As attorneys committed to helping veterans and military families with legal issues, we are alarmed by the growing crisis of veterans and active duty military personnel who commit suicide— many of which could have been prevented. The decision to commit suicide is often linked to an opioid dependency and the VA’s failure to properly treat that dependency.It can also be caused by the VA’s failure to provide prompt and appropriate medical treatment for PTSD, depression, anxiety and other invisible injuries of war.We hope this article will shed light on this subject and answer some of your questions.
A problem of growing magnitude
Unfortunately, over the last few years, suicide has become an increasing cause of death for veterans and active duty military personnel.
According to a report by the National Institutes of Health (NIH): “As of 2009, more Operation Enduring Freedom/Operation Iraqi Freedom veterans had died from suicide and lethal drug overdoses than from combat itself.” In fact, the saddest statistic may be this: Suicide rates among younger veterans, those between the ages of 18 and 34, spiked more than 10 percent in the years 2015-2016. When comparing veteran suicide rates by age group, younger veterans had the highest suicide rate in 2016, at 45 per 100,000.
A Veteran’s Administration study puts the suicide rate for veterans (as well as reservists, active duty personnel and those in the National Guard) at the heartbreaking average rate of 20 per day, or as many as 7,300 per year.
Additionally, that same study reveals:
- From 2005 to 2016, veteran suicide rates were 30 per 100,000
- In 2016, the suicide rate was 1.5 times greater for veterans than for non-veteran adults
- In 2016, the suicide rate for women veterans was 1.8 times greater than the suicide rate for non-veteran women
Suicide and opioid dependency
For those and the families of those affected, suicide is an unbearable tragedy. Everyone’s situation and the motives that lead to suicide are unique and often complex. For veterans’ PTSD, depression, anxiety and substance abuse amplify the susceptibility to suicidal thoughts.
Opioids have been widely prescribed to veterans for treating everything from back pain to psychiatric issues—most notably PTSD. It is widely known that these drugs, including brand-names such as Vicodin®, Percocet and Oxycontin® as well as generics such as codeine, are highly addictive.
The link between opioid dependency and Big Pharma
Pharmaceutical companies, like Purdue, have used misleading marketing and advertising tactics to target veterans and increase their opioid use. Some of those tactics included paying advocacy groups to create “fake educational” material with misleading information and paying doctors to convince the public OxyContin was safe.
“Exit Wounds”, a misinformation campaign designed by American Pain Foundation funded by Purdue Pharma, told veterans chronic pain users do not become dependent on opioids – which we know to be absolutely false.Exit Wounds went as far as to convincing veterans to demand OxyCotin, and paying doctors to say that opioids were dangerous only for people predisposed to addiction.
According to a lawsuit, Purdue created the campaign because they considered veterans to be high-profit customers since many of them suffered chronic and painful conditions.
The unique circumstances that veterans face make them especially susceptible to opioid dependency and addiction. A 2013 survey shows that the rate of substance use disorders (SUD) has increased steadily. Whereas 4.7 percent of veterans of the Vietnam era from 1964-1975 suffered this problem, the rate for veterans of wars occurring after September 2001 nearly tripled to 12.7 percent. A big part of that is the increase in prescription opioids.
One 2009 study bears that out: “The military recently released data confirming the magnitude of the prescription opioids and other substance misuse problem among active-duty personnel. In 2009, an estimated 14 percent of active-duty Army service members were taking opioids with prescription. Prescription opioid misuse among Department of Defense personnel increased 9 percent between 2002 (2 percent) and 2008 (11 percent), while illicit drug use, including misuse of prescription drugs, also spiked in that same period from 3 percent to 12 percent.”
Negligent opioid prescribing practices by the VA means that opioids are frequently inappropriately prescribed to treat either the physical or emotional pain (PTSD, depression or anxiety) that veterans face. The sad fact is that suicidal thoughts may increase by 60 percent among those taking these highly addictive drugs.
Suicide and the VA’s negligent attempts to treat opioid dependency
What happens when prescriptions are no longer available or when a veteran has been misusing prescription opioids? The VA’s answer to the situation is called the Opioid Safety Initiative. In turn, this has caused a number of veterans with opioid dependency issues to go “cold turkey[JJ1] ” while waiting for alternative answers to their needs. If the pain or the withdrawal symptoms become overwhelming, vets often turn to street drugs: most notably, heroin.
Addiction alone is difficult. When it leads to hopelessness, and results in veteran suicide, it is a personal and national tragedy. The risk for suicide death was over two-fold for male veterans with opioid use disorder. For female veterans, it was more than eight-fold.
Suicide prevention efforts at the VA have fallen off sharply due to departmental turmoil
Although reducing the high suicide rate among veterans is the Department of Veterans Affairs main clinical priority, suicide prevention efforts at the agency drastically reduced due to the lack of leadership at the VA.According to a 2018 government investigation, the suicide prevention office had an outreach budget of $6.2 million and only spent $57,000.This happened largely because key leadership posts remained vacant leaving the department in confusion.
“At a time when 20 veterans a day still die by suicide, V.A. should be doing everything in its power to inform the public about the resources available to veterans in crisis,” Representative Tim Walz, the Minnesota Democrat who requested the investigation, said in a statement. “Unfortunately, V.A. failed to do that.”
Real life stories behind the suicide statistics.
The motives for suicide are complex and wide-ranging. Combat veterans and others who have served at or near the “front lines” have a particularly difficult time adjusting to civilian life. They have often been exposed to horrors few outside the military can imagine. Reconnecting with family and community, looking for a job and figuring out how military skills do (or do not) apply, getting used to an individualistic, rather than a team-oriented, culture, and the worry and fear that go along with making the transition can add up to a great deal of stress.
Statistics are one thing but the real life stories of these vets are even more compelling.Here a just a few. . .
A 2014 broadcast on National Public Radio (NPR) tells the story of Bryan McDonel, whose opioid drug dependency started in the field:
“In the lead-up to his second tour in Iraq, Bryan McDonel got hit in the back by a trailer hitch while loading heavy equipment and wound up getting back surgery. He missed some training, but his company needed his expertise with satellites and radios, so they made sure he was classified as “fit to deploy.”
“We knew the deployment was coming up, and I didn’t want to let my team down,” McDonel says. “You know that whole, ‘I’m not gonna get left behind.’ … I was hard-headed. I ended up probably reinjuring it before it had time to heal.”
“The troops, if they got hurt, they’d just shove you a bag of pills, said Bryan’s father, Mike. You never got a bottle and knew what was in it; you always got a baggie… Everything under the sun, from Adderall to Percocet to hydrocodone, oxycodone, you name it… ‘Well here, here you go.’ Well, several of them got dependent. And I guess there’s that fine line between what’s dependency [and] what’s addiction.”
Mike McDonel never thought his son had crossed that line. Neither did Bryan — until his third deployment, this time to Afghanistan. He went on a two-week assignment to Kandahar airfield without enough pills. No big deal, he thought. Bryan went to the medic who informed him that he was experiencing withdrawal from the Vicodin. She put him on Percocet.
Bryan finished up his last deployment, tired but proud. He had a chest full of medals and even a Bronze Star. And then everything came apart.
Bryan failed a routine urine test in August 2011. Among the prescribed drugs in his system, he tested positive for morphine. His commander told Bryan he’d probably be kicked out of the military, possibly with a less than honorable discharge. “Once it spiraled out of control, there was no gaining it back. I resigned my position,” says Bryan. “I called my wife and told her.” Without a job, (and now divorced) he lost the house and moved in with his parents.
Bryan did a bunch of things he’s not proud of to get drugs. When he stole money from home, his parents kicked him out. He lived in his car. If he wasn’t an addict before, he was now. “Since then it’s been one day at a time,” Bryan says. “Looking daily to find work, every day, working hard to try and start relationships again.”
Then there is the story of veteran Kevin Keller, who took his own life in the summer of 2014. Doctors and nurses at the VA tried to “wean” Keller off the very painkillers they had prescribed. According to Keller’s friend, ““The medications were the only thing that was helping him, and when they took that away from him, his life just went downhill.”
Kevin Keller’s story is not an isolated incident – from October 2017 to November 2018 there were 19 suicides that occurred on VA campuses, according to the Department of Veteran Affairs. A federal investigation into one that occurred in Minneapolis found the VA made multiple errors including failing to communicate with family and not scheduling a follow-up appointment.
More recently, 55-year-old Marine Colonel Jim Turner shot himself outside the VA facility in Bay Pines, Florida. His final note: “I bet if you look at the 22 suicides a day you will see VA screwed up in 90 percent.”
Potential legal remedies for opioid dependent veterans and their families
If you are a veteran or have a family member who is at risk for suicide because of prescription opioids, you may have legal recourse against the Veterans Administration (VA) or its physicians. The Center for Investigative Reporting indicates that the VA wrote 1.7 million opioid prescriptions for 443,000 veterans who came into 143 facilities for outpatient care. These “overprescribing habits” have led to the issues with dependency, addiction and suicide among our veterans.
Actions can be taken against the Veterans Administration for medical malpractice because of negligent management of PTSD and other maladies. The federal government does pay for many of the VA’s mistakes: $200 million for less than 1,000 cases between 2002 and 2012. Since then, legal settlements have nearly tripled, primarily for malpractice lawsuits.
Depending on individual circumstances, it is also possible to bring actions against major pharmaceutical companies for their role in the opioid crisis.Big Pharma failed to adequetly warn about addiction risks, deliberately withheld information, and intentionally deceived medical professionals and patients about potention and risk of addiction.
To learn more about your rights and what actions you may be able to take, please contact us online or call our office at 844-295-7558.