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The Toll of Headache Disorders on Post-9/11 Veterans

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headache disorders-veterans-migraines

Our military veterans face a host of physical, emotional, and mental challenges when returning from deployment, including migraines and headache disorders.

Julienne Verdi

Executive Director, Alliance for Headache Disorders Advocacy

Headache disorders are prevalent in the veteran population, and studies show that veterans are more likely to develop migraines or other persistent headache disorders than civilians. Not surprisingly, migraine diagnoses increased by 27% among all branches of the armed forces from 2001 to 2007, according to a report by the Department of Defense, as a result of deployments in Iraq and Afghanistan. Moreover, post-traumatic headache was found to occur in up to 92% of military personnel who sustained a mild traumatic brain injury (TBI) and was associated with chronic daily headaches. Another study showed that 36% of veterans who had completed a 12-month deployment to Iraq were either diagnosed with or exhibited symptoms of migraine. Globally, migraine is the second leading cause of disability and is a condition associated with reduced quality of life, interference with relationships, decreased work productivity, and higher use of medical services.

Headache Disorders Centers of Excellence

The Alliance for Headache Disorders Advocacy (AHDA), a national organization that secures equitable policies for those living with headache disorders, has been advocating for this community for over a decade. Specifically, AHDA was able to secure funding from Congress in 2018 to create Headache Disorders Centers of Excellence (HCoEs) within the Veterans Health Administration. The initial funding was for at least five centers. AHDA has continued its advocacy for veterans at its annual Headache on the Hill Advocacy Day, where patients, physicians, caregivers, and other advocates meet with their members of Congress to advocate for policy proposals. As a result of these efforts, additional funding was secured in 2019, 2020, and 2021 to increase the number of centers to 19 (7 core or “hub” sites and 12 Consortium sites). During this fiscal year, it is expected that an additional 14 centers will be funded, bringing the total number of VA Headache Centers of Excellence (HCoEs) to 28 nationwide. HCoEs not only provide specialty care for veterans living with headache disorders, but they also focus on research as well as training of physicians and other medical professionals in headache treatment.

While the VA HCoEs are a positive step forward, there is more that can and should be done to address headache disorders for our veterans. During the wars in Iraq and Afghanistan, federal contractors filled holes in the ground with garbage, medical waste, vehicles, and plastics, and then doused them in jet fuel and set them on fire. Soldiers then breathed in the toxic fumes from these pits. Possible correlations between exposure to these burn pits and headache disorders have been identified, as well as many other health conditions and cancers. 22.2% of veterans deployed with duties involving burn pits reported functional limitations specifically due to migraine, compared to 12.4% of similarly deployed veterans who were not exposed to burn pits.

Supporting our veterans

In May 2022, Senate Veterans’ Affairs Committee chairman Jon Tester (D-Mont.) and ranking member Jerry Moran (R-Kan.) announced a bipartisan agreement on the Sergeant First Class Heath Robinson Honoring Our PACT Act of 2022 to provide healthcare and benefits to veterans who were exposed to these toxins. The released text of the compromise bill includes 23 toxic exposure-related conditions to the VA’s list of service presumptions. Unfortunately, despite their prevalence and burden for post-9/11 veterans, headache disorders were not included. It is possible the exclusion of headache disorders may be due to reluctance around expected costs associated with adding the conditions. Unfortunately, even with the increase to 28 HCoEs, HCoEs will likely not have adequate resources to care for all those experiencing burn pit-related headache disorders. Additional funding must be allocated to meet the immense burden of these conditions within our veteran community. The AHDA believes that, regardless of cost, we cannot abandon our veterans when they need us the most.

“The Alliance for Headache Disorders Advocacy is honored to support our veterans by advocating for necessary changes to key federal policies,” says Katie MacDonald, director of federal policy for the AHDA. “We will continue to advocate for additional funding, research, and recognition for veterans living with headache disorders, including those exposed to burn pits.”

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