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Combating heroin addiction in Vietnam vets and what we can learn in today’s epidemic

Posted on 02-28-16 in Addiction, PTSD, Recovery

Opiate use was prevalent among American soldiers deployed in Southeast Asia during the Vietnam War — an estimated 10 to 20 percent of soldiers serving in Vietnam were addicted to heroin and other illicit drugs. The 1970s “heroin epidemic” affected a large percentage of U.S. soldiers serving in Vietnam and substantially increased the number of drug-related hospitalizations and overdose deaths.

Concurrently, there was a rapid increase in illicit drug use among youth during the 1960s. Both the Nixon administration and American public feared that large numbers of veterans addicted to opium and heroin would further spread drug use in the U.S. Similar to the opioid epidemic we face today, Operation Golden Flow highlights the importance of environmental factors and early intervention in reducing drug addiction.

President Nixon’s Operation Golden Flow

The stressful combat situations experienced by soldiers during the war; widespread availability of cheap, high-quality and extremely potent heroin in Vietnam in 1970; and reduced taboos against drug use in Vietnam compared to the U.S. were major factors that contributed to the high rates of heroin use among American soldiers, said Duncan Stanton, Ph.D., with the University of Pennsylvania.

In response to the growing heroin epidemic among soldiers serving in Vietnam, President Richard M. Nixon declared a “War on Drugs.” Through the Special Action Office for Drug Abuse Prevention’s (SAODAP) Date Eligible for Return from Overseas (DEROS) program, Operation Golden Flow required soldiers to submit a urine sample for drug screening by urinalysis prior to returning to the U.S. Soldiers who tested positive for drugs such as opiates, amphetamines or barbiturates at the DEROS screening were given early intervention for drug addiction and went through detoxification for five to seven days prior to their return home.

In the 1973 Vietnam Drug User Returns report, Lee N. Robins, Ph.D., with the Washington University School of Medicine, indicated that approximately 1,400 of the 13,760 Army-enlisted men who had returned to the U.S. from Vietnam in September 1971 tested positive for drugs (narcotics, amphetamines or barbiturates) at the time of departure.

The SAODAP assisted in a follow-up study of the military men who had returned from Vietnam to the U.S. in September 1971. Remarkably, the number of positive drug tests significantly decreased following Operation Golden Flow. Only a year after soldiers’ return to the U.S., opiate addiction rates were down to 1 percent among soldiers, and only 5 percent of men who returned home after becoming addicted in Vietnam relapsed within a year.

Subsequent relapse was also uncommon among soldiers returning to Vietnam. In fact, only 12 percent of soldiers relapsed within three years, according to the second follow-up in 1974. The results indicated that by subjecting soldiers to a mandatory drug urinalysis screening and providing them with early intervention for drug addiction, the prevalence of heroin and other drug abuse and addiction was significantly reduced in this population.

Role of the environment in drug addiction

During Operation Golden Flow, it became apparent that addiction was a brain disease that was also impacted by environmental factors affecting soldiers, including boredom and stress. Not only was Vietnam’s location and culture very different from that of the U.S., but soldiers were surrounded by the widespread use and availability of illicit drugs.

Illicit drugs were also highly potent and cheap, and many soldiers turned to drug use as a way to self-medicate or deal with stressful and horrific experiences of combat. Importantly, many of the environmental factors contributing to the widespread use of illicit drugs among American soldiers were no longer present following the soldiers’ return to the U.S., which may have contributed to the large decrease in drug addiction rates.

It turns out that both genetics and environmental factors play an important role in whether a person initiates drug use and becomes addicted to alcohol or drugs. While genetic factors increase a person’s vulnerability for developing an addiction, genes only account for a percentage of the risk involved in drug and alcohol dependence.

Researchers examining risk factors involved in drug and alcohol addiction consider environmental factors (i.e., characteristics in a person’s surroundings) — such as poverty, drug availability, stress, exposure to drug use among family and friends, family conflict and childhood abuse — to significantly increase a person’s susceptibility to developing drug addiction.

Importance of early intervention for opioid dependence

Heroin use has re-emerged as a significant problem in the U.S., and today we are facing yet a similar opioid epidemic. Addiction to heroin and prescription opioid pain medications such as OxyContin and Vicodin are occurring at alarming rates — there were approximately 1.9 million people who were addicted to prescription opioid pain medications and 435,000 people who were regular users of heroin in 2014.

In addition, overdose deaths due to prescription opioid pain medications and heroin have increased in the past 10 years. Forty-four people die in the U.S. every day from overdose of prescription opioid pain medications, and heroin-related overdoses nearly quadrupled between 2002 and 2013, according to the Centers for Disease Control and Prevention (CDC).

There is much to learn from how the heroin epidemic has been dealt with successfully in the past and the high success rate seen with Operation Golden Flow. Drug addiction among soldiers serving in Vietnam was greatly reduced by disrupting the environment. Just as early intervention for drug use was important for the soldiers serving in Vietnam, the intervention for drug use and co-occurring problems is also important among youth who are now initiating heroin and other drug use.

The Sovereign Health Group provides evidence-based behavioral health treatment plans for patients with substance abuse, mental illness and co-occurring disorders. Detoxification and urinalysis drug screening is provided for patients with substance use problems during treatment. For more information on our treatment programs, please contact our 24/7 helpline.

About the author

Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at news@sovhealth.com.