Prescriptions for four opiates -- hydrocodone, oxycodone, methadone and morphine -- have risen by 270 percent in the past 12 years, according to data obtained by the Center for Investigative Reporting through the Freedom of Information Act. The increase far outpaced the overall increase in VA patients, and varied widely across the country.
The agency issued more than one opiate prescription per patient, on average, for the past two years. Though prescription rates vary, many believe VA doctors are overwhelmed and overmedicating.
“Giving a prescription, which they know how to do and are trained to do, is almost a default,” said Dr. Stephen Xenakis, a psychiatrist and retired brigadier general who served as commanding general of the Army’s Southeast Regional Medical Command.
The VA has been aware of the problem for some time. In 2009, new VA regulations required an “integrated approach” pain management, relying less on narcotics to reduce symptoms.
But changes aren't implemented uniformly and prescription rates vary widely. Further, the wait for treatments for root causes can be so long that the drugs are prescribed in the meantime.
“The VA is very segmented, very siloed, and you have a lot of fiefdoms where hospital directors are just running their own show out there,” said Tom Tarantino, a former Army captain and chief policy officer for the advocacy group Iraq and Afghanistan Veterans of America.
“They basically have a blank check,” said Greg Waggoner, whose brother died after an overdose of VA-prescribed painkillers and tranquilizers. “We need better control and people need to be held responsible.”
In response to the publication of opiate prescription data, the VA only issued a statement saying they are engaged “in multiple, ongoing efforts to address prescription drug abuse among veterans seen in our healthcare system.”
But the report uncovered cases where veterans were prescribed opiates even when their records showed they were trying to kick an addiction, sometimes with VA-administered detox.
“It’s so sick. It’s so wrong,” said Kathy Fazio, whose veteran son Tim is battling addiction after suffering a traumatic brain injury in Fallujah, Iraq. In addition, he has been diagnosed with PTSD, anxiety, and mental disorders which are made worse by opiates.
“The kid is flagged everywhere with what he’s addicted to, and they’re still giving him Percocets," Fazio said. "He’s better off to the Veterans Administration dead than … paying all that money to help him.”
In Tulsa, Oklahoma, where opiate prescription rates are highest in the nation at 1.6 per person, the effects can be seen in court, where there is a special docket for veteran offenders.
“If I have to wait 30 days, 45, all the way up to 90 days to be able to get seen by my doctor, I’m probably going to go out and try to find something to deal with the pain prior to,” said Craig Prosser, the court's mentor coordinator.
John Cloud, a Vietnam veteran who is the American Legion’s liaison to the court says eventually, the vets develop a tolerance and the VA prescriptions aren't enough. “They’ll go to the streets and buy the drugs, turn to alcohol” and may engage in criminal acts.