Fighting prescription drug abuse among wounded soldiers uneven, report says

• The Pentagon should make sure close monitoring of drug use is uniform
• A thousand drug overdoses reported in one year.
• Military needs to be able to take back unused pills to avoid abuse.

Even after a dozen years of war, top Pentagon health officials have yet to impose uniform standards on fighting prescription medication abuse among troops wounded in combat, according to a Defense Department inspector general's report issued Friday.

The result is a patchwork of efforts among military branches, with some of them tougher than others in making sure that a recovering service member isn't abusing prescription pain pills or psycho-tropic medications, the report said.

Investigators found, for example, that the Army has an aggressive policy to guard against wounded troops "doctor shopping" and using the same prescription to obtain more pills than they are prescribed, potentially for abuse. The Army threshold for closely monitoring a soldier's prescription practices is when he or she is receiving four drugs, including one that is a controlled substance.

The Navy also provides the same scrutiny, but at some locations the threshold is only if a sailor or Marine is receiving five controlled substances.

"Medication management polices, especially for the high-risk patient population of wounded warriors, need to be standardized," the report said.

Dr. Jonathan Woodson, the Pentagon's top medical officer, said he agreed with the report's findings. Corrective steps are being taken, according to responses cited in the report.

The inspector general report is the second review in two days critical of Pentagon healthcare practices. A study issued Thursday by the Institute of Medicine complained that dozens of programs have been launched across the military during the wars in Iraq and Afghanistan aimed at preventing mental illness, but there is little evidence that any work.

The inspector general report issued Friday noted that in 2010 -- the latest data cited -- nearly a thousand troops were hospitalized for drug overdoses. A Pentagon health survey of troops conducted the next year found that one in four use pain medication.

The IG report focused on a potential drug abuse among patients who are supposed to receive the most focused care in so-called Wounded Warrior units. Dozens of overdose deaths have occurred in these units during the war years.

The report also urges the Pentagon to be more aggressive in seeking federal approval for allowing pharmacies to take back unused medication from troops.

Currently, these "take-back" programs are conducted only twice a year at military installations under the legally required auspices of the federal Drug Enforcement Administration.

The inspector general said the Pentagon should speed efforts to obtain DEA authority to conduct take-back programs routinely at military pharmacies.

"Wounded warriors did not have a reliable, safe, accessible and accountable method to dispose of medications that were no longer needed for treatment," the report said.