So having seen what opioid abuse has done to the civilian population in the previous blog (\u201cOpioid abuse may be fueling a heroin epidemic\u201d), let\u2019s take a look at what it is doing to our nation\u2019s vets.<\/p>\n
\u201cMore than 50 percent of all veterans enrolled and receiving care at VHA (Veterans Health Administration) are affected by chronic pain, which is a much higher rate than in the general population,\u201d said a 2014 VA report. \u201cVeterans who suffer from chronic pain also experience much higher rates of other co-morbidities (post-traumatic stress disorder, depression, traumatic brain injury,) and socioeconomic dynamics (disability, joblessness) that may contribute to the challenges of pain management when treated by opioids.\u201d<\/p>\n
However, prescription painkillers became the preferred tool for dealing with that pain.<\/p>\n
The Center for Investigative Reporting, using data provided under the Freedom of Information Act, said prescriptions for four opioids (hydrocodone, oxycodone, methadone and morphine) surged by 270 percent between 2000 and 2012, leading to addictions and a fatal overdose rate that was twice the national average.<\/p>\n
In 2014, the VA said it issued 1.7 million prescriptions for opioids to 443,000 vets to be taken at home.<\/p>\n
Citing a VA Office of Inspector General\u2019s report, the Center for Ethics and the Rule of Law (CERL) said: \u201cBetween 2010 and 2015, the number of veterans addicted to opioids rose 55 percent to a total of roughly 68,000. This figure represents about 13 percent of all veterans currently prescribed opioids.\u201d<\/p>\n
Alarmed, the VA began cutting back its painkiller prescriptions in 2010. The agency says it reduced the number of vets receiving painkillers by 115,575 individuals between 2012 and 2015 and that it has 100,000 fewer vets on long-term opioid therapy.<\/p>\n
Still, it says it treated 66,000 vets for opioid addiction in fiscal 2016.<\/p>\n
\u201cWe owe it to the nation\u2019s veterans to help them end their dependence on opioids,\u201d said VA Secretary Robert McDonald, \u201cand break the downward spiral that all too often leads to homeless, prison or suicide.\u201d<\/p>\n
McDonald said vets are 10 times more likely than the average Americans to abuse opioids and that such abuse is a leading cause of homelessness among vets.<\/p>\n
However, one problem is that there\u2019s no adequate replacement for prescription painkillers. \u201cWe do not have another silver bullet that we can say, \u2018Instead of opioids, try this,\u2019\u201d Dr. Carolyn Clancy, the VA\u2019s deputy under-secretary for health, told FRONTLINE Enterprise Journalism Group. \u201cIt\u2019s much more a matter of individualizing and trying different alternatives, and that can be really frustrating for patients, as well as clinicians.\u201d<\/p>\n
Some VA centers have started to introduce programs on managing chronic pain by use of yoga, acupuncture, qigong and tai chi, but those programs are rarities. Most therapy is still cognitive behavioral, which isn\u2019t very effective for chronic pain.<\/p>\n
Furthermore, the VA system is currently overloaded, and most physicians don\u2019t have the time to experiment with alternative therapies. And doctors are often pitted against their skeptical colleagues in trying to provide pain relief in a way that\u2019s effective, but not dangerous to the patient.<\/p>\n
Even the regulations adopted by the federal Drug Enforcement Administration have had a backlash by forcing vets to return every month to a VA facility to renew their medications. This only increases the patient load at facilities that may have a three- to six-month wait even to get an appointment.<\/p>\n
So what does this do to our vets? Listen to the stories that some of them have told the nation\u2019s news media in the past few years:<\/p>\n
\u00a0<\/strong><\/p>\n Robert Deatherage,<\/strong> a 30-year-old Army vet, told the Wall Street Journal that he has battled addictions to pain pills and heroin after suffering severe injuries in Afghanistan. He said he hit rock bottom a year before when he took refuge in an empty church in Fayetteville, N.C., and tried to kill himself \u2013 twice.<\/p>\n \u201cI was just so sick of being as sick as I was,\u201d he told the WSJ. First, he tried to shoot himself, but the gun misfired, so he injected himself with all the drugs he had, but he didn\u2019t overdose.<\/p>\n Believing he might recover after all, Deatherage walked to a nearby VA Medical Center, but it was full so they sent him back onto the street with a jacket from the lost and found and the phone number for a homeless vets coordinator. After he picked up his disability check a few days later, however, he checked into a motel that he knew was frequented by vets and addicts.<\/p>\n \u201cIt gets discouraging,\u201d Deatherage told the Journal. \u201c\u201dIt makes it easier just to say, \u2018F\u2014k it, I\u2019ll just keep doing what I\u2019m doing.\u201d<\/p>\n The youngest son of a single mom, Deatherage adored his grandfather, a Vietnam helicopter pilot who died when he was 10. Shortly after enlisting in 2006, Deatherage was prescribed Percocet for a back injury during helicopter training and continued taking the painkillers during his deployment to Afghanistan in 2009-10.<\/p>\n \u201cI got blown up seven times,\u201d he told the WSJ. \u201cI would go see my medic, get bandaged, get Percs and get on with it.\u201d During that time, he suffered back, neck and facial injuries, and he suffered a traumatic brain injury when he cracked his skull during an explosion.<\/p>\n Later stationed on the West Coast, he was prescribed opioids for his pain and began buying additional relief from other soldiers. He lost his job, his savings and his marriage, and he received a medical discharge for substance abuse in 2014.<\/p>\n \u201cThey threw me out of there and said \u2018Take care of yourself,\u2019\u201d he told the WSJ. \u201cSo I did.\u201d<\/p>\n Deatherage spent the next two years either in jail or homeless, according to the Journal. At the time of publication, he remained in jail.<\/p>\n <\/p>\n Craig Schroeder, <\/strong>a former Marine corporal, was injured by a roadside bomb in the \u201cTriangle of Death,\u201d a region south of Baghdad, according to the Washington Post. He suffered a traumatic brain injury and lost some hearing, memory and movement. Due to pain from a broken foot and ankle, as well as a herniated disc in his back, he has had a steady supply of prescription opioids.<\/p>\n But after the DEA regulations were put in place to reduce opioid prescriptions, he was unable to get an appointment to see his doctor in North Carolina for nearly five months, he told the Post.<\/p>\n \u201cIt was a nightmare,\u201d he said. \u201cI was just in unbearable, terrible pain. I couldn\u2019t even go to the ER because those doctors won\u2019t write those scripts.\u201d<\/p>\n His wife Stephanie told the Post that getting her husband a VA appointment became her main mission in life, but she said the VA seemed to become hostile toward patients who asked for painkillers.<\/p>\n \u201cSuddenly, the VA treats people on pain meds like the new lepers,\u201d she told the Post. \u201cIt feels like they told us for years to take these drugs, didn\u2019t offer us any other ideas, and now we\u2019re suddenly demonized, second-class citizens.\u201d<\/p>\n <\/p>\n Jeffrey Waggoner, <\/strong>a former paratrooper, was sent to a VA hospital in southern Oregon for detoxification from a brutal addiction to painkillers, but instead of sobering Waggoner up, medics doped him up, the Center for Investigative Reporting reported.<\/p>\n CIR obtained medical records in which one doctor said, \u201cwhen not stimulated, (he) lies on the gurney and rapidly falls asleep.\u201d And a nurse reported that Waggoner\u2019s \u201ceyes were like slits and he appears to be overly sedated\u201d as he was rushed to the emergency room after falling out of bed.<\/p>\n Waggoner told a nurse at the Roseburg, Ore., VA hospital that he had been taking painkillers since he had been injured by a rocket-propelled grenade blast in Afghanistan and that he suffered from severe flashbacks that interrupted his sleep.<\/p>\n \u201cThen, inexplicably, the VA released him for the weekend with a cocktail of 19 prescription medications, including 12 tablets of highly addictive oxycodone,\u201d CIR reported. \u201cThree hours later, Wagoner, 32, was dead of a drug overdose, slumped in a heap in front of his room at the Sleep Inn motel.\u201d<\/p>\n \u201cAs a father, you\u2019d want to know why this happened to your child,\u201d his father, Greg Waggoner, told the center. \u201cYou send your child to a hospital to get well, not to die.\u201d<\/p>\n The center also reported that medical records showed doctors at the southern Oregon VA hospital where Waggoner was treated prescribed eight times as many opioids as their colleagues at the VA hospital in Manhattan.<\/p>\n <\/p>\n Ken Grady, <\/strong>a 45-year-old Air Force veteran, has been prescribed OxyContin, Percocet, Vicodin, and fentanyl patches throughout the 2000s to relieve pain from a series of surgeries for back injuries, the Wall Street Journal reported. \u00a0<\/strong>\u201cThe VA made it so easy,\u201d he said. \u201cIt was endless, and I abused it.\u201d<\/p>\n When he couldn\u2019t get prescriptions, he was able to buy opioids on the street, often outside the Fayetteville, N.C., VA hospital from patients who had just had their own prescriptions re-filled. While he has been struggling to stay clean, Grady told the Journal that he has spent all but 65 days of the preceding two and a half years in VA-funded treatment or in jail.<\/p>\n During one stay at the VA\u2019s mental health unit, a doctor prescribed him Percocet for chronic back pain, he said, but he told the doc \u201cPlease don\u2019t give me that.\u201d<\/p>\n More recently, the WSJ reported, Grady had several teeth pulled by a VA contractor who prescribed him Vicodin for pain. He took the pills that time, relapsed, bought some more on the street and landed in jail again, where he remained at press time.<\/p>\n <\/p>\n Army veteran Joshua Renschler <\/strong>developed liver damage after years of taking 13 drugs, including opioids, to numb his back pain following a mortar blast in Iraq, according to FRONTLINE.\u00a0 In testimony before Congress, he said doctors in Washington kept prescribing pills to manage the pain and the side effects of the medication, but offered few other solutions.<\/p>\n \u201cWhen it comes to opioids, if we\u2019re relying on the VA to provide this care, it almost mandates the need for opioid-based therapy, as sad as that is,\u201d Renschler said, adding that he still struggles with severe pain, but now avoids medications due to his liver damage.<\/p>\n \u201cI\u2019m just about as good as I\u2019m going to get,\u201d he said.<\/p>\n FRONTLINE also interviewed Jim Reed, <\/strong>an Army veteran and anesthesia provider who is concerned about the Army\u2019s reliance on prescription painkillers. Although he suffers from chronic neck pain, he refused a VA doctor\u2019s prescription for opioids, as well as one pill to help him sleep and another pill to help him stay awake. Instead, he said he take Motrin and practices relaxation techniques.<\/p>\n But most vets don\u2019t question the doctor, he added. He routinely sees vets in their 20s and 30s who are taking a \u201claundry list\u201d of medications.<\/p>\n \u201cWe\u2019re sentencing these young people to a life of chemical dependency,\u201d Reed told FRONTLINE. \u201cThey\u2019re living these lives of despair because we\u2019re just not doing things that make sense, that are evidence based.\u201d<\/p>\n <\/p>\n Finally, the Center for Investigative Reporting told the story of Tim Fazio. <\/strong>Fazio started getting opioids from the VA in 2008 and has received nearly 4,000 oxycodone pills and more than a dozen bottles of Tramadol, another opioid painkiller.<\/p>\n But Fazio told CIR that he\u2019s never been in serious physical pain \u2013 he uses the painkillers to blot out feelings of guilt for surviving when many of his close friends have not. On a shelf, he keeps a picture of four of his Marine Corps buddies; one killed himself, another was found dead in a Florida ditch after battling opioid addiction and PTSD, and a third was charged with murder.<\/p>\n \u201cLast year, researchers at the San Francisco Medical Center published a paper in the Journal of the American Medical Association that found VA doctors prescribed significantly more opioids to patients with PTSD and depression than to other veterans \u2013 even though people suffering from those conditions are most at risk of overdose and suicide,\u201d CIR reported.<\/p>\n Dr. Stephen Xenakis, a psychiatrist and retired brigadier general, told the center such prescriptions are counter-productive. \u201cOpioids have an adverse effect for most of these patients,\u201d said Xenakis, who was commanding general of the Army\u2019s Southeast Regional Medical Command. \u201cThey make sleep more difficult because they disrupt your usual sleep pattern, and as your sleep gets worse, your mood and your anxiety get worse, and you find yourself not being able to think as clearly.\u201d<\/p>\n Furthermore, opioids are downers, so they tend to make depressed vets even more depressed, Xenakis said.<\/p>\n Hospital records indicate that the VA knew Fazio was an addict in 2009 and provided him with detox. But VA doctors continued to prescribe opioids for three more years until his parents hired an attorney and threatened to sue the agency for medical malpractice, CIR reported.<\/p>\n \u201cIt\u2019s so sick. It\u2019s so wrong,\u201d his mother, Kathy Fazio, told the center. \u201cThe kid is flagged everywhere with what he\u2019s addicted to, and they\u2019re still giving him Percocets. He\u2019s better off to the Veterans Administration dead than \u2026 paying all that money to help him.\u201d<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" So having seen what opioid abuse has done to the civilian population in the previous blog (\u201cOpioid abuse may be fueling a heroin epidemic\u201d), let\u2019s take a look at what it is doing to our nation\u2019s vets. \u201cMore than 50 percent of all veterans enrolled and receiving care at VHA (Veterans Health Administration) are affected […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-450","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/posts\/450","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/comments?post=450"}],"version-history":[{"count":1,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/posts\/450\/revisions"}],"predecessor-version":[{"id":451,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/posts\/450\/revisions\/451"}],"wp:attachment":[{"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/media?parent=450"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/categories?post=450"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ericnewhouse.com\/blog\/wp-json\/wp\/v2\/tags?post=450"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}