The Drug Enforcement Administration implemented rules last year to cut down on veterans’ abuse of narcotics, requiring patients to renew their prescriptions each month with a visit to the doctor. But because the Department of Veterans Affairs has such a massive patient backlog, many veterans suffering from extreme pain have been left without medication.
Technically, the regulations apply to anyone using opioids, but since the rules have taken effect, they’ve hit veterans hardest, owing to scores of injured veterans returning from the Iraq and Afghanistan wars, the Washington Post reports. A study published in the Journal of the American Medical Association in 2012 concluded that those returning from Iraq and Afghanistan with mental health diagnoses like PTSD are at an elevated risk of “receiving opioids for pain, high-risk opioid use, and adverse clinical outcomes.”
Based on VA data, over half a million veterans use prescription opioid pain killers. After revelations of facilities like the Tomah VA Medical Center earning the reputation of “Candy Land” among veterans, the VA is starting to admit it has a problem. (RELATED: Congressmen Demand Investigation Into Out Of Control Opioids At VA Facility)
But it’s still a question whether the scandal-plagued VA will be able to accommodate the new influx of veterans on a regular basis. In one recent example, although veteran Craig Schroeder suffers from a traumatic brain injury after being hit by an explosion in Iraq, he’s been denied care for five months, since it’s almost impossible to get an appointment at the VA. During that time, he’s been bedridden and in extreme pain.
“It was a nightmare. I was just in unbearable, terrible pain,” he told the Post. “I couldn’t even go to the ER because those doctors won’t write those scripts.”
According to John Downing, CEO of Soldier On, an organization dedicated to helping homeless veterans, the addiction problem is real, it’s national, and the VA needs to work closely with the DEA in order to bring the problem under control, but that’s not the whole story.
“First of all, what the DEA is doing is absolutely necessary,” Downing told The Daily Caller News Foundation. “Doctors find that the easiest way to get people out of their offices is just to write the prescription. So, the DEA regulations are necessary and the VA needs to get in compliance, but the follow-up issue is whether the VA will continue to punish veterans. The underlying problem is the huge bureaucracy which lacks integrity, and we know this from the horrible lists of backlogs. Their wait listing system is designed to make the VA look good and the veterans suffer.”
According to an investigation by CBS News in 2013, from 2002 on, prescriptions for narcotics are up by 259 percent, resulting in a rate of overdose which is nearly twice the national average. Young veterans are especially at risk of chronic opioid use, a 2010 study published in the Journal of Opioid Management found.
“Generally, we at Concerned Veterans for America like to limit the amount of government involved in our day to day lives, but in this case, will the regulation end up hurting veterans? Not if the VA takes appropriate action,” Darin Selnick, senior veterans affairs adviser of Concerned Veterans for America, told TheDCNF.
“In theory, I understand the reason for the regulations. Doctors like to say yes to patients, and they don’t like to be bothered, so there’s a lot of potential for abuse. But the bottom line is that the VA has the ability to do whatever it wants. I’ve worked there in the past for almost 8 years. Yet, the VA is a behemoth that doesn’t adapt very well, even though they certainly have the resources, the ability, the intelligence, and the technology. For example, they’re not very efficient in the use of their doctors, so there’s low productivity.”
According to Selnick, what the VA needs to do is prioritize veterans who make regular appointments for prescription renewals, but the main obstacle is layers and layers of bureaucracy.
“Veterans should be able to get scripts,” Selnick continued. “If a hospital knows it has veterans who are on these medications, especially pain meds, then these veterans should be prioritized in the scheduling system. It’s an internal coordination issue between the scheduling system and the support staff. If these patients need to be seen on a monthly basis, then that needs to be caught and flagged and the schedule needs to be adjusted.”
What’s desperately needed, says Downing, is something like a Choice Card. It needs to be one which is pre-loaded with benefits and doesn’t have any of the onerous and excessive rules currently plaguing the Choice Card, where veterans have to move 40-miles away from the nearest VA facility in order to be eligible to use the card, or if they’ve had to wait beyond a certain amount of time.
With something like a Smart Card, on the other hand, veterans on opioids could go to local doctors and local pharmacies using pre-loaded benefits and easily alleviate the patient backlog problem, but Downing argues, “the reason that’s hard to get is because you have a bureaucracy that wants to continue to get paychecks on the backs of veterans. That really offends me.”
“This whole smokescreen—let’s get to the core of it. Maintaining the VA’s bureaucracy should not be the goal. It should be delivering services with dignity and respect.”
A poll released earlier in February by Concerned Veterans for America determined that 88 percent of veterans are interested in healthcare options outside of the VA.
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