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Many troops who take prescriptions for pain or psychiatric conditions leave the service without a plan to transfer their medications, leaving them open to serious health consequences related to withdrawal or abuse, a new government report finds.
Between 2009 and 2011, 94,000 service members — about one in 12 — left the military with a psychiatric or pain medication prescription. Fewer than half, 47 percent, directly transitioned to Veterans Affairs Department care where their adherence to their medication regimen could be tracked, according to the Government Accountability Office.
The others were discharged or demobilized without arrangements for continuing their prescriptions. In some cases, they left without a list of their medicines or even a copy of their medical records, GAO noted in "Medication Needs During Transitions May Not Be Managed for All Servicemembers," published Nov. 14.
The transition is significant, GAO analysts said, because it is a time when patients are at risk for "misuse or inappropriately discontinuing their use of medications."
"Patients can discontinue taking medications at any time, including while they are under a provider's care, but literature suggests there is greater risk for these issues during transition periods," the report states.
Troops in special programs, including those with severe medical problems or enrolled in warrior transition units, have access to transition assistance programs, including transferring prescriptions to VA.
But the Pentagon lacks a formal policy for all troops who leave the service.
"The efforts available to all service members are limited," the report stated.
According to GAO, more than 9 percent of the 378,000 troops that left the service in 2011 had an active prescription for a pain medication or psychiatric drug.
The most commonly prescribed medication, prescription-strength ibuprofen, doesn't cause adverse health effects when discontinued.
But other prescriptions including opioids and mental health medications, can cause withdrawal symptoms or exacerbate a condition when abruptly stopped, the report noted.
Non-steroidal anti-inflammatories accounted for the top four pain medications prescribed to discharged troops: ibuprofen, naproxen, meloxicam and Celebrex. Percocet ranked fifth, making up 7 percent of the pain prescriptions between 2009 and 2011.
The four most common psychiatric medications prescribed to troops discharged from 2009-2011 were Zoloft, accounting for 12 percent of the prescriptions, Celexa, trazadone and Wellbutrin.
Quetiapine, an anti-psychotic medication also known by the brand name Seroquel, ranked fifth, at 6 percent of the psychiatric prescriptions.
In its report, GAO recommended the Pentagon:
• Develop a transition policy for all service members, including providing a list of current medications to all members leaving the service.
• Work closely with VA to manage service members' prescription requirements during transition.
In its response, the Pentagon concurred with GAO's findings but said it would be "burdensome" to have a stand-alone process for providing each departing service member a list of medications.
Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson noted troops can get a current list within a copy of their medical records and said VA providers can access the information.