Closing Candy Land: Our Vets are Stuck in the VA’s Revolving Door
Across our nation, the brave men and women who defended its freedoms are suffering. The burden they bear isn’t regret, loss, emotional trauma or illness…even though all of these things may be present. No, the cargo many of them carry is the weight of persistent pain. For nearly 60 percent of our veterans returning from the last ten years of war, chronic pain is the most common medical problem.
And what kind of “help” have we provided our brave veterans? First we drugged them, then we denied them. Let’s take a look at what happened and continues to happen.
VA Turns to Opiates
As masses of vets sought treatment for their pain, the VA started doling out prescriptions. Opioids became the go-to solution.
Between 2001 and 2013, pain medications from the VA – such as oxycodone and morphine – increased by 259 percent. In Minnesota, VA prescriptions for morphine and oxycodone more than doubled for every 100 patients active during that time.
The Tomah, Wisconsin, VA medical center handed out so many drugs that vets started calling the place “Candy Land.” In 2012, the Tomah VA dispensed roughly 712,000 oxycodone pills, up from the mere 50,000 dispensed in 2004. The hospital’s chief of staff, psychiatrist David Houlihan, a.k.a. the “Candy Man,” prescribed, an average of 25,000 mg of morphine to each and every patient he saw in 2012.
Meanwhile, public awareness of the addictive qualities of opioids was rising. Concerns about high use and abuse rates encouraged many to seek alternatives – that included our veterans.
As if by some form of magic – poof! – tramadol (Ultram) came onto the scene. Thought of as the “safe alternative” to opiates, tramadol was supposed to be less habit-forming and easier to tolerate than “stronger” counterparts like oxycodone.
VA Doctors handed out free samples of Ultram, with little restriction on usage, due to its drug classification. But the perception of tramadol was far from accurate: Tramadol-related ER visits skyrocketed. Abuse rates surged. By 2012, 3.2 million people were using tramadol for non-medical purposes.
A Painful Toll on Vets
As it stands right now, the VA reports more than half a million veterans are on prescription opioids. In fact, the number of VA scripts written for narcotics has more than tripled – that includes prescriptions for oxycodone and methadone, two extremely powerful (and often fatal) opiates.
By 2011, the American Public Health Association reported that the overdose rate among VA patients was nearly two times the the national average.
The Centers for Disease Control and Prevention was eventually forced to chime in, labeling the resulting painkiller craze as “the worst drug addiction epidemic in the country’s history, killing more people than heroin and crack cocaine.”
In the wake of a media nightmare, VA pain experts were forced to admit that they had indeed been over-medicating our veterans. They went on to say the widespread abuse of opiate painkillers “likely” contributed to homelessness and suicide among vets.
Time to Make Some Changes
- VA Policies Under Fire
Facing mounting criticism for their drug policies, the VA suddenly opted to cut dosages and cancel prescriptions. They also began encouraging vets to use alternative therapies such as chiropractic care, yoga and acupuncture. The VA’s new goal was to identify and treat the root causes of pain instead of prescribing addictive drugs to mask them. They announced the launch of 13 new research projects – with a price tag of nearly $22 million – to study non-drug approaches to treating chronic pain.
- Enter the DEA
By 2014, plenty of evidence had mounted showing the dangers of tramadol, prompting the DEA to reclassify the drug as a controlled substance. The move directly affected thousands of vets prescribed tramadol for their pain. The VA also announced, as of August 2014, tramadol prescriptions would have a maximum of five refills and each prescription would be re-written every six months. They also warned that the new refill limits could result in prescriptions expiring even sooner.
The DEA rulings eventually led to a decline in opioid prescriptions at VA hospitals and clinics; however, the number of veterans seeking chronic pain treatment continues to increase.
Where is the VA Failing Our Vets?
Cut off from their pain medications, many of our veterans are left in limbo, struggling to cope with crippling pain. While the VA claims to offer additional treatment and support, these alternative services notoriously lack effectiveness and availability. Case in point: Vets seeking an appointment with the VA’s chiropractor in Minneapolis are placed on a waiting list for up to two months. Why the long wait? Well, turns out there’s only one chiropractor on staff to treat thousands of Minneapolis vets. Do the math on that one.
Other pain management programs attempt to provide “one-size-fits-all” treatments that many veterans claim are not effective. Inconvenient scheduling, lack of available locations and long commutes are just a few of the additional ongoing problems that make it hard for many working veterans.
Veterans also report a lack of communication regarding new policies. With no explanation or notification of policy changes, many vets received prescriptions for a much lower number of pills each month – some weren’t even written a prescription at all.
Somewhere along the line, the decision was made to wean hundreds of vets off opiate painkillers – a choice that was made for them, not with them. Period. Even the vets who lacked a history of addiction received letters in the mail, informing them they would no longer be able to get prescriptions for painkillers. No explanation or offer of alternative treatment was provided.
A huge number of veterans eventually came forward, reporting that the new policies caused a spike in depression, panic attacks and other withdrawal problems – all thanks to the sudden stoppage of opioid meds.
What Does the Future Hold for Vets in Pain?
As of today, we still have thousands of vets who aren’t being adequately treated for chronic pain. Most, if not all, VA locations are still understaffed and forced to turn away vets on a daily basis. Additionally, alternative therapies and counseling services are either nonexistent or they have ridiculously long waiting lists.
The current policies aren’t working. The system is broken and our vets will continue to suffer until it’s fixed.
On the flip side, we still have a good number of vets who are prescribed tramadol for chronic pain. And while it provides some relief, veterans generally aren’t warned about the side effects of this opioid drug and they don’t understand the pills are addictive.
On one hand, the VA still faces criticism about the number of pain pills it prescribes. On the other hand, a growing number of complaints are voiced about the VA withholding pain medication. It would certainly appear we have a lack of consistency; some VA locations pass out plenty of painkillers like tramadol, while others totally slam the door on opiates.
With a lack of solutions, vets in chronic pain face an uncertain future. A growing number are turning to heroin, while others double up on addictive anti-anxiety medications to ward off the crippling depression that comes from daily pain.
While the solution is unclear, we know one thing for sure: The current policies aren’t working. The system is broken and our vets will continue to suffer until it’s fixed. As U.S. Rep. Tim Walz, D-Minn noted, “You’ve got to be offering these guys more than one yoga class a week.”
Additional Reading: Don’t Be Fooled: Tramadol Abuse Poses Very Real Dangers
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