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Wednesday
Feb262014

VA Cites Drop in Opiate Prescriptions, But Some Pols Skeptical of Progress

Photodisc/Getty Images(WASHINGTON) -- U.S. Department of Veterans Affairs senior officials told a panel of skeptical House lawmakers Wednesday that the VA has reduced the number of veterans receiving opiates by 20,000 since October in response to congressional pressure and media scrutiny.

"The VA has a very good story to tell," Dr. Robert Jesse, the agency's principal deputy undersecretary for health, told a subcommittee of the House Committee on Veterans' Affairs.

Jesse and his boss, the undersecretary for health, Dr. Robert Petzel, predicted that improvement will be accelerated by a new initiative reported on by ABC News on Tuesday to expand physician training and alternative therapies around the country.

Those alternatives include acupuncture, meditation, imaging therapy and, possibly, spinal stimulation, along with increased access to specialists in treating the root causes of pain.

But despite the upbeat testimony, Rep. Dan Benishek, R-Mich. -- the subcommittee chairman -- said he was frustrated.

"It remains to be seen whether this effort will generate meaningful results for our veterans," he said after the hearing. "VA still has a lot of explaining to do on how this problem escalated in the first place and why it's taken them so long to do anything about it."

In September, The Center for Investigative Reporting revealed that VA prescriptions for four highly addictive opiates -- hydrocodone, oxycodone, methadone, and morphine -- had surged by 270 percent between 2001 and 2012.

That far outpaced the increase in patients and contributed to a fatal overdose rate among VA patients that was nearly double the national average.

The story helped spark a congressional hearing in October, where VA officials promised to develop a plan to combat the problem. On Tuesday, that plan came in the form of an Opioid Safety Initiative, which builds on pilot programs already underway in various cities.

The initiative announcement came hours before broadcast of a new joint investigation by ABC News and CIR.

In that report, a VA physician, Dr. Basimah Khulusi, came forward to say she had been forced out of her job in Kansas City, Mo., after some veterans complained that she would not prescribe high doses of opiates.

VA officials said they could not comment on Khulusi's employment. Jesse argued that the drop in veterans receiving narcotic painkillers proves practices already are changing.

"There is concentrated and accelerated attention in this area," he said.

Asked about the numbers behind the drop, VA spokeswoman Victoria Dillon said that between September and December, patients receiving an opioid prescription declined from 665,786 to 646,234 -- about 3 percent.

Decorated Army veteran Justin Minyard said he hopes the change is real. After multiple injuries in Afghanistan and Iraq, Minyard became addicted to opiates prescribed by the VA for chronic pain.

"I was in a fog for years," he said. "There were better options to treat my pain and those weren't presented to me first. The priority was treating me the fastest, seemingly least expensive way, and it was the most detrimental."

Minyard said he was finally able to get off pain medication after trying spinal cord stimulation, but when he asked the VA about obtaining a spinal stimulator two years ago, he was told he would have to fail with opiate treatment first.

"My response is, 'What is your definition of failure? Is it addiction or is it death? Accidental overdose?'" he asked. "When I accidentally overdose, does this mean I'll be able to access treatment?"

Veterans around the country raised questions about how available the alternative therapies promised by the VA would be.

In Texas, U.S. Army veteran Chas Jacquier, who sustained multiple concussions during bomb blasts in Afghanistan and has a bulging disk in his back, told CIR he had to wait three months to see a neurologist.

When he finally saw the specialist on Tuesday, he said the doctor talked to him about future acupuncture or chiropractic care -- but nothing was scheduled and any future appointments appeared to be weeks, or months, away.

"I would like some alternative therapy," Jacquier said, "but all I get is meds."

Still, Minyard said the change in VA policy could give more veterans access to alternative therapy and reduce their dependence on painkillers.

"Thank God. Now how do we fix it?" he asked. "Let's start fixing. We can start this afternoon. It's not too little, too late. Absolutely not."

This story was reported by The Center for Investigative Reporting (CIR) and ABC News. ABC News senior producer Teri Whitcraft contributed to this report. Reach aglantz@cironline.org and follow him on Twitter at @Aaron_Glantz.


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