[Congressional Record (Bound Edition), Volume 154 (2008), Part 12]
[Extensions of Remarks]
[Pages 16647-16648]
[From the U.S. Government Publishing Office, www.gpo.gov]


   EXPRESSING CONCERN FOR THE UNMET MENTAL HEALTH NEEDS OF RETURNING 
                                SOLDIERS

                                 ______
                                 

                         HON. CHARLES B. RANGEL

                              of new york

                    in the house of representatives

                         Monday, July 28, 2008

  Mr. RANGEL. Madam Speaker, I rise today to enter into the Record an 
article from the New York Times published on July 8, 2008 titled 
``After the Battle, Fighting the Bottle at Home.''
  Alcohol abuse is rising among Afghanistan and Iraq veterans, many of 
them trying to deaden the repercussions of war and disorientation of 
home. The problem is particularly prevalent among those suffering from 
post-traumatic stress disorder. Increasingly, these veterans are 
spilling into the criminal justice system. Their stories are similar: 
coming back from war with lost jobs, crushing debt and ruptured 
families.
  In May, House and Senate passed bills that would require the 
veteran's agency to expand substance-abuse screening and treatment for 
all veterans. However, this legislation does not provide immediate 
relief to veterans. For active duty service members, the military faces 
a shortage of substance-abuse providers on bases across the country, 
while the insurance plan, Tricare, makes it difficult for many 
reservists and their families to get treatment. Finding treatment 
programs that accept Tricare often ends in frustration and few 
residential rehabilitation programs have the accreditation required by 
the plan. An advocacy group, Veterans for America, found the demand for 
psychological help was so great, and the system so burdened, that 
soldiers often waited a month to be seen.
  The Pentagon's most recent survey of health-related behavior found 
that for the first time in more than 20 years, a quarter of the 
soldiers surveyed considered themselves heavy drinkers, defined as 
having 5 or more drinks at least once a week. Consequently, suicides 
have also reached a high in the Army last year in which alcohol or 
drugs were cited in 30 percent of the 115 cases, the Pentagon reported.
  Last January, a city court judge in Buffalo, Robert T. Russell, 
noticed a surge of recent veterans with substance-abuse and mental-
health problems in the city's courtrooms. He created the Nation's first 
Veterans Court, where, instead of jail, veterans arrested for low-level 
crimes, mostly tied to alcohol or drugs, are enrolled in treatment.

                [From the New York Times, July 8, 2008]

             After the Battle, Fighting the Bottle at Home

                          (By Lizette Alvarez)

       Most nights when Anthony Klecker, a former marine, finally 
     slept, he found himself back on the battlefields of Iraq. He 
     would awake in a panic, and struggle futilely to return to 
     sleep.
       Days were scarcely better. Car alarms shattered his nerves. 
     Flashbacks came unexpectedly, at the whiff of certain 
     cleaning chemicals. Bar fights seemed unavoidable; he nearly 
     attacked a man for not washing his hands in the bathroom.
       Desperate for sleep and relief, Mr. Klecker, 30, drank 
     heavily. One morning, his parents found him in the driveway 
     slumped over the wheel of his car, the door wide open, wipers 
     scraping back and forth. Another time, they found him curled 
     in a fetal position in his closet.
       Yet only after his drunken driving caused the death of a 
     16-year-old cheerleader did Mr. Klecker acknowledge the depth 
     of his problem: His eight months at war had profoundly 
     damaged his psyche.
       ``I was trying to be the tough marine I was trained to be--
     not to talk about problems, not to cry,'' said Mr. Klecker, 
     who has since been diagnosed with severe post-traumatic 
     stress disorder. ``I imprisoned myself in my own mind.''
       Mr. Klecker's case is part of a growing body of evidence 
     that alcohol abuse is rising among veterans of combat in 
     Afghanistan and Iraq, many of them trying to deaden the 
     repercussions of war and disorientation of home. While the 
     numbers remain relatively small, experts say and studies 
     indicate that the problem is particularly prevalent among 
     those suffering from post-traumatic stress disorder, as it 
     was after Vietnam. Studies indicate that illegal drug use, 
     much less common than heavy drinking in the military, is up 
     slightly, too.
       Increasingly, these troubled veterans are spilling into the 
     criminal justice system. A small fraction wind up in prison 
     for homicides or other major crimes. Far more, though, are 
     involved in drunken bar fights, reckless driving and alcohol-
     fueled domestic violence. Whatever the particulars, their 
     stories often spool out in unwitting victims, ruptured 
     families, lost jobs and crushing debt.
       With the rising awareness of the problem has come mounting 
     concern about the access to treatment and whether enough 
     combat veterans are receiving the help that is available to 
     them.
       Having cut way back in the 1990s as the population of 
     veterans declined, the Veterans Health Administration says it 
     is expanding its alcohol- and drug-abuse services. But 
     advocacy groups and independent experts--including members of 
     a Pentagon mental-health task force that issued its report 
     last year--are concerned that much more needs to be done. In 
     May, the House and Senate passed bills that would require the 
     veterans agency to expand substance-abuse screening and 
     treatment for all veterans.
       ``The war is now and the problems are now,'' said Richard 
     A. McCormick, a senior scholar for public health at Case 
     Western Reserve University in Cleveland who served on the 
     Pentagon task force. ``Every day there is a cohort of men and 
     women being discharged who need services not one or two or 
     five years from now. They need them now.''
       For active-duty service members, the military faces a 
     shortage of substance-abuse providers on bases across the 
     country, while its health insurance plan, Tricare, makes it 
     difficult for many reservists and their families to get 
     treatment.
       In the breach, a few states, including California, 
     Connecticut and Minnesota, have passed laws or begun programs 
     to encourage alternative sentences, often including 
     treatment, for veterans with substance-abuse and mental-
     health problems.
       In recent years, the military has worked to transform a 
     culture that once indulged heavy drinking as part of its 
     warrior ethos into one that discourages it and encourages 
     service members to seek help.
       ``The Army takes alcohol and drug abuse very seriously and 
     has tried for decades to deglamorize its use,'' said Lt. Col. 
     George Wright, an Army spokesman. ``With the urgency of this 
     war, we continue to tackle the problem with education, 
     prevention and treatment.''
       That is a tricky mission in time of war.
       ``The problem in today's military is soldiers have to be 
     warriors, killers, do war, but we don't allow them any 
     releases like we used to,'' said Bryan Lane, a former special 
     forces sergeant who sustained a traumatic brain injury in 
     Iraq and has post-traumatic stress disorder, or PTSD. ``You 
     can't go out and drink, you can't get into a fight. It's 
     completely unrealistic.''
       The military, he said, is trying to create a contradiction: 
     ``a perfect warrior, and then a perfect gentleman.''
       Warning Signs Grow
       Fort Drum, in the North Country of New York just outside 
     Watertown, is home to the Army's most-deployed brigade--the 
     Second Brigade of the 10th Mountain Division. Late last year, 
     several thousand soldiers returned after 15 months in Iraq. 
     Some had served three, even four, tours, and they quickly 
     overwhelmed the base's mental health system. A study by an 
     advocacy group, Veterans for America, found the demand for 
     psychological help was so great, and the system so 
     overburdened, that soldiers often waited a month to be seen.
       Many also did what generations of homecoming soldiers have 
     done: they salved their wounds in local bars. With drinking 
     off-limits in Iraq, at least openly, they were that much more 
     likely to binge, that much less able to tolerate it.
       The base's commander, Maj. Gen. Michael L. Oates, says that 
     since his arrival in early 2007, misconduct related to 
     substance abuse has reached ``unacceptable'' levels, despite 
     a toughened regimen of education, designated-driver programs 
     and penalties.
       ``The rate of illegal drug use is slightly up; the rate of 
     alcohol is more than slightly up,'' General Oates said. ``I'm 
     not a teetotaler. I'm not against people drinking. I'm 
     against misconduct.''
       By last March, he had seen enough. He ordered the base's 
     newspaper, The Fort Drum Blizzard, to publish the names and 
     photographs of all soldiers charged with drunken driving. To 
     date, at least 116 have appeared. Half were combat veterans 
     who had returned in the last year, the general said, though 
     others may have deployed earlier.

[[Page 16648]]

       Most returning soldiers readjust after a few months. But 
     the general estimated that at least 20 percent turned to 
     heavy drinking or drugs--typically ``the first signal that 
     there is something wrong.''
       Across the military, the precise dimensions of the problem 
     are elusive, especially since the different branches largely 
     keep their own statistics. Many studies do not distinguish 
     between servicemembers who have seen battle and those who 
     have not. What is more, behavior becomes far harder to track 
     when servicemembers leave the military.
       Even so, a variety of surveys, as well as anecdotal 
     evidence and rising alarm in many military communities, 
     indicate growing substance abuse among recent combat 
     veterans. Of particular concern are members of the National 
     Guard and reserves, as well as recently discharged 
     servicemembers, who can lose their bearings outside the 
     camaraderie and structure of the military.
       In the Army, which has the bulk of the troops in Iraq and 
     Afghanistan, the Pentagon's most recent survey of health-
     related behavior, conducted in 2005 but released last year, 
     found that for the first time in more than 20 years, roughly 
     a quarter of soldiers surveyed considered themselves regular 
     heavy drinkers--defined as having five or more drinks at 
     least once a week. The report called the increase--to 24.5 
     percent in 2005, from 17.2 percent in 1998--``an issue of 
     concern.''
       Perhaps the best monitor of recent combat veterans'' mental 
     health is the Pentagon's postdeployment survey. Reflecting 
     concern about heavy drinking, the latest report, published 
     last November, introduced a question about drinking habits. 
     Of the 88,235 soldiers surveyed in 2005 and 2006, three to 
     six months after returning from war, 12 percent of active-
     duty troops and 15 percent of reservists acknowledged having 
     problems with alcohol.
       While drug use decreased substantially after 1980, when the 
     military cracked down, it has increased slightly in the Army 
     and the Marines since 2002, the behavioral survey said. 
     Experts say that, in some cases, troubled combat veterans are 
     more prone to use drugs after leaving the military.
       In general, studies find that drinking is more prevalent in 
     the military than in the civilian population; the behavioral 
     survey reported that heavy drinking among 18- to 25-9-year-
     old men in the Army and the Marines was almost twice as 
     common as among their civilian counterparts.
       Heavy drinking or drug use frequently figures in what law 
     enforcement officials and commanders at military bases across 
     the country say is a rising number of crimes and other 
     examples of misconduct involving soldiers, marines and recent 
     veterans.
       ``Alcohol and drug use starts a cascade of worse 
     problems,'' said Dr. McCormick, the task force member, who 
     recently retired as director of mental health for the state 
     veterans affairs system in Ohio. ``It's like throwing 
     gasoline on fire.''
       Most cases involve low-level misconduct. From 2005 to 2006, 
     for example, ``alcohol-related incidents''--mostly drunken or 
     reckless driving and disorderly conduct--more than tripled at 
     Fort Hood, Tex., according to information released to the 
     Pentagon task force. Other statistics showed a similar 
     pattern throughout the Army, a task force member said.
       The Marines, filled with young men drawn by the corps' 
     hard-charging image, have traditionally had the military's 
     highest drinking rates. While the behavior survey showed a 
     slight decrease in heavy drinking after 2002, it showed an 
     increase in binge drinking. The Marines also reported a rise 
     in alcohol-related incidents.
       Sometimes, though, substance abuse becomes a factor in 
     major crimes. This year, a New York Times examination of 
     killings in this country by veterans of Iraq and Afghanistan 
     found that drinking or drug use was frequently involved in 
     the crimes.

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