Shared Burden: The Military and Civilian Consequences of Army Pain Management Since 2001.

摘要

The Army has an opioid drug problem that is not going away under current personnel policies and medical practices. The survey results recorded here indicate that senior officers attending the U.S. Army War College (USAWC) recognize that the opioid problem is distinct in nature and origin from those of recreational drug abuse. Yet, these officers are saddled with a legacy drug enforcement structure and outdated procedures that do not track opioid usage across the force and do not address the root cause of the issue. They are commanding units under a regulatory structure that belatedly responds to opioid-related misuse with the same misconduct-focused disciplinary policies as those for recreational drug use, rather than with a proactive medical and personnel approach crafted for this unique problem set that emphasizes prevention and rehabilitation. The USAWC officer survey responses reflect the fact that the majority of these future Army leaders see misuse originating out of prescribing practices, a lack of medical monitoring, and a lack of soldier training and education on the dangers of opioids, rather than from undisciplined soldiers. This Carlisle Paper is not meant to be the final word, but the beginning of a new conversation. The survey samples were not from random populations, but specifically chosen groups of leaders with specialized knowledge and expertise in this area. The samples presented do not claim to represent the views of all judges or all Army officers. But the trends from their responses are intriguing, as they break from past presumptions and perceived truths regarding opioid use. They suggest a new way of thinking about the Army s opioid problem, as well as its impact on combat readiness and civil-military relations. The comparison of the two surveys reveals that, in most instances, there is not a significant gap between civilian judge and senior Army officer thinking as to the nature and seriousness of the problem.