The Enid News and Eagle, Enid, OK

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November 1, 2013

Opiate overload: Muskogee VA top issuer of opiate prescriptions

Editor’s note: This story is an abridged version of an investigative project produced by The Center for Investigative Reporting. The story reveals, among other things, that the VA Medical Center in Muskogee has issued the highest number of prescription painkillers among VA hospital systems in the country. The article also depicts veterans appearing in Tulsa’s Veterans Treatment Court.

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Since the Sept. 11, 2001, terrorist attacks, the U.S. Department of Veterans Affairs, charged with helping veterans recover from war, instead masks their pain with potent drugs, feeding addictions and contributing to a fatal overdose rate among VA patients that is nearly double the national average.

Prescriptions for four opiates — hydrocodone, oxycodone, methadone and morphine — have surged by 270 percent in the past 12 years, according to data the Center for Investigative Reporting obtained through the Freedom of Information Act. CIR’s analysis  for the first time exposes the full scope of that increase, which far outpaced the growth in VA patients and varied dramatically across the nation.

The data shows the agency has issued more than one opiate prescription per patient, on average, for the past two years. In interviews, advocates and experts said the skyrocketing prescription rate confirmed their worst fears: that the agency is overmedicating its patients as it struggles to keep up with their need for more complex treatment.

CIR project and interactive map

“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 problem, Xenakis said, is opiates hurt more veterans than they help.

Senior VA officials declined to be interviewed by CIR about the prescription epidemic. Instead, the agency produced a written statement saying it was engaged “in multiple, ongoing efforts to address prescription drug abuse among veterans seen in our health care system.”

The agency long has been aware of the problem. In 2009, new VA regulations required clinicians to follow an “integrated approach” to helping veterans in pain, including a stronger focus on treating the root causes of pain rather than using powerful narcotics to reduce symptoms.

But despite the regulations, VA doctors are prescribing more opiates than ever and the data suggests adoption of the regulations varies wildly.

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