|WSJ Exposes VA's Perverse Role in Vet Oxy Rampage|
|WSJ Exposes VA's Perverse Role in Vet Oxy Rampage|
|Addiction Treatment Industry Newswire|
12/31/2016 -ATIN- In a pathbreaking piece of addiction-oriented investigative journalism, the Wall Street Journal has exposed the perverse and highly disturbing role the Veteran's Administration has played in creating a mass of painkiller addicted veterans returning from the seemingly endless Middle East conflicts U.S. armed forces have been engaged in following the two dastardly 2001 terrorist attacks on New York City's World Trade Center.
Excellence and Insight
We here at Treatmant Magazine have nothing to add to the WSJ piece... it's excellence, insight and story-telling speak for themselves...
Same Story, Different Era
We will say this though: from today's contemporary times back to the industrial age, down through the Renaissance and the Middle Ages and even going back to ancient Greek and Roman times, institutions that have been touted as created for the public good and to serve and help the people have often, through either simple mismanagement, outright corruption or even sheer stupidity, wound up doing as much harm as they do good.
Below is the text of the WSJ Article
The VA Hooked Veterans on Opioids, Then Failed Them Again
The agency overprescribed painkillers to returning soldiers, fueling addiction; now rehab facilities are overwhelmed
By Valerie Bauerlein and Arian Campo-Flores
FAYETTEVILLE, N.C.-Robert Deatherage, a 30-year-old Army veteran who has battled addiction to pain pills and heroin since suffering severe injuries in Afghanistan, says he reached rock bottom a year ago when he holed up in an empty church and tried to kill himself. Twice.
"I was just so sick of being as sick as I was," he says. He put a gun in his mouth and pulled the trigger, but it didn't fire. He says he then used two syringes to shoot all the drugs he had, but didn't overdose.
Mr. Deatherage took the failure as a spiritual sign and walked to the nearby Veterans Affairs Medical Center. The facility didn't have any space and turned him away, offering only a jacket from the lost and found and a phone number for a homeless veterans coordinator. After he picked up his disability check a few days later, he checked into a hotel where he knew other addicts, including veterans.
"It gets discouraging," Mr. Deatherage says. "It makes it easier to just say, ‘F--- it, I'll just keep doing what I'm doing.' "
Shortly after enlisting in the Army, Robert Deatherage was prescribed Percocet for a back injury. Wounds from Afghanistan meant more painkillers.
The U.S. Department of Veterans Affairs acknowledges its role in creating a large population of opioid-addicted veterans by overprescribing painkillers for injuries and post-traumatic stress disorder. After the agency tightened prescribing practices in 2013, many veterans bought pain pills sold illicitly on the streets. When those became too expensive, they sought heroin and fentanyl, a potent synthetic narcotic. The VA is now struggling to undo the damage. Hampered by budgetary and bureaucratic obstacles, it has failed to build a rehabilitation program robust enough to meet the overwhelming demand for treatment from the tens of thousands of veterans with opioid addiction, say analysts who have studied the issue. That has left many veterans to fend for themselves, tapping whatever resources they can find to battle a chronic, complex-and frequently fatal-condition.
In Fayetteville, home to Fort Bragg, the largest military installation in the U.S., 47% of opioid prescriptions are abused, according to an April study by Castlight Health Inc., a health enterprise-software company. Yet the VA health system here has no residential addiction-treatment program, no inpatient opioid detoxification facility and only five doctors in a 21-county area able to dispense medications like buprenorphine, used to treat opioid abuse.
"The Fayetteville VA is one of the worst in the country," says Justin Minyard, a retired Army first sergeant who has battled opioid addiction and testified before Congress about the issue. "There's no help for veterans dealing with the addiction they now have." Elizabeth Goolsby, director of the Fayetteville VA Medical Center, says Mr. Deatherage's "is not a typical story." He should have been sent to the local hospital emergency room if the VA's crisis mental health unit was full, she says.
The Fayetteville VA serves the fastest-growing veteran population in the nation, with 70,000 patients last year, up from 42,000 in 2010. It is moving quickly to meet demand, Ms. Goolsby says. It has added facilities and reduced wait times for primary care to four days, from 29 days in 2014, when an audit found the hospital had among the longest wait times of 700 VA facilities in the country.
The VA is working to increase treatment capacity nationwide and expand alternatives to the use of painkillers, such as acupuncture, says Carolyn Clancy, deputy undersecretary for health for organizational excellence at the Veterans Health Administration. The department also is aggressively addressing the supply of prescription opioids. Since 2012, the peak of opioid prescribing, the VA has reduced the number of its patients on long-term or high-dose painkillers by about a third.
"We owe it to the nation's veterans to help them end their dependence on opioids," said Veterans Affairs Secretary Robert McDonald in a September speech, "and break the downward spiral that all too often ends in homelessness, prison or suicide." More than a decade of war in Afghanistan and Iraq produced a flood of veterans with severe physical and mental conditions. Because of advances in battlefield armor and combat care, serious injuries now have 90% survival rates, compared with 40% in the Vietnam War, according to Rollin Gallagher, director of the national pain management program at the VHA. Yet many survivors are returning with permanent damage, such as amputations and spinal-cord injuries.
While many injured veterans required opioids, VA medical centers prescribed the drugs in too many cases, and often for months instead of days or weeks, department officials now say. The VA treated more than 66,000 veterans with opioid-use disorders in fiscal 2016, according to the agency.
Military communities are magnets for veterans seeking camaraderie. In Fayetteville, the metropolitan population of 349,000 people includes 77,000 soldiers and civilians working at Fort Bragg, 63,000 active-duty family members and 98,000 veterans and their family members. Units based here, including the 82nd Airborne Division, have deployed repeatedly to the Middle East since 9/11, sending home a steady stream of severely injured soldiers.
Fayetteville has had an active drug scene for years, police say, partly because it is bisected by Interstate 95, a trafficking thoroughfare. The district attorney here says the flood of pills from the military was a key cause of the local opioid crisis, which also affects many civilians. Air Force veteran Ken Grady, 45, says the local VA prescribed him OxyContin, Percocet, Vicodin and fentanyl patches in the 2000s because of a series of surgeries for back injuries. "The VA made it so easy," he says. "It was endless, and I abused it."
During one stay at the VA's crisis mental health unit, a doctor in another section prescribed him Percocet for his chronic back pain, he says. "Please don't give me that," he says he told the doctor. Mr. Grady says he has sometimes bought drugs from veterans selling just-filled narcotic prescriptions outside VA facilities.
Ms. Goolsby, director of the Fayetteville center, says VA facilities are sprawling public places, and it would be regrettable but not unheard of for veterans to sell pills on campus. She also says the VA has improved its record-keeping to better track prescriptions for veterans with substance-use disorder.
The VA system's treatment options are limited. The Fayetteville VA has an outpatient alcohol detox unit but no opioid detox unit. It refers veterans to other local facilities for detox, the initial period of up to about a week when an addict comes off drugs, endures withdrawal and is stabilized. The VA then refers them to its outpatient substance-abuse treatment program, the much longer process of overcoming addiction and underlying issues through therapy, group programs and medication. The outpatient program has 1,000 visits a month, and saw a total of 2,800 new patients from January to October of this year.
Addicted veterans can be referred to one of the VA's 43 inpatient rehab centers around the country, which combined have 906 beds, according to a 2014 VA audit. Waits are usually longer than 30 days, though, which deters referrals, and beds often stay empty because of lack of staffing, the audit said.
Alan Shay Davis, a moonlighting obstetrician, started filling in as the medical director three years ago after a loved one became addicted to opioids. His clients range from veterans and active-duty soldiers to stay-at-home mothers and blue-collar workers. "I've been a part of the problem for some patients," he says, by prescribing opioids in his obstetric practice. "Hopefully now I'm part of the solution."
In his spare time Robert Deatherage tattoos himself. The one on his wrist references a PTSD-awareness movement.
His mother, Louise Johnson, 54, says her son had been fooling no one since he came home with a blank stare and a gallon-sized Ziploc bag full of VA prescriptions.
Mr. Deatherage outside the VA's outpatient mental health building in Fayetteville, NC.
On the Cover: Jacob Levinson
Founder, CEO MAP