This literature review of opioid use within the military in light of the ongoing opioid crisis is certainly timely. At the risk of being crass, the most vital weapon system in America’s arsenal of defense is the military service member. Our national survival depends on those young women and men who meet the Department of Defense (DoD) standards and are willing to “protect and defend the Constitution of the United States against all enemies…” I congratulate the authors for providing supportive evidence on the impact of America’s opioid crisis on this most important military asset. Perhaps the most sobering message of this manuscript is the impact the nation’s opioid crisis is having on the age 15–24 population in terms of mortality. Notwithstanding the tragedy that death from opioid overdose represents, the country depends on this same demographic to fill the ranks of our military. A young person with a drug use history is usually precluded from serving in the military or obtaining a security clearance. The first exposure for many young Americans to opioids occurs through the medical community in the management of acute pain after some medical procedure or trauma, possibly trauma incurred while serving in the military. The effectiveness of opioids in the management of acute pain, particularly combat trauma, is without question. Having served in combat support hospitals as an anesthesiologist in both Iraq and Afghanistan, the idea of managing combat trauma without opioids in these environments would be challenging, to say the least. I agree with the authors that opioids, “are an essential component of battlefield medicine.” If one accepts the premise that opioids can be useful medications in certain medical situations, then opioids, per se, are not the problem. LTG Eric Schoomaker, the 42nd Surgeon General of the United States Army, understood this when he commissioned the Pain Management Task Force (PMTF) report in 2010 ...
Language: en
LA - en SN - 0026-4075 UR - http://dx.doi.org/10.1093/milmed/usz490 ID - ref1 ER -