Report: VA's reduction of narcotic painkillers had tragic consequences

When the Minneapolis Veterans Medical Center decided to limit the dispensing of narcotic painkillers to stop veterans from becoming drug dependent, the new policy led to sometimes tragic results, according to a recent Star Tribune report.

Veterans who used narcotic prescriptions to handle chronic pain felt abandoned. Some who obtained narcotics from other sources overdosed and died, reported Mark Brunswick, a military affairs reporter for the newspaper.

Brunswick, who spent months reporting on the VA's changed policy spoke to MPR News' Tom Weber on Tuesday.

Key points

Brunswick's reporting documented how after years of freely prescribing narcotics for chronic pain, the Minneapolis VA created a first-in-the-nation program aimed at reducing prescriptions of opioid-based medicines.

"The VA took a look at the number of prescriptions they had for particularly high dosage opioids and realized they had a problem and they had actually, in some ways, created addicts from these vets and then they needed to do something about it," Brunswick said.

Nationwide, the number of VA prescriptions to treat chronic pain with narcotics has tripled from 2002 to 2013, according to the newspaper. At VA hospitals in Minneapolis, St. Cloud, and Fargo, N.D., prescriptions for opioid-based medicines such as morphine and oxycodone more than doubled for every 100 patients from 2001 to 2014, according to the newspaper.

In reporting his two-part series, Brunswick thoroughly examined data in Minnesota and met many veterans and their families. The stories detailed how the VA's well-intentioned effort affected them.

"The sort of unintended consequences were the vets went outside of the VA or vets tried to wean themselves off [narcotics] and then found themselves in trouble because these drugs that they had been given really they did find themselves in need of them," Brunswick said.

The drug-reduction program did not have sufficient resources to meet veterans' needs, he said.

When some returned with problems, Brunswick said, "they were kicked out of the VA programs and left to fend for themselves."

VA response

Dr. Franz Macedo, medical director of the Minneapolis VA Comprehensive Pain Center, said VA doctors are educating veterans about pain management and focusing on rehabilitation.

"What we're doing at the Minneapolis VA is fantastic and I'm proud of it," Macedo said.

Because opioids carry a safety risk, the first thing VA officials did when they launched the program was to provide veterans access to mental health and pharmacists, said Peter Marshall, director of pain management at the Minneapolis VA.

"The VA is doing more and more to try to address the [veterans'] problems," he said.