For some wounded veterans, strong prescription drugs can be cause of more pain

Some veterans from the wars in Iraq and Afghanistan have returned home to face another battle: addiction to narcotic painkillers prescribed by their doctors. Aaron Glantz of the Center for Investigative Reporting takes a look at whether these wounded warriors are being overmedicated with prescription opiates.

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    Next: a troubling account of the consequences of overprescribing addictive painkillers to veterans.

    The death rate from overdoses of those drugs at Veterans Affairs hospitals is twice the national average. But data shows the VA continues to prescribe increasing amounts of narcotic painkillers to many patients.

    Our story comes from the Center for Investigative Reporting.

    The correspondent is Aaron Glantz.


    U.S. Army Specialist Jeffrey Waggoner received a funeral with full military honors. He was medically evacuated out of Afghanistan in 2007 after he sustained a groin injury when a rocket-propelled grenade exploded during a house-to-house search.

    But that's not what killed him. Waggoner survived his deployment. He died back home in this motel, just hours after being discharged from a Department of Veterans Affairs hospital in Oregon. While recovering from his wounds, Waggoner's mental state deteriorated. He became addicted to painkillers. And the Army sent him to the detox center at this VA hospital in Roseburg to get clean.

    But the hospital continued to give him narcotics. And after two months, they released him with a massive cocktail of drugs, including 12 tablets of the painkiller oxycodone. Since Jeff's death, his father, Greg, has been trying to piece together what happened.

    GREG WAGGONER, father of U.S. Army Specialist Jeffrey Waggoner: I couldn't believe the amount of medications that was being prescribed to him.


    After he left the hospital, Jeff went to a nearby motel.


    He picked up a six-pack of beer. He checked into a room, has a couple beers, decides he's hungry. He goes next door to a restaurant, orders up a plate of nachos and another beer, and then becomes very groggy,


    The surveillance footage shows what happened next. Jeff fumbles with the keys to his room, barely able to stand. He nods, then lurches forward and collapses.

    Waggoner lay on the floor for an hour until the paramedics arrived. They tried to revive him, but it was too late. The state medical examiner concluded that, in addition to the two beers, Jeff consumed eight oxycodone pills, along with tranquilizers and muscle relaxants that he got from the VA.

    Greg Waggoner has never watched the video. He believes the VA was complicit in his son's death.


    The last thing you would think is that you have a child in the hospital trying to get care, that somebody would call at your door and tell you that he passed away.


    Since Waggoner's death five years ago, the Roseburg hospital's narcotic prescription rate has continued to rise. We tried to interview the hospital director, but our request was denied.

    Last year, doctors in Roseburg wrote more opiate prescriptions per patient than at any VA hospital in the country, according to data obtained by the Center for Investigative Reporting. The center analyzed 12 years of prescription data from the VA and found that prescriptions for four highly addictive painkillers have surged by 270 percent since the war in Afghanistan began, far outstripping the increase in patients.


    Dr. Stephen Xenakis is a psychiatrist and retired Army brigadier general. He says the data shows the agency is overmedicating patients as it struggles to keep up with their need for complex treatment.

    BRIG. GEN. STEPHEN XENAKIS, retired M.D., U.S. Army: They're working in these clinics. They're very busy. They have got time constraints. They have got pressures, and giving a prescription, which they know how to do and they're trained to do, is almost a default.


    Xenakis says that prescription opiates actually hurt most veterans, rather than help them.


    If you have been exposed to a number of blasts and are already feeling the effects of the blasts, and then you add a medication for pain like an opiate, that's going to make your thinking problems even worse. And not only that — you're going to feel more depressed.


    The VA has known about this problem for years. In 2011, VA researchers published a study showing the fatal overdose rate among VA patients is nearly double the national average. And four years ago, the agency adopted regulations designed to get doctors to use alternatives to prescription opiates.

    We spent a month trying to get someone from the VA to go on the record about prescription painkillers, but no one would talk to us.

  • MAN:

    I want to get back to overmedication.


    The issue is drawing interest on Capitol Hill. In March, Dr. Robert Petzel, the VA's undersecretary for health, testified before the Senate Committee on Veterans Affairs.

    DR. ROBERT PETZEL, Department of Veterans Affairs: Let me deal first with opioids, which is the most dangerous, in my mind, of our overmedication issues.


    Petzel says the VA uses opiates only as a last resort.


    When you're not able to manage the pain in any other way, it's opioids. And then there are very careful protocols about how that prescribing should be done.


    But the data shows the rate of prescriptions for opiates continues to rise. And, across the country, we found veterans addicted to painkillers they got from the VA.

    In Newport, New Hampshire, Tim Fazio is trying to stay clean. Fazio is a Marine Corps veteran who served in Iraq and Afghanistan. Two years after he came home, he went to the VA for help. Since then, VA doctors have provided him with nearly 4,000 oxycodone pills.

    TIM FAZIO, Marine Corps veteran: I thought the painkillers were OK because a doctor was prescribing it to me. If the doctor is giving this to me, I'm going to take it, you know?

    And [EXPLETIVE DELETED] if it makes you feel good, I'm going to take 15 of them, you know what I mean?


    Fazio deployed to Fallujah, and he survived a three-day firefight in Afghanistan. He wasn't severely wounded in the war. He says he took the pills to blot out the guilt and shame of surviving, when so many of his fellow Marines died after coming home.

    His medical records show the VA knew he was an addict, yet continued to dole out more opiates. At Tim's family home in Western Massachusetts, his father, Mike Fazio, has built a basement shrine to his family's military legacy.

    MIKE FAZIO, father of Tim Fazio:This is my son Tim. When he — this is when he got out of boot camp. He was so proud.


    Fazio says his son's life started spiraling out of control after Tim's best friend from the Marine Corps died. He encouraged Tim to get help at the local VA hospital. The doctors loaded him up on painkillers.


    That was the beginning and the end for him.


    Tim was hooked, and overdosed again and again. His parents kicked him out, and he moved in with Eric Demetrion, another former Marine. The two fed each other's addictions, and when they ran out of pills, they bought heroin. Eventually, Tim realized he need to move out.

    Three months later, Demetrion died of an overdose. Today, Fazio is living with his girlfriend. He's been clean for six months now, but staying off opiates hasn't been easy. In July, after a violent confrontation landed him in a VA emergency room, he was shocked when an agency doctor again prescribed oxycodone.

    Tim says he filled the prescription, and then stared at the bottle.


    I opened it a couple of times a day for probably three or four days to try to take one out. I said, if I take this, I'm not going to be — I'm not going to be living where I am right now. I'm going to be off and running again. It's going to send me on my way. So, I flushed them.


    With his mind no longer deadened by opiates, flashbacks and anxiety make him angry and explosive. And, so, despite that recent history, Fazio still turns to the VA for help.

    He's up early this morning, waiting for a shuttle to take him to the VA.


    My goal is to figure out where this rage, anxiety and all this is coming from, when I have been sober. I got to figure out where that comes from and how to cope with that, I guess.


    The Department of Veterans affairs remains a refuge for Tim. He says it's a place where he can surround himself with other veterans, men and women who have survived war, only to battle addiction at home.


    That story was originally part of a new investigative radio pilot called "Reveal." That airs this week on many public radio stations. "Reveal" is produced by the Center for Investigative Reporting and PRX. You can find a link to their related online material on our website.