PTSD Veterans Fight Addiction to Prescription Painkillers

At WSJ, "For Veterans With PTSD, A New Demon: Their Meds: Threat of Addiction to Prescription Painkillers Heightened With Mental Illness":

NEWPORT, N.H.—Desperation drove Timothy Fazio, a former Marine, to turn up around midnight at a veterans' hospital near Boston. His post-traumatic stress disorder was causing flashbacks and blackouts. He had leapt from a balcony.

And he had overdosed, twice, on painkillers originally prescribed for a hand injury suffered in Iraq.

"I want detox," Mr. Fazio told doctors that night in 2008, his medical files say.

After a week of withdrawal, Mr. Fazio checked himself out of the Veterans Health Administration hospital—and was given 168 pills of the same opiumlike drug he was already addicted to, according to his files, which The Wall Street Journal has reviewed. The next day, the hospital gave him another 168 pills.

PTSD and painkillers are the twin pillars of a new mental-health crisis in America. Many of the more than two million Americans who served in Iraq or Afghanistan suffer, as Mr. Fazio does, from a mixture of pain and PTSD. The VA treats many of them with powerful opioid painkillers for their pain. But opioids can be a combustible mix with mental illness because of a heightened addiction risk.

Effectively, some critics say, it amounts to treating mental illness with addictive narcotics.

A study by a VA researcher found that veterans with PTSD were nearly twice as likely to be prescribed opioids as those without mental-health problems. They were more likely to get multiple opioid painkillers and to get the highest doses. Veterans with PTSD were more than twice as likely to suffer bad outcomes like injuries and overdoses if they were prescribed opioid painkillers, the study found.

In Mr. Fazio's case, between 2008 and 2011 the VA prescribed him more than 3,600 pills containing oxycodone, a narcotic painkiller from the same family as heroin and morphine, his records show. He overdosed a total of six times.

"I was always a tough kid, but I feel like this has been the toughest fight of my life," Mr. Fazio said in March, after a spell of homelessness that saw him sleeping in an ATM lobby. "I don't know if I'm going to win it."

The VA declined to comment on Mr. Fazio's treatment and said it would review his records. It said it follows uniform guidelines and procedures for veterans' pain care, adding that those are being reinforced with further training of doctors and patients in safe opioid use. "The Veterans Health Administration has worked aggressively to promote the safe and effective use of opioid therapy for veterans," it said.

The number of vets with both PTSD and pain isn't known. But some 30% of Iraq and Afghanistan veterans under VA care have PTSD, VA figures show, and more than half suffer chronic pain.

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