For example, dozens of records list only generic descriptions for cause of death, such as “mixed drug toxicity” or “drug intoxication.”
Still, at least a third of the accidental overdose deaths specifically involved some type of narcotic painkiller, the investigation reveals.
Topping the list is methadone, a synthetic narcotic popularly known as a medication prescribed to help heroin addicts kick the habit but now widely prescribed as a painkiller. It has contributed to at least 60 military deaths — more than any other drug, legal or illegal, according to the data.
These painkillers belong to a family of medications known as opioids, synthetic versions of opium. With names such as methadone and oxycodone (brand name OxyContin), these drugs have found wide use in the past decade in the treatment of chronic pain.
Opioids in high doses, or when mixed with alcohol or other drugs, can depress the central nervous system, sometimes fatally.
About one in seven soldiers is currently prescribed some form of opiate, according to the Army.
Opioids are particularly dangerous, experts say, when combined with another class of drugs called benzodiazepines, or “benzos.” With names like alprazolam (brand name Xanax) and diazepam (Valium), these drugs are commonly prescribed to treat anxiety, including post-traumatic stress disorder.
However, benzodiazepines increase the respiratory-depressant effect of narcotics. Taken together improperly, they can stop the respiratory system entirely.
According to the military data, at least two dozen deaths involved a combination of opioids and benzodiazepines.
“One thing we’ve learned in the last decade is that the effect of opioids, like methadone, is enhanced when it’s co-ingested with a benzodiazepine,” said Dr. Bruce Goldberger, a professor and director of toxicology at the University of Florida.
Some experts peg the spike in prescription-drug use to the tens of thousands of physically and mentally wounded returning from two war fronts over the past decade. They are being prescribed drugs to which they often become addicted or abuse either willfully or through lack of proper medical oversight.
Goldberger pointed to the challenges of treating those returning from the war zones.
“PTSD patients suffer from anxiety disorders, so they would be prescribed drugs like Xanax, but also may be seeking treatment for pain, so they’re being prescribed drugs like methadone,” he said. “It’s really a very complicated medical situation.”
Dr. Lynn Webster, medical director of Lifetree Clinical Research and Pain Clinic in Salt Lake City, who has written extensively about safe prescribing practices, encouraged family members to be extra vigilant and closely monitor loved ones on these medications, particularly at night. Be on the lookout for heavy snoring or long pauses between breaths, he said.
“These are signs that happen prior to dying,” he said. “Family members can fail to recognize that this is an impending calamity.”