The enemy at home: Veterans addicted and dying from VA pain pill - 13 WTHR Indianapolis

The enemy at home: Veterans addicted and dying from VA pain pills

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Marine Jeremy Brooking survived a sniper’s bullet in Iraq, but then lost three years of his life to VA-prescribed narcotics. Marine Jeremy Brooking survived a sniper’s bullet in Iraq, but then lost three years of his life to VA-prescribed narcotics.
This is a one-month supply of drugs (approximately 1,300 pills) that Brooking got from VA doctors. This is a one-month supply of drugs (approximately 1,300 pills) that Brooking got from VA doctors.
Former VA doctor Pamela Gray says she witnessed “gross malpractice” resulting from the VA’s pain management policies. Former VA doctor Pamela Gray says she witnessed “gross malpractice” resulting from the VA’s pain management policies.
Army doctors prescribed Lance Pilgrim Oxycontin for a broken finger. He later died from an overdose of pain killers. Army doctors prescribed Lance Pilgrim Oxycontin for a broken finger. He later died from an overdose of pain killers.
Since 2001, prescriptions for narcotics increased dramatically at VA medical centers like this one in Indianapolis. Since 2001, prescriptions for narcotics increased dramatically at VA medical centers like this one in Indianapolis.
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    Military records and independent studies obtained by 13 Investigates show many returning veterans received staggering amounts of powerful narcotics to treat their physical and emotional wounds.More >>
    Military records and independent studies obtained by 13 Investigates show many returning veterans received staggering amounts of powerful narcotics to treat their physical and emotional wounds.More >>
Whistleblowers say military doctors and VA have overprescribed powerful narcotics for more than a decade.

An Eyewitness News investigation shows thousands of US soldiers, airmen, sailors and Marines survived the wars in Iraq and Afghanistan only to be ambushed back home by an unexpected enemy. Military records and independent studies obtained by 13 Investigates show many returning veterans received staggering amounts of powerful narcotics to treat their physical and emotional wounds. Veterans and military insiders are now coming forward to expose the Department of Veterans Affairs’ flawed and dangerous pain management program. They insist that program accidentally killed returning servicemen and destroyed thousands of lives.

Bob Segall/13 Investigates

INDIANAPOLIS - As a boy growing up in southern Indiana, Jeremy Brooking knew he wanted to serve his country.

"Ever since I was little, I knew that's what I wanted to do. I wanted to be a Marine," he says. "Becoming a Marine, it was a dream come true."

That dream was cut short by an Iraqi sniper.

Barely a year after his graduation from Mitchell High School, the new Marine was on patrol in Fallujah. Brooking was looking for signs of trouble – insurgents planting road-side explosives or suicide bombers – when his observation post came under attack.

"I just heard this pop and flew backwards. I knew I was shot," he told WTHR, looking down towards his chest.

A single armor-piercing round penetrated Brooking's bullet-proof vest and lodged between his heart and his spine. As medics rushed him to surgery, fellow Marines placed an urgent phone call to Brooking's wife and then handed the phone to Jeremy for what was characterized as a final phone call.

"They told me it was really bad," recalls Tia Brooking, unable to hold back tears. "I remember telling him I love him, but I didn't want him to know I knew he probably wasn't going to make it."

He did make it. Despite being pronounced dead twice before surgery, despite suffering a brain injury due to massive blood loss, despite having a bullet lodged millimeters from his heart that doctors believed to be too dangerous to remove, the 19-year-old Marine survived the sniper attack and was sent to Camp Lejeune, NC, to recover.

That's when Brooking discovered a new enemy the military hadn't discussed with him.

"Getting shot was just the beginning. After I got home, that's when the real battle began," he said.

1 Veteran + 1 Year = 15,000 Pills

The battle Brooking is talking about is an addiction to pain killers. Military doctors prescribed him 22 different medications -- many of them powerful narcotics like Oxycontin and Hydrocodone -- to numb his chest pain. A VA hospital gave Brooking 43 pills a day. That's nearly 1,300 pills a month. More than 15,000 pills a year. A 1-month supply of medication filled a plastic grocery bag.

"I lost three years of my life where I barely remember anything," he said. "I'd sleep 23 out of 24 hours of the day because of those pills. It destroyed our family. It really destroyed me."

Tia Brooking saw her childhood sweetheart turn into a different person. He rarely talked. He could barely walk. He fell asleep while eating cereal.

When she complained to doctors at the VA hospital and asked for a different pain treatment, she received bad news.

"The doctor said 'Your husband is never going to get better. This is how he's always going to be.' And I said 'What can I do?' And he said 'I can write you any prescription you want. Tell me what you want, and I'll write it.' He said 'I'm in the business of writing prescriptions.' I remember him saying that, and I said 'I don't want prescriptions. I want him to get better," she recalls, shaking her head. "It was horrible. Sometimes … when I got home, I thought he was going to be dead."

"Inexcusable" increase

Brooking's experience is far from unique.

Data obtained by Eyewitness News shows tens of thousands of veterans are addicted to opioid pain killers since returning from combat – and the amount of narcotics prescribed by the military healthcare system is staggering.

At the Roudebush VA Medical Center in Indianapolis, the number of prescriptions issued for both hydrocodone and morphine jumped more than 400% in the decade following 9-11. The dramatic increase, documented by The Center for Investigative Reporting, far outpaced the VA’s center’s 43% increase in patients during the same time period.

The jump is even bigger at the VA system in Marion, Ind. The number of prescriptions written for hydrocodone climbed 639% and morphine prescriptions skyrocketed 1,252% between 2001 and 2012. During that time, the number of patients at the Marion VA increased 63%, according to CIR's analysis.

It's a similar story at VA facilities all over the country, and Dr. Pamela Gray saw it firsthand.

"This is inexcusable, it really is," she said.

Gray was a doctor at the VA Medical Center in Hampton, Va., from 2008 to 2010.

"The patients that I came across, it was not at all unusual to get 1,000, 2,000, 3,000 tablets per 30 days," she said. "These were excessive amounts, often mailed to the patient's home and the patient didn't even have to come in for a visit. This is gross malpractice."

Gray remembers the VA issuing a prescription for painkillers to a veteran who, just 48 hours earlier, had been released from the VA emergency room after she attempted to commit suicide by overdosing on the exact same medication.

"Doctors were told ‘Give the patient what [they] want,' and when I questioned that, I was met with resistance," Gray told 13 Investigates.

She believes the VA medical system was -- and still is -- entrenched in a culture that relies too heavily on treating pain with narcotics.

"I don't care how entrenched it is. It doesn't give you the right to kill people under the guise of medicine," Gray said.

Rising death toll

13 Investigates has discovered narcotics overdoses have been killing veterans at an alarming rate.

WTHR obtained records from the Indiana State Department of Health that provide a sobering reality: in Indiana alone, an average of 24 Hoosier veterans died each year from 2008 to 2011 because of opioid-related overdoses.

Nationwide, the death toll is much higher.

"It's such a terrible loss to lose a child. It's a part of your heart that is cut out and gone forever," said Judy Pilgrim.

Pilgrim's son, Lance, is among those veterans who survived a foreign war, then later died from an overdose of pain medication back home.

"We never thought about the battle going on after he got back from the war. We felt like once he got back here safe, he was OK," she said.

Lance Pilgrim was deployed to Iraq in 2003 as a rocket launch specialist in the U.S. Army. He returned to Daingerfield, Tex., with no physical injuries. But he had terrible nightmares about the horrors he experienced during his deployment.

"He was very quiet and withdrawn. I had never seen him like that," said his father, Randy. "He was really struggling but he didn't want to really talk about it."

Like many soldiers returning from Iraq, Pilgrim was suffering from severe emotional pain. When he later broke a finger playing football at Fort Sill, Okla., no one understood the significance of what was about to happen.

Army doctors prescribed Pilgrim Oxycontin and Oxycodone for his finger pain, and a downward spiral followed. The opioids helped Pilgrim numb his debilitating depression and anxiety triggered by Post Traumatic Stress Disorder.

"It was a seriously addictive painkiller, and I was shocked they'd give it to him for a broken finger," his father said. "They also gave him Hydrocodone for a root canal. He got hooked on pills after that. At one particular time, he called me on a cell phone, and I picked my son up sleeping in a dumpster. That's how serious it had gotten."

Lance began going AWOL from his army post and, upon the advice of his parents, finally reached out for help.

"He went to his commanding officer and said ‘I have a problem,' and he was told 'You do not have a problem. Go back to the barracks,' his mother said.

Pilgrim eventually got into to a VA treatment program for PTSD. But doctors there prescribed him even more narcotics – even though his medical chart warned he had battled opioid addiction. Just days later, a few miles from his childhood home, the young veteran was found dead inside a motel room. The official cause of death: accidental drug overdose from too much Methadone and Hydrocodone.

VA responds

The Department of Veterans Affairs is aware of the many overdose deaths that have occurred nationwide involving veterans addicted to narcotics.

"We acknowledge it's a significant problem. Any person who dies from overdose of prescription opioid use is too much," said Dr. Matt Bair, a pain management doctor at the Roudebush VA Medical Center in Indianapolis. "There has been an over-reliance on medication therapy… and these increased rates of prescription use have been done with the absence of new research showing this is a good thing."

Bair says the VA realizes it now needs to reduce the high levels of narcotics dispensed to veterans – especially those suffering from PTSD and other psychological disorders.

"We've learned that [opioids] may be harming some patients and that may not be the most safe and effective approach," he told WTHR.

Following Congressional hearings about the VA's prescription painkiller policy in 2013 – including testimony from Gray – the Department of Veterans Affairs announced changes affecting VA medical centers nationwide.

Roudebush and other VA facilities began to initiate what they refer to as the Opioid Safety Initiative.

"It's a multi-faceted approach to try to reduce opioid use," explained Bair. "I don't think opioids should be the only tool in our tool kit. They shouldn't be the only treatment we provide."

There is now a focus on offering other treatments. In Indianapolis, that means veterans now have access to yoga, tai chi and creative arts classes designed to reduce veterans' stress and pain. And some patients are getting permission to go outside the VA system for alternative therapies once shunned by the military.

Success story

Adessa Naylor says she's been battling chronic pain for 15 years.

She retired from the Air National Guard after suffering a serious back injury while on active duty in 1999. Through the VA, Naylor endured years of surgeries and heavy doses of narcotics – with little success.

"I've been taking Vicodin on and off for years," she said. "I just realized nothing was really working. I got to the point where I was getting a dependency, where I'm going ‘I need more and I need more. I need some help.'"

In February, Naylor got that help under the VA's new Opioid Safety Initiative and redesigned pain management program.

A VA doctor in Indianapolis recommended she try acupuncture and sent her to an outside practitioner. Within two weeks, Naylor says the impact was miraculous.

"The pain used to be so bad, I stayed in bed most of the time. I couldn't do anything," she recalls. "Then they put the little needles in, and I feel better. I'm back on my feet again."

Naylor is now able to grocery shop, dress herself without assistance and throw a ball with her grandson – all impossible tasks just a few months earlier while she was taking opioids.

"I am more functional now. We went from taking Vicodin on a daily basis – two to three pills a day, every day – to not having to take any Vicodin. I was shocked," Naylor told WTHR. "The pain is not gone. It's still there, but I'm learning to manage my pain, and I don't have to take another pill to do it."

Costly delay

VA insiders (and many veterans) wonder why it's taken so long for veterans like Adessa to get treatment options other than narcotics.

Over the past decade, as thousands of veterans lost their quality of life to painkillers – and many others died -- the VA was ignoring warnings from its own doctors.

Gray, for example, tried to wean her patients off narcotics and into alternative treatments such as water therapy as early as 2008, but she says VA administrators told her to stop.

"I was told by the department chair of internal medicine to think twice about not prescribing these narcotics," the doctor said. "I was ordered to write these drugs or be fired. I was ordered, as a physician with 25 years of experience, by a non-physician to do something that was medically incorrect. That is an intolerable position."

Gray says the VA has a severe shortage of qualified pain specialists, and when faced with writing prescriptions or creating pain management programs, she believes VA supervisors choose the more cost effective option.

"It was just so much easier to keep the narcotics flowing, and nothing has changed," she said during an interview at her Virginia home. "These drugs are cheap and they are readily available. Sometimes, though, you can't do what's cheap. You have to do what's right."

The VA eventually did fire Dr. Gray in 2010 after she complained publicly about the VA over-prescribing veterans. Even though her concerns were justified, it would take the VA nearly five years to start making the changes she suggested.

And even now, those changes can be hard to find.

Painfully slow progress

While Naylor is grateful to be receiving acupuncture therapy instead of narcotics, she says it was not VA doctors who initiated the idea.

"It was my idea," she said. "I told them ‘You've got to do something. We have to try something different because what you're doing isn't working." Naylor had that conversation with VA doctors in February – several months after the VA initiated its Opioid Safety Initiative in Indianapolis.

"You have to advocate for yourself. No one else is going to do it for you," she added.

Other veterans tell 13 Investigates it is very difficult to get into alternative pain treatment programs at the VA. They say the VA's offerings are still very limited and that some veterans now try to avoid all contact with the VA's pain program.

"A lot of us are afraid to do anything there because if you disagree with the doctors, they can cut you off and you risk losing access to all of your VA healthcare," said a veteran, who asked not to be identified for fear of reprisal.

VA officials admit there is still a lot of work to do as the VA shifts away from its reliance on narcotics.

"That's a welcome shift, but I think it's a shift or a transformation that will take some time," said Bair.

Gray believes the changes should be fully implemented as soon as possible.

"Why the delay? How many lives were lost? These people served their country. They deserve the same in return from the country," she said.

Victims' families agree that time is of the essence. Some veterans, like Jeremy Brooking, have simply given up on the VA's pain program.

He's now seeing a private doctor who's helped the Marine stop taking opioids all together.

"For some reason, pain management became associated with just prescribing narcotics," said Carmel pain specialist Dr. Dmitri Arbuck, who's been treating Brooking since 2012. "That should really be stopped. It's the wrong practice and there are so many other options."

Brooking admits he still struggles daily with the aftermath of his injuries, but says "I've got my life back" after breaking free from his addiction to opioids.

He knows other servicemen are not as lucky. Brooking recently lost a close friend – another fellow Marine – who overdosed on pain medication prescribed by a VA hospital.

"I don't know why we're still doing this, why this is still happening," he said. "More veterans are dying here at home by these narcotics than are dying overseas, and that's not right."
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