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Time is running out: The MISSION Act is failing our veterans who struggle with addiction

Hundreds of service members at Fort Belvoir Community Hospital gathered during a spring formation and uniform transition ceremony May 4, 2017. (Reese Brown/Fort Belvoir Community Hospital)
October 28, 2020

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Substance Use Disorder (SUD) among Veterans is a growing problem resulting in overdose, suicide, alcohol poisoning, liver disease, etc., yet when a Veteran asks for help it is not viewed or treated as an emergency situation. Leading up to the presidential election, both President Donald Trump and Democratic presidential nominee Joe Biden have made caring for America’s Veterans a top campaign priority. Biden’s plan includes expanding access to emergency mental health treatment, and Trump recently released the PREVENTS roadmap aimed at preventing suicide among Veterans.

Without major adjustments to current operating procedures, thousands of Veterans will be left missing in action by a VA system that’s still poorly equipped to handle the onslaught of patients. Regardless of who wins the election, Americans must demand—and hold our leaders accountable for—immediate changes that will give our Veterans urgent access to substance use treatment that can save thousands of lives each year.

The Numbers are Piling Up & Time is Running Out

One in 15 Veterans had a SUD in the past year, with the issue most prevalent in those who’ve served since September 2001. In fact, about 1 in 10 vets seen at the VA returning from the wars in Iraq and Afghanistan have a problem with alcohol or other drugs. And given the strong connection between PTSD and substance use, it’s no surprise that 1 out of every 3 vets who seek treatment for SUD also have PTSD.

Already this year, American Addiction Centers has fielded more than 600 calls from Veterans seeking help for substance use issues and the number grows every day. Of those, less than half were able to get the help they needed through the VA’s Community Care Network, self-pay or private insurance. That means more than half (53%) fell off the radar and didn’t get treatment simply because we couldn’t move them through the VA system in time.

Why not? When a Veteran calls for help, we have a very small window to intervene—typically just 24-48 hours, during the peak time of crisis. After that, most vets fall off the radar and back into their usual pattern of substance use. Tragically, that single phone call may be the only one they ever make to get help; the shame, embarrassment and substance-driven clouded judgment may prevent them from ever calling again. If we can’t get them into treatment immediately—within that 24-48 hour window—we may have lost the opportunity, and could lose the Veteran completely to overdose, suicide or the disastrous health effects of long-term substance use.

MISSION Act Missing the Mark

So, what’s the hold up on providing urgent SUD care? The Community Care referral process looks good on paper, but in reality, is far too cumbersome. The MISSION Act allows Veterans access to community care at non-VA facilities, but SUD is not viewed or treated as an emergency situation.

Instead, to receive treatment, a Veteran must first contact the VA and request a community care consult, which may take several days or even weeks to get on the schedule (the MISSION Act allows for up to 21 days). Once the consult is completed it is forwarded to the community care office, which may take a few days to review and approve. We owe it to our vets to get them the help they need when they need it, not make them wait for days or weeks. We may never get another chance.

Urgent Demand Calls for Urgent Care

We must take swift action to get our Veterans the help they need immediately in order to turn the tide of substance use disorder, overdose and suicide among American heroes. Here’s what we need from our next president to make it happen:

  1. Treat a call for help as a medical emergency. We know that people die from addiction—from overdose, alcohol poisoning, liver disease, etc.—but when they reach out for help, it’s not viewed with urgency by much of the VA system. Instead, it’s treated as a non-acute condition and Veterans are funneled into the community care referral process, and that’s where we lose them. We need a broad-scale attitude and policy change at the VA that treats a call for help as an emergency and allows us to get a Veteran into treatment within that critical 24-48 hour window.
  2. Emergency room consultation and immediate referral to care. Many Veterans go to their local emergency room for treatment of acute conditions including intoxication and overdose. But, since addiction isn’t viewed as an emergency, the VA may send the Veterans home after stabilization and not authorize and/or pay for community care. In addition, we need across-the-board authorization for Veterans to walk into their local emergency room and get the community care consult on the spot.
  3. More support for telehealth. A new bill just signed into law on Oct. 17 by President Trump has recently expanded access to telehealth for Veterans, which is a strong move in the right direction. Giving our vets access to remote mental and behavioral health resources can help them overcome the barriers to care caused by COVID restrictions and lack of access to providers in rural areas. However, we desperately need more telehealth providers in order to turn this policy into a practical solution. I urge our next president to increase funding to hire more personnel trained in addiction, mental and behavioral health treatment to serve our Veterans.

The medical community and society as a whole are finally beginning to recognize addiction and SUD as a disease, which is exactly what’s needed in order to devise urgent, effective treatment to help America’s Veterans. But it will take more than new policy to solve the problem.

Now, we must urge our leaders to enact real, ground-level change in the way vets gain access to addiction treatment when they need it most—during that critical 24-48-hour window. Without emergency intervention, we could lose them forever, and that’s a terrible tribute to the men and women who’ve risked their lives fighting for our freedom.

Georgie Koppermann, VP of Military Affairs, American Addiction Centers