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Drug policy: Sailors must follow prescription

Jun. 9, 2012 - 10:56AM   |   Last Updated: Jun. 9, 2012 - 10:56AM  |  
Stricter prescription drug regulations require sailors to follow prescriptions exactly.
Stricter prescription drug regulations require sailors to follow prescriptions exactly. (Utah Attorney General)
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dod and drug abuse

The Navy started testing for benzodiazepines and hydrocodones in response to a Defense Department policy change announced Jan. 30.
DoD officials were concerned with rising prescription drug misuse rates. Twelve percent of troops use medicines improperly compared with 4 percent of civilians, according to the most recent DoD Survey of Health Related Behaviors Among Active Duty Military Personnel.
In the 2008 survey data, researchers found 14.7 percent of sailors said they had abused pain relievers in the past year and 4.5 percent said they had abused tranquilizers.
Some of the brand-name drugs targeted by the new policy, according to the Drug Enforcement Administration:
Benzodiazepines: Ativan, Ambien, Centrax, Doral, Klonopin, Librium, Paxipam, Serax, Tranxen, Valium, Xanax
Hydrocodones: Vicodin, Lortab, Lorcet-HD, Hycodan, Vicoprofen

The goal of the Defense Department's new drug testing policy is clear: stop troops from misusing prescription meds. But there's a gray area when it comes to enforcement, and having a doctor's scrip may not be enough to keep you out of trouble.

The policy, outlined in a fleetwide message, took effect May 1 and added benzodiazepines and hydrocodones to the list of substances screened in urinalysis tests. Benzodiazepines, such as Ambien, Xanax and Valium, can be used to treat insomnia or anxiety. Hydrocodones, such as Vicodin, are prescribed to treat coughs and pain.

Sailors who "pop positive" for any of these drugs but have a valid prescription in their medical records won't be punished, according to the message, NAVADMIN 130/12.

The key word is "valid."

Sailors have to follow the instructions on the bottle to the letter. Not doing so could end a career, lawyers say. Sailors who are unsure about their prescription should consult their primary care manager before taking pills, according to the Navy Bureau of Medicine and Surgery.

"A service member cannot be subjected to discipline for use of a controlled prescription medication if taken in accordance with the prescriber's instructions and intended treatment plan," BUMED spokeswoman Shoshona Pilip-Florea said.

Problems can arise, for example, if a sailor uses pain medication long after the initial symptoms were alleviated. Say a sailor has Vicodin prescribed "as needed" for back pain. He saves a few pills and takes them when the pain flares up again — a few years later.

If this sailor gets flagged in a urinalysis test, convincing his commander he has a valid prescription could be tough. The same goes if a sailor gets pills for back pain but later uses them for another ailment — neck pain, for example.

BUMED would not speak about specific scenarios because each incident is handled on a case-by-case basis, Pilip-Florea said.

BUMED said there are established procedures for handling positive urinalysis results. The sailor's commanding officer or a designated person in the chain of command investigates how and why the drug was used. The procedure includes consulting the sailor's physician.

The physician tells the sailor's chain of command whether the medicine was taken in line with the doctor's instructions and makes a recommendation. The CO is responsible for deciding how to proceed from there, Pilip-Florea said.

Lawyers who regularly represent service members who have been charged with a drug crime said the legality of using a prescription medicine long after it was prescribed depends on the doctor's instructions. They said sailors should carefully read the label on the medicine bottle; those words could determine whether the drug can be taken after it's been sitting awhile in the medicine cabinet.

"You would have to follow what the doctor's orders are," said Stephen Karns, a former Army judge advocate who now defends service members. For example, if a prescription says to take a drug twice a day for back pain as needed for 10 days, taking any pills on Day 11 or afterward is not allowed.

If the prescription is more open-ended, a sailor has more wiggle room, Karns said, as would a sailor whose prescription didn't mention the specific ailment being treated.

"If you take drugs outside the prescription, that is abuse of drugs, technically," said Bruce White, a retired Marine colonel and JAG officer who now defends service members.

Sailors' primary care managers will be able to clarify questionable drug scenarios, BUMED said. Oftentimes they can do this over the phone or via email, and a sailor's physician or corpsman can note the advice in medical records.

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