Fighting the war over prescription painkillers

A veteran’s widow pushes for change as the Columbus VA rethinks its prescription policies

Heather and Scott McDonald and their daughter Reise after the Iraq war veteran returned home to Columbus.

Courtesy of Heather McDonald.

Heather and Scott McDonald and their daughter Reise after the Iraq war veteran returned home to Columbus.

When he returned from his service in Iraq in 2010, Scott McDonald was happy and excited about the future.  Returning to civilian life after 15 years in the Army, he and his wife Heather moved into a new house, bought a car and were trying to have another baby. They already were parents to 10-year-old Reise.

“Everybody thought now that he is getting out of the army, he’s going to finally live that life he’s been dying for,” said Heather McDonald.

But as the next two years progressed, Heather and Reise began recognizing changes in Scott’s behavior after he took his daily pain medication.  The stay-at-home dad was always tired, more reserved and more zoned out or “absent” than he had been before.

Heather blamed the changes on double doses of medication prescribed for Scott by the Columbus Veteran Affairs medical clinic staff. 

“My husband was receiving medication at the pharmacy and two days later the exact same medicine would come in the mail,” she says.

Not knowing what he was supposed to do, Scott took both medications twice a day, as prescribed on the bottles.

Heather McDonald said Scott took daily doses of 500 to 800 milligrams of Ibuprofen, and Meloxicam, which was prescribed for his back pain caused by an injury suffered in Iraq.  She said nurse practitioners and doctors at the VA kept increasing the doses, without conducting any tests or examinations to see what the medications were doing to his health.

Scott didn’t like to take what he called his “Lucky Charms,” Heather said, but he was a good soldier who didn’t question orders – if the VA prescribed the drugs, he would take them. So, early on September 12, 2012, Scott returned home from another visit to the VA with Percocet, another narcotic for pain relief, in hand.

The next morning, she found Scott dead on the coach.  He was 35 years old.

“I just knew when I looked at him that he was gone!” said Heather with tears in her eyes.

Heather believes her husband’s death was the result of too many medications and could have been prevented by better monitoring of his prescriptions and regular blood tests to determine whether multiple medications were affecting his health. She is now rallying for changes at the VA; she’s testified before a Congressional committee and gotten local and national support from veterans and their widows who also want to curb the use of painkillers.

“I fully, 100 percent believe that the VA knows exactly what’s going on and that they know that they give our men and women medications, without blinking an eye. They give these medications to these people without doing proper tests, without the proper psychiatric evaluations, to keep them quiet, to keep them happy,” Heather said.

“So they keep them doped up, and they keep them stupefied and they kill’em. Period. That’s what I believe,” said Heather.

A nationwide problem:  painkiller prescriptions for vets soaring

Heather McDonald’s take on the VA and its use of medications is born of pain and loss and her cynicism may seem exaggerated. But statistics indicate that the prescriptions of painkillers for veterans have risen dramatically in the last decade.

The Center for Investigative Reporting, a non-profit news organization based in California, this fall published the results of a national investigation into the increases in VA prescriptions for painkillers between 2001 and 2012.  It showed that prescriptions for powerful opiates have tripled for veterans nationwide.

Prescriptions issued through the Columbus VA have risen 550% since 2001, according to the CIR investigation. For every 100 patients who visit a clinic, 75 of them leave with a prescription for opiates.  The Columbus VA facility had one of the highest percentage increases in the state, though other areas also saw big jumps in opiate prescriptions.

The VA Healthcare System of Ohio in total saw a 291.9% increase in the number of opiate prescriptions, or 64 for every 100 patients.

Dr. Edward Bope, chief of primary care at the Columbus VA, agreed that overuse of painkillers is a problem in society overall and an issue for the Veterans Administration. But he doesn’t think the VA is the main culprit.

“I think the numbers of physical injuries have risen. People are coming back (from war) with true injuries, and second, we have become a society of people that feel pills can fix anything,” said Bope.

“Drugs, narcotics are a big issue in our society right now. People tend to take medicines to change the way they feel, instead of working on the issues to change the way they feel,” he said.  Bope said doctors can’t always control whether patients take more pills than are prescribed, or hang on to old prescriptions that they shouldn’t be taking.

Bope said that with increased governmental and media attention to the overuse of prescription drugs, particularly within the last year, the Ohio Department of Veterans Services in Columbus has been developing solutions to the problem.

“We here in Columbus, and VA in general, are taking this group of veterans very seriously, offering specific services to them targeted at their special needs,” he said.

Bope said the VA is looking at each of its patients individually and trying to devise alternative treatments.  Some of the options being tried include substituting long-acting narcotics such as morphine for shorter-acting narcotics that may be more harmful, reducing doses and changing the combinations of medications administered.

Bope said the VA is using a new computer program to better analyze “every prescription that goes out of here to make sure that it’s safe for a patient, and I believe that if people take medicine as prescribed, they will remain in that safe zone.”  He said the program is better equipped to monitor prescriptions picked up at outside pharmacies and the VA pharmacy.

Drug-free alternatives

The new drug treatment programs still are being tested for the effectiveness, said Bope, but he added that therapies that don’t use medication can be helpful as well. They can include physical therapy, water therapies, massage and acupuncture.

Heather McDonald says that soldiers often are very private about their health issues, especially if they’re mental health issues.  For the longest time she tried to suggest to Scott that he might be suffering from Post Traumatic Stress Disorder (PTSD). But her expressions of concern only upset him.

“It wasn’t until another service member stood up and told him ‘man, you have PTSD’ that he took it seriously and got help,” she said.

One group of veterans in Columbus wants to help veterans cope with PTSD and other issues in a drug-free way.

Alvin Buryzynski, vice president of the Military Veterans Educational Foundation (MILVETS) in Columbus, said most veterans are afraid to open up when coping with PTSD, because there still is a stigma attached to it in today’s society.  The VA’s brochures and information seminars often aren’t enough to help overwhelmed veterans trying to start a new life.

Buryzynski and members of MILVETS created a program called “Operation Let’s Roll” in Columbus. It offers a sport that combines fighting techniques such as jiu-jitsu and judo and only involves grappling, rather than hitting. Its aim is to release aggression without doing any harm.

“It’s a way to bring these service members back in an arena and participate in an activity that they are well aware of, instead of doing something self-destructive or self-medicating,” said Buryzynski, an Iraq war veteran.

Buryzynski said the sport offers a common bond for former military combatants and opens up the door for them to talk about other things, such as traumatic experiences in battle or their current battles with PTSD.

”My main concern is that service members who are returning receive the assistance that they need and they get to know that our society is a whole parachute, and there are other alternatives, other than taking the opiates or painkillers,” said Buryzynski.

Calling on the VA to change

For Heather McDonald, it is not society that has to do a better job, it’s the VA.

“I want to see regulations changed. I don’t want little girls to wake up to get ready for school and have to walk pass their daddy covered in a white sheet,” she said.

In November, Heather testified before the U.S. House Committee on Veterans Affairs about overdoses among returning soldiers.  She is arguing for more restrictions on numbers of prescriptions and better oversight of how they are dispensed. In Scott’s case, for example, he received the same medication by mail and at the pharmacy – a duplication she says should not have occurred.

Still awaiting the committee’s decision about taking up legislation, she hopes that one day, the issue will go before the Senate, too.

“And guess what Obama, I’m coming for you,” said McDonald.

Throughout her battle against the VA, Heather has encouraged other widows to come forward and tell their stories.  Veterans also have expressed their gratitude to Heather for her work.  Many of them fear losing their jobs if they speak out in public, she said, but hearing their stories gives her strength to speak on their behalf. 

Heather struggles to survive and honor her husband
Heather McDonald continues to advocate for improved prescription drug monitoring for veterans like her husband Scott.

Courtesy of Heather McDonald

Heather McDonald continues to advocate for improved prescription drug monitoring for veterans like her husband Scott.

While she advocated for veterans and their families, Heather McDonald fought for several months with the VA over the reasons for Scott’s death.  The battle took its toll.

She said the autopsy results showed Scott had liver damage, but was otherwise healthy.  It showed the cause of death as a reaction to the combined medications he was taking.

McDonald says that when she contacted the VA about Scott’s death benefits, which would include his pension, the VA told her that they would pay her immediately if she would agree to the cause of death being suicide, brought on by PTSD.

Scott had been diagnosed with PTSD, but Heather does not believe that’s what caused his death.   She believes he wanted to live and that his death was caused by his being prescribed too many drugs.

“We suffered. My car was repossessed; I had to pick up a second job. We did whatever we had to do, because I was not going to let the VA sit there and make my husband another statistic of PTSD,” said McDonald.

After a 10-month wait, the VA awarded Scott’s death benefits to Heather.  Officials at the VA said they would not talk about Heather McDonald’s pension benefits case.

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