substance Abuse | Addiction | Mental Wellness | Opioid Safety

The United States is in the middle of an opioid overdose epidemic, according to the Centers for Disease Control and Prevention, which calculates that more than 350,000 deaths are attributed to opioid overdoses nationwide since 1999. The military is at the forefront of efforts to help curb those numbers through its expansion of medically assisted treatment, also known as MAT.

Vice Adm. Raquel C. Bono, director of the Defense Health Agency, reported to the House Armed Services Committee last month that the military’s rate of deadly opiate overdoses is a quarter of the national average, according to House transcripts. Dr. Fuad Issa, chief of the implementation section at the DHA Psychological Health Center of Excellence, said the availability of MAT has a lot to do with breaking the cycle of addiction.

In 2016, the Department of Defense expanded the availability of MAT as part of the TRICARE benefit, with the goal of increasing successful treatment and reducing the number of overdoses and deaths due to opiate abuse, said DHA clinical psychologist and senior policy analyst Dr. Krystyna Bienia.

“Drugs like methadone, naltrexone, and buprenorphine as a medically assisted treatment plan relieve withdrawal symptoms and psychological cravings that make opiate addiction so hard to overcome,” she said. “Used correctly, and in conjunction with psychotherapy, support, and counseling, they can help users overcome the addiction to opioids.”

The Substance Abuse and Mental Health Services Administration points out that the benefits of MAT include not only curbing withdrawal symptoms and preventing cravings, but also providing medical supervision. MAT works to normalize brain chemistry, block the euphoric effects of opioids (which include prescription drugs such as hydrocodone and oxycodone), and stabilize body functions without the negative effects of the abused drug. MAT has proven to be clinically effective and significantly reduces the need for inpatient detoxification. Bienia notes that MAT provides a comprehensive, individually tailored program of medication and behavioral therapy.

Yet some MAT medications have challenges of their own. Methadone, for example, doesn’t produce euphoria; rather, it tricks addicts into thinking they’re getting the opiate, according to the National Institute on Drug Abuse. Methadone works by changing how the brain and nervous system respond to pain. But according to Issa, methadone itself can be addictive.

That’s why Navy Capt. Edward Simmer, psychiatrist and chief clinical officer for TRICARE, believes it’s important to realize that the medication is only one component of the treatment plan. He suggests part of his patients’ treatment is going to 12-step programs such as Narcotics Anonymous, and including other community support.

“There’s a large social component to drug use,” Simmer said. “Relapses are often caused by being around others who use drugs, or stresses associated with drug use. Therefore, successful treatment requires eliminating these triggers to the greatest extent possible.”

Bienia explained that the duration of MAT depends on the patient. “After months or a year or more of treatment, the medication can be gradually reduced and eventually stopped … but in some cases [it] has to be taken for a lifetime,” she said.

Issa noted that in the past, opiate users had to get their medication at a special dosing site, but today, a prescription for drugs effective in alleviating opiate withdrawal symptoms, such as the combination of buprenorphine and naloxone, can be filled at a local pharmacy. The 2016 TRICARE Mental Health and Substance Use Final Rule allows TRICARE-authorized physicians to provide office-based opioid treatment.

Issa said he believes this may be making a difference, noting that in addition to TRICARE changes, DoD has been training medical providers on the risks of opioids. The number of DoD opioid prescriptions dropped by 56 percent between 2013 and 2017.

According to Bono’s testimony to the House committee, less than 1 percent of active-duty service members are abusing or addicted to opioids.

In 2017, the DHA Psychological Health Center of Excellence, along with the Medical Directorate - National Capital Region, trained 192 physicians to prescribe MAT, and more nurse practitioners are being added this year to expand the network and coverage of MAT providers, said Issa.

“Beating an addiction is a drastic change in someone’s life, but treatment works,” said Simmer. “People do overcome addiction when everyone works together. There is hope.”

You also may be interested in...

CBD oil off limits for service members

Article
1/23/2020
A service member checks the label on a supplement. Service members must remain diligent and check labels on consumer products and follow official guidance on CBD products. (U.S. Air Force photo by Staff Sgt. Nicole Leidholm)

The use of CBD products is prohibited for use by service members

Recommended Content:

Armed Forces Medical Examiner System | Substance Abuse

DHA PM 6025-01: Primary Care Behavioral Health (PCBH) Standards

Policy

This Defense Health Agency-Procedures Manual (DHA-PM), based on the authority of References (a) and (b), and in accordance with the guidance of References (c) through (i), establishes the Defense Health Agency’s (DHA) procedures to establish required standards for: a. Military Medical Treatment Facilities (MTFs) and primary care clinics for adult, child and adolescent, health behavior, behavioral medicine, and behavioral health services in primary care. b. Behavioral Health Consultants (BHCs). c. Behavioral Health Care Facilitators (BHCFs). d. External Behavioral Health Consultants (EBHCs). e. Primary Care Clinic Leaders.

Shining light on those wintertime blues

Article
1/8/2020
Seasonal Affective Disorder (SAD) affects millions of Americans every year and is believed to be more common in parts of the country where the sunshine is less prevalent, such as here. SAD symptoms can include a down mood, loss of interest in activities that are normally enjoyable, change in appetite, sleep patterns, fatigue and loss of energy. (Navy photo by Douglas Stutz)

About seven percent of people experience a depressive episode every year

Recommended Content:

Mental Wellness | Sleep

Air Force warns Airmen of e-cigarette risks

Article
12/16/2019
An Airman holds an electronic cigarette at Scott Air Force Base, Illinois. The Centers for Disease Control and Prevention is investigating the more than 2,000 cases of e-cigarette, or vaping, product use associated lung injury that have occurred across the country. (U.S. Air Force photo by Airman 1st Class Erica Crossen)

Many e-cigarette products have a higher concentration of nicotine

Recommended Content:

Substance Abuse | Tobacco-Free Living

Don’t die for the high: Fentanyl kills

Article
12/11/2019
Due to the increasing relevance of the drug, the Department of Defense added fentanyl and its metabolite, norfentanyl to all service Drug Demand Reduction Program drug tests. (U.S. Air Force photo by Staff Sgt. Nicole Leidholm)

Fentanyl is up to 100 times stronger than morphine

Recommended Content:

Substance Abuse

Mental Health Professionals

Congressional Testimony
11/26/2019

S. 3129, SAC Report for FY 2019, 115-290, Pg. 211

Recommended Content:

Mental Health Care | Mental Wellness

DoD adds fentanyl to drug testing panel

Article
11/22/2019
An Airman from the 436th Air Wing inspects a bottle before being asked to provide a urine sample November 8, 2019. The DoD has a zero tolerance policy for the illegal or improper use of drugs by service members. (U.S. Air Force photo by Staff Sgt. Nicole Leidholm)

Fentanyl is an opioid, similar to heroin

Recommended Content:

Substance Abuse | Armed Forces Medical Examiner System

Are you sad or are you SAD?

Article
11/20/2019
Some individuals suffer from Seasonal Affective Disorder (SAD), also referred to as Depressive Disorder. As the name suggests, it’s a form of depression that occurs during the seasonal change to winter. (U.S. Air Force photo by Trevor Cokley)

In the U.S., SAD is estimated to affect 10 million people

Recommended Content:

Mental Wellness

Getting creative: Reducing opioid use for returning warriors

Article
11/5/2019
Airmen of the 174th Attack Wing participate in a weekly yoga class. Classes are intended to present an alternative way for 174th members to build both mental and physical strength. Yoga is also a way to alleviate chronic pain in the body. (U.S. Air Force photo by Staff Sgt. Duane Morgan)

With the rise in opioid-related drug abuse and death, the Military Health System looks to complementary pain management treatments

Recommended Content:

Opioid Safety | Pain Management | Warrior Care

Suicide Prevention spotlight: Military behavioral health technicians

Article
10/1/2019
Senior Airman Brandon Haag goes through new patient paperwork, Feb. 9, 2015, at the Mental Health clinic on Scott Air Force Base, Ill. A typical protocol when a new patient comes in is getting to know the background history of the patient to help them and the provider they will see know what will help in a crisis or difficulty. Haag is a 375th Medical Group mental health technician. (U.S. Air Force photo/Airman 1st Class Erica Crossen)

Suicide prevention is aided by behavioral health technicians in many settings

Recommended Content:

Mental Wellness | Suicide Prevention

Health agencies investigating severe lung illnesses linked to e-cigarette use

Article
9/12/2019
"While the CDC investigation of the possible cases of lung illness and deaths reportedly associated with the use of e-cigarette products is ongoing, Service members and their families or dependents are encouraged not to use e-cigarette products,” advised Dr. Terry Adirim, Deputy Assistant Secretary of Defense, Health Services Policy and Oversight. (DoD photo)

Thirty-three states report 450 possible cases, six deaths

Recommended Content:

Tobacco-Free Living | Substance Abuse | Public Health

Opioid Abuse and Non-Opiate Pain Management

Congressional Testimony
7/12/2019

H.R. 6157, HAC Report for FY 2019, 115-769, Pg. 298

Recommended Content:

Opioid Safety | Pain Management

New clinical recommendations on cognitive rehabilitation for TBI released

Article
6/24/2019
Dr. Gregory Johnson (right), Tripler Concussion Clinic medical director, has Army Spc. Andrew Karamatic, Department of Medicine combat medic, follow his finger with his eyes during a neurologic exam at Tripler Army Medical Center, Honolulu. (U.S. Air Force photo by Staff Sgt. Christopher Hubenthal)

Cognitive rehabilitation focuses on improving thinking and communication skills

Recommended Content:

Mental Health Care | Traumatic Brain Injury | Mental Wellness

Practicing yoga to stimulate the mind, body, spirit

Article
6/21/2019
Dr. Bhagwan Bahroo, staff psychiatrist, demonstrates a deep-breathing posture as he leads a weekly yoga class for Psychiatry Continuity Service Program participants at Walter Reed National Military Medical Center. (DoD photo by Leigh Culbert)

Programs at Walter Reed incorporate yoga basics to promote healing

Recommended Content:

Mental Wellness | Mental Health Care

Opioid Safety Do's and Don'ts

Infographic
6/7/2019
This infographic provides a list of do's and don'ts if you or a loved one is prescribed an opioid.

This infographic provides a list of do's and don'ts if you or a loved one is prescribed an opioid.

Recommended Content:

Opioid Safety
<< < 1 2 3 4 5  ... > >> 
Showing results 1 - 15 Page 1 of 7

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing | Download a PDF Reader or learn more about PDFs.