Center for Investigative Reporting: As VA Opiate Overdoses Skyrocket, Veterans’ New Enemy Is Addiction

The federal agency entrusted with the health and well-being of America’s military veterans has over-prescribed them with opiates, a pain-killer fix to more complex problems, according to a new report by the Center for Investigative Reporting. The national non-profit news organization found, based on records obtained through the Freedom of Information Act and other data, that the Department of Veterans Affairs has issued a 270% increase in four highly addictive opiates over the last 12 years. The number of veterans has increased 41%. The four are hydrocodone, oxycodone, methadone and morphine. Prescriptions for hydrocodone, most widely used in Vicodin, increased the most at 578%, followed by methadone at 280%, morphine at 240% and oxycodone at 65%. Headlined “VA’s Opiate Overload Feeds Veterans’ Addictions, Overdose Deaths,” the exclusive report by CIR’s veterans reporter, Aaron Glantz, found startling data. Among its findings: Despite new VA rules in 2009 requiring more focus on treating the underlying cause of a veteran’s pain rather than dispensing powerful narcotics for symptoms, there was “little adherence helping veterans manage pain,” and “little adherence to a national standard.” The data showed that the VA hospital system in Roseburg, Oregon, in 2012 wrote the highest number of opiate prescriptions, whereas the VA in Puerto Rico wrote the lowest number, followed by Cleveland, Ohio. And the VA hospital an hour outside Tulsa, Oklahoma, has the highest rate of prescribing opiates in the decade since 9/11. Glantz spoke with numerous vets and their families, and focused on a particularly tragic fatal overdose as the report’s narrative spine: The case of Army Spc. Jeffrey Waggoner, a paratrooper injured in a rocket-propelled grenade blast in Afghanistan. The VA’s medical staff prescribed Waggoner, 32, with painkillers even after it called for him to seek treatment to his addiction to them, the CIR report concluded. The news organization analyzed a decade of data spanning 9/11/2002 through 2012, and received two segments of information: the number of opiates prescribed by the VA and the number of patients served at every VA hospital and clinic. It features an interactive map for readers to localize. In response, VA officials declined to be interviewed about the reported prescription epidemic, but issued a written statement that assured that it has underway “multiple, ongoing efforts to address prescription drug abuse among veterans seen in our healthcare system.” Apart from the military, addiction in the general population to painkillers has risen. A July 2013 policy report by the Centers for Disease Control and Prevention (CDC) called the rise in opiates abuse “epidemic.” Nearly three out of four prescription drug overdoses are caused by prescription painkillers — also called opioid pain relievers. The unprecedented rise in overdose deaths in the U.S. parallels a 300% increase since 1999 in the sale of these strong painkillers. These drugs were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined. The misuse and abuse of prescription painkillers was responsible for more than 475,000 emergency department visits in 2009, a number that nearly doubled in just five years. More than 12 million people reported using prescription painkillers non-medically in 2010, that is, using them without a prescription or for the feeling they cause. That was the case for another of the vets that the CIR report profiled: Tim Fazio, who said the VA supplied him with nearly 4,000 oxycodone pills since his 2008 return home from serving in Iraq and Afghanistan. Fazio told CIR that he had no acute pain that would require such an opiate but leaned on the drug to silence powerful survival guilt for living when many friends didn’t make it. His late roommate, Eric Demetrius , 33, and a fellow Marine Corps vet, overdosed June 1. The pair had met at a VA psychiatric hospital in Massachusetts and after moving in together, abused oxycodone and other pain killers prescribed by the VA. When they ran through those, the CIR report detailed, they’d buy them on the street. Stated CIR: “Fazio’s medical diagnoses include PTSD, traumatic brain injury and anxiety, conditions for which opiates hinder recovery, studies show. Yet the VA’s scientists report that the agency’s doctors regularly prescribe opiates to these patients anyway. Last year, researchers at the San Francisco VA Medical Center published a paper in the Journal of the American Medical Association that found VA doctors prescribed significantly more opiates to patients with PTSD and depression than to other veterans – even though people suffering from those conditions are most at risk of overdose and suicide. Researchers at the agency’s Health Services Research and Development Service reported in 2011 that veterans seen by the agency’s doctors were dying from prescription drug overdoses at nearly twice the national average. Elements has written this report on CIR data with the organization’s permission. Here is the full report.

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