"If a service member had an honorable discharge and then is diagnosed with PTSD by Veterans Affairs, the VA doesn't share its records with the Department of Defense, so [the latter] is free to call those veterans up," says Paul Sullivan, an Army veteran, former VA project manager, and executive director of Veterans for Common Sense. "The veteran has two choices: tell them about the condition or not. Even then, you can say, 'I might have PTSD, but I want to go.' "
Those who get home and stay in the States are frequently met with a VA course of treatment that's more concerned with keeping costs down than working toward true mental and emotional stabilization.
"They're [the VA] in the dark ages in a number of different areas," says Gordon Erspamer, the California-based lead attorney in a class-action lawsuit against the VA that attempted to get immediate treatment for all veterans with PTSD. "On the health-care side, the veterans I've spoken to say that, even if you get in to see them, they give you four or five pills, [ask you to] come back, [then offer] group-therapy sessions one day a month — and the health care is rationed."
Nearly everyone contacted for this story agreed with Erspamer (whose federal lawsuit failed this past year and is heading into appeals) that group therapy (which — by admitting to a weakness in front of your peers — is anathema to those in the military culture) and medication are seemingly the VA's only means of dealing with mental-health issues.
The Pentagon's inadequate internal communications are more troublesome when trying to identify the medications a soldier has taken on the battlefield. Where a combat soldier could procure meds in the field with few repercussions, that same soldier returns home a veteran with no proof of his prescription record. This could lead to complications or downturns from coming off the medication, or having to deal with the stigma of re-diagnosis, especially if it's done at a VA center or in group therapy, where other veterans are present. Health experts say many veterans struggling with reintegration into civilian life would rather stop treatment altogether than feel reduced in the eyes of their peers.
With nearly 150,000 mental-health patients in the VA system, lack of communication between the VA and DoD increases the risk that a vet with medication-dependency problems will fall through the cracks into full-fledged abuse. In response to a FOIA request by the Phoenix, the VA says it has seen the number of veterans from Iraq and Afghanistan treated for addiction to prescription drugs annually rise from 961 in 2005 to 1865 in 2006, 2996 in 2007, and 4646 in 2008. Military medical experts and veterans say that underreporting by embarrassed or ashamed vets may be keeping those numbers from rising further.
If veterans aren't getting prescriptions filled, or are too ashamed to seek proper treatment, both doctors and veterans say they may turn to the next best thing. Whether it be cocaine or methamphetamine to simulate the rush of combat, or heroin to satiate an opiate addiction brought on by painkillers, substitutes are plentiful.