VA Opioid Scandal

Benjamin KrauseA Wisconsin VA has come in the cross hairs of national media after the Drug Enforcement Agency and VA OIG started investigating a VA opioid scandal related deaths of veterans.

Known as “Candy Land,” the Tomah VA Medical Center and its chief of staff Dr. David Houlihan have been linked to over prescribing controlled narcotics. The over prescribing led to the recent death of Marine Corps veteran Jason Simcakoski and is possibly linked to the deaths of others.

The 35-year-old veteran checked into the Tomah VA last summer. At the time, he was taking over one dozen drugs. The drugs included anti-psychotics, tranquilizers, and a painkiller. Dr. David Houlihan then added Suboxone, which is an opioid used to treat addiction. Jason Simcakoski died of “mixed drug toxicity” a few weeks later.

Simcakoski was not the only veteran getting high doses of drugs from VA. According to VA pharmacist David Hughs, some veterans were prescribed 800 oxycodone pills a month, “enough to wipe out a typical retail pharmacy in one go.” Hughs went on to critique the facility for its obsession with less urgent issues like an asbestos problem or spilling a Coke can on a computer keyboard.

The Drug Enforcement Agency is now investigating the opioid issue and the State of Wisconsin is also evaluating three health care providers for violating ethics rules including Dr. David Houlihan.

Houlihan was previously admonished by the State of Iowa some years prior to moving to Tomah for inappropriate relationships with patients. VA apparently thought it was wise to hire him into the Tomah VA facility.

Meanwhile, veterans across VA are being hit hard by new restrictive policies that prohibit previous prescriptive practices. Without warning, VA stopped filling prescriptions for painkillers that many veterans desperately need to cope with extensive war wounds such as missing limbs and blast exposure.

So where are you at on the issue with the VA opioid scandal? Have you been harmed by VA cutting you off without notice or did you experience problems from careless prescriptive practices?

Source: http://www.nbcnews.com/news/us-news/wisconsin-va-dubbed-candy-land-probed-pain-pill-overkill-n306996

37 COMMENTS

  1. The VA’s reaction is a bit like child mentality in that their knee-jerk reaction has been literally, overkill, in now simply stating NOBODY can have ANY opioid painkiller, rather than doing the proper thing and actually evaluating HIRING PRACTICES and ACCOUNTABILITY of the VA’s practitioners.
    No…instead, without warning, recklessly and abruptly without even the option of titrating people off said meds….doing it COLD TURKEY is incredibly dangerous! THAT is certainly NOT the medically preferred method in the “real medical world” and I wonder with trepidation, how many additional suicides the VA will be directly responsible for when Veteran’s that are in SO MUCH PAIN, they perhaps see no other option because it comes across CLEAR the VA simply is heartless and could care LESS,
    RECKLESS.
    I can smell CLASS ACTION LAW SUIT.
    Why?
    It’s definitely MALPRACTICE to ignore one’s OATHE as a medical professional.
    In the REAL world, that is.

    • Lawsuits and even class action lawsuit the VA has contained [re: Mofo.com class action lawsuit in 2007–73 pages 300 issues]; however, the VA cannot handle the Public nor a Public driven Media [where Carl Icahn cannot call the shots]….this is when Americans tell the politicians how it is!

    • It is sad. Denying pain medication does open the door to make suicide an option. I’d never contemplated it while my pain was being controlled but I have to admit, without the medication, suicide appears pleasant. Even though I have everything to live for and wonderful people in my life, it’s all for naught if it’s overshadowed by the elephant in the room – debilitating pain. The option becomes desirable.

      • Gulf Vet, You bring up a good point and a point that not may people want to look at because of the nature of it (suicide because of the pain). Not looking into this part of the problem with the cut off of the pain meds needed to have a quality of life; this is sometimes the result of it. I would be interested to see a number that shows how many vets and other people have taken this route because of the pain. I know how you feel because of my own problems with the VA I was taking morphine for my pain for 2+ yrs. and I moved from WA to IN. The problem started when I tried to get the med from the Indy VA. They would not continue it and I was cut off cold turkey. After four months of they Indy VA stating that they can find nothing wrong with me ( I have many yrs. of the condition in my VA records that the Indy VA refuses to look at), the Indy VA finally prescribed Vicodin. I go from a strong pain med to the weakest med. It is funny how they can prescribe me a narcotic for a condition that they say I don’t have. I can only hope that other vets get what they NEED and that the others need to understand that some of us need these meds as we have no other option(s) available to us and this helps us through everyday.

      • Gulf Vet, you should look into the Wisconsin State Department of Veterans Affairs. It is separate from the federal DVA and has many good veterans involved in it. Staying busy with them may help in some way. I served on their Long Term Care Committee there several years ago, and was shocked at how big that department is, how many activities they have, and how many benefits they provide to Wisconsin veterans.

        They have long term care facilities at King and at Union Grove that are huge, with veterans all over the nation trying to get in to them. Wisconsin is one of the top states in the nation with a well run state level Department.

        As for VA pharmacies, I still have a gallon zip lock bag from the early 1990’s that are full of all of the various prescriptions the VA provided. Back then, they didn’t care to provide help beyond giving you a prescription and sending you on your way. I figured it wasn’t good to mix all those pills since no pharmacist ever checked what other prescriptions a veteran might have, and how they might interact with one another.

        In the mid 90’s while in the Houston VA, I was given Seldane and an antibiotic at the same time because nobody every checked other prescriptions a vet was given. Several years later the FDA pulled Seldane off the market because it caused heart problems when patients took it with anti-biotics.

        I don’t know what changed over the years, I had not gone to the VA from 2010 until 2014, but now when I get a prescription filled, I cannot get it filled without first seeing a pharmacist who checks what other medications I might be on. I am not sure all VA’s do this, but they should.

  2. 02/24/2015

    Dear Benjamin Krause,

    Its more—than just the VA and the Veterans—it is the whole Tomah Community that suffered by this drug trafficking and having the citizens/veterans hooked on the drug —-Dr. David Houlihan was prepping the community to be placed on the incoming heroin [like I said before get use to saying sabotage]—the citizens/veterans will be looking for a substitute after being cut off by the doctors/administrators who think they are doing the right thing by an abrupt stop in the drug flow.
    Hence—Holly: One Face of the National Heroin Crisis
    By Jeffrey Benzing | PublicSource Published at 4:42 PM EST on Dec 12, 2014
    http://www.nbcphiladelphia.com/news/health/Holly-One-Face-of-the-National-Heroin-Crisis-285654641.html

    Cut off with no ramp down—Pure Evil and most Americans don’t give a damn or see the damage this administrative behavior is doing.

    Lot of Germans had settled in Wisconsin. I wonder if the State Department and Senator Feinstein has to open another investigation into another Genocide of a German community [first investigations— searching for the missing Donauschwaben in Los Angeles in 2006].

    And for this…”Houlihan was previously admonished by the State of Iowa some years prior to moving to Tomah for inappropriate relationships with patients. VA apparently thought it was wise to hire him into the Tomah VA facility.”

    Where is USA Today/Gannett/Carl Icahn to tell us about the inappropriate relationships with patients????

    And dear old Bob blew one out last Month—about Special Forces—–this is going to be the beginning of the end for him. [You said it not me!—What a “Capstone”].

    Sincerely,

    Don Karg

    • @Don,

      I hope you DO realize that *not everyone* is “hooked” on their prescribed pain medicine and do not feel a “need” for the so-called “high” addicts in fact chase…no, we Veterans that take our pain meds as properly prescribed require them to simply be out of physical “pain’…not pacifying nor masking some veiled addiction.
      People tend to personify a drug or even the very “streets”, thus vilifying those that genuinely need RX’s to have a semblance of a normal day without excruciating pain.
      Not every sole, nor most, will go to the “streets” just because their RX has been abruptly cut-off without real medical necessity.
      These types of things make it continually harder for those of us that genuinely require this class of RX and now that pharmacies are prime targets for robberies, if you get your meds at a civilian pharmacy, most now have a timed safe mechanism, meaning you have to sit there and wait for an extra half hour at least for the pharmacists to even have access to them to dispense.
      I have absolute compassion and empathy for those addicted to any drug…legal or otherwise, BUT it’s not doing anyone ANY favors in making it look as if the class of medicine MAKES a person an addict by simply taking it….and that’s the stance the VA has clearly taken. Kind of like a 2 year olds’ temper tantrum…if THIS Dr. is in trouble and over-prescribing, then let’s take ALL pain meds away from ALL Veterans….WTF?! Does this even make ANY sense?
      No.
      It’s reckless and passive-aggressive.
      It’s the VA.

      • There is a thin line between use of needed pain medication and addiction. Yet, doctors at the VA – in Tomah – choose to blame the veteran when in fact it’s their own shortcomings which sear this issue into the forefront. Cutting off access is not the answer.

        It’s a body chemistry known fact the body will adjust to a certain dose and eventually need a higher dose. This does make it easy to make one appear to be drug seeking.

        The demeaning point is these doctors well know of this issue yet choose to blame the veteran who appears to be drug seeking. They’re just going to freeze all controlled medication to cover their own self.

        To cut a person off from access is childish, cruel, inhumane, and promoting of suicide.

        While needed medication thresholds increase with time, the path to addiction increases as well. Blaming veterans as drug seekers and hence denying them access is putting the blame on the wrong place.

        The VA itself should hold a greater responsibility. Where is the thinking they can have a high number of people needing pain management but have no specialized clinic to monitor and adjust controlled meds? Who in their right mind would prescribe 800 pain pills a month and not see a need for intervention? A specialized clinic in the monitoring of pain is the check and balance the system needs.

        Still, the VA chooses to ride that thin line of addiction and if anything goes wrong, they’ll just point their finger at the veteran and cut them off from access.

      • I can’t get a small Rx for percodan filled; they are being held back and I am furious about all this; I am in great sympathy with you vets you should be honored not treated like bad children who just want to get high!

        I am 69 and suffer trauma, FMS, spinal stenosis, all kinds of peripheral stuff; I would never have been let in the military! Our entire population of chronic pain patients is being harmed badly by our nations refusal to teach patient to secure their meds an keep them safe and things like that!
        We are victims being blamed for our pain and I am furious and I want all pain patients, both military and civilian, to unify against government attacks on it’s citizens and begin to return blame for an addicts bad behavior back to that addict and force lawbreakers into rehab at once! My alternative is to roll back & forth while suffering the symptoms of a severe influenza or take my medicines and appear quite normal though only a few hours a day! This is war; we need to gather & resist with all we have!
        Our government is there to serve our needs not judge our need for pain relief! Or to judge or personal decisions the nerve just appalls me!

  3. I get care at Tomah and I was harmed by being cut off from access to a pain medication. I was very clear about the level of my pain and it was confirmed with a MRI but the doctor repeatedly chose to deny positively needed to reduce that pain.

    I was left to taking 6000 MG a day of Tylenol which did little to help. My days spent were in such debilitating pain I could do little other than the smallest of activities of daily living. My functioning went from accomplishing and walking when I was on pain meds to getting nothing done.

    Interesting, in a recent AARP article, it states that people who don’t get appropriate pain management lose more than 10 percent of their brain function. They go on to say that brain loss takes 10 to 20 years off a person’s life.

    From personal experience, without pain meds I know my level of processing information is greatly reduced. I know I’m spending most hours not being able to think things through because of the pain.

    While over prescribing is unethical, completely denying pain medication is a form of torture and surpasses the unethical threshold.

    • Maybe Mr. Benjamin Krause, Esq. (lawyer) can give advice and/or recommendations of taking the VA hospital and/or your doctors to Federal Court for failing to provide adequate medical care to you, as well as other malpractice.

      This can be useful for other Veterans who have similar issues at the local VA hospital.

  4. Not being a Doc or even medically astute, I wouldn’t care or try to give an OPINION, but I do HOPE / PRAY THAT OUR GOVT. cleans up it’s ACT as far as Veteran policies.
    ACCEPTING RESPONSIBILITY FOR the damages caused by these MINDLESS WARS, would be a good START.

  5. Ben,

    While on active duty as a medical corpsman during the TET, I was injured three times and simply can not function without pain killers. Over the last forty-five years it has been necessary to incrementally increase the dosages to control the pain. The VA “lost” my medical records as soon as I filed a claim for disability. After a five year battle I finally obtained a rating for other medical issues unrelated to my primary problems. The result is I can not get the meds I need from the VA, I have to get the prescriptions filled through the normal civilian process. What meds I can get from the VA are generic’s that are very near the experation date. Anyone who can read a PDR understands that meds lose potency the older they get. The VA facility I have to use is ranked next to last in quality of care on the current list of facilities. Over medication is not my problem, it is not getting what I need at all.

    SSGT, R.D.

    • Russ, do you have your medical records on paper? If not, did you try and get them from the Release of Information office at your local VAMC? This would show that you have had this condition and have been treated for it. You can also show that you have had previous prescriptions for the med(s) you are trying to get. If you have been getting treatment from the same VA then you should have no problem getting them. I always get my records from the VA when I’m there. I get them about every couple of months unless there is something that I want to make sure has been put in my records then I get them sooner. Do not get your records from the Myhealthevet Website; it will not have everything that you need to have.
      Also get your C-file if you don’t have it. You can get it from your Regional Office. It will have things in there that can help as well as hurt you when trying to getting an increase. Look over every page of it and if anything makes you stop or hesitate about what you just read then somehow mark that page and check it over again and write down anything (or copy the paper and then you can mark on it) and further investigate what you are seeing. I found that my C-file had been lost for three months during my attempt to get an increase. The paper stating that was in the file. It was asking other people if they knew were my file was as they could not find it. If you need anything else, I will try and help. I fought for my increase for 6 yrs. and I know how frustrating it can be. Remember, you have to look out for number one. The organization that you have helping you may be doing a great job or they may not care and are acting as if they do. Mine should have been fired. She was terrible. I finally looked through my C-file and presented my own paperwork at my VBA hearing. The woman from the organization that was helping me was speechless because I had not told her that I was going to do this. Afterwards she told me that they could not help me any further and if I wanted to pursue this on my own I could. I did receive an increase after the VBA. I know that Ben has a book that helps on this subject and it may be something to look into. The more you have, the more it helps.

  6. I actually did not hear a PEEP about ANY of this on National News…but I also do not watch “Fox and Friends”, as my IQ would diminish otherwise.
    Furthermore, WHY is it NOT in the mainstream media about the VA cutting ALL VETs pain management meds across the whole system? Something does not seem quite right here.

    • Ya namnibor, it’s called, “early warning” for what is yet to come. And what is yet to come aint to pretty. Sure wished I would have went through with a past project that involved producing affordable housing for veterans in what I was proposing we do, that was to produce veteran based communities. Anyone know someone or a group with deep pockets to fund a feasibility run on producing the first ever veteran community of housing? I know 110% tbat I would make it a success. Once established we could begin to institute care from the local level up. Not from the top down. Contact me.

      • scott that model was used after ww2 in Levittown but there was employment at grumann and Fairchild Republic aerospace and also NYC in a great employmennt time . Today you have to find the employment before you build the homes.

    • Please call NPR and ask for stories about this I want civilian & Veterans to unite to fight for our rights to our healthcare we ALL deserve better I need small doses of percodan to “bump” Vicodin it’s all pretty small but it keeps me ambulatory!

  7. I for one use the Tomah VA & have had absolutely no problems. I take oxycodone for my pain 3 to 4 times daily. My doctor did tell me that YES I will be addicted to this drug, but not like you think. I take it for pain & have no feelings as to I have to have it for the HIGH. I don’t even have any high and all it does is stop some of the pain for me to function some what. Yes I am addicted and if I stop taking them I will go into withdrawal.
    Hope this helps someone.

    • Your post helps me because it is exactly what my prescription is for. Although, my opioid painkiller is prescribed by a non-VA, it is being maligned in lines with all other opiod prescriptions out there in the general patient population.
      I have had 2 failed major spinal reconstructive surgeries, risky spinal shots do not work ( expensive however).
      The painkiller also stabilized my mood, duh, not a happy camper if getting shooting, stabbing pains.
      Now, with DEA in lines with demonization of opiod painkillers, are bullying doctors into cutting off prescriptions to patients with bona-fide medical conditions.
      This actually creates medical emergencies, withdrawals are not just nausea and diarrhea ( cannot keep mess down) but cardiac arrhythmia, anxiety( physical manifestations).
      Treatment costs of opioid pain-managment is pennies compared to all other methods, epidural shots ( average 300 dollars), physical therapy ( which sometimes aggravate the inflammation thus thereby creating a false perception of need for more visits.
      All I can say is that my pain was sort of managed, I could actually have a quality of life best achievable with minimal costs but my doctor cannot prescribe my opioid painkiller anymore due to interference. But legally, it would also constitute Medical Malpractice because cutting off prescriptions creates a foreseeable danger of risk and harm, physically and MENTALLY.

  8. I work as a substance abuse counselor in Indiana. I am service connected and I have treated many veterans at the facility I currently work at Fairbanks Hospital . Many veterans come here for treatment because the Rhoudebush Hospital , the Marion and Battle Creek facilities all are horrible centers that the veterans have relayed to me . It seems that the workers there dont give a crap , sounds familiar and the veterans want to get clean so they wont use the VA. As far as the opiate problem, when you dispence pain meds for so long and then stop the pain and detox is to hard to overcome so either the veteran is buying the pills on the street or second optrion is to buy heroin , which is cheaper . Once again the veteran is forgotten!! Why do you think so many veterans commit suicide ?

    • Tim, I am one of those who has had trouble with the Indy VA. I moved to IN from WA with the understanding from the Indy VA that my meds would be the same (unless the med was not in their formulary) so I was not worried about the move. What a nightmare! I know that my problem is not as bad as some other vets but you are proving that the Indy VA is so afraid to prescribe the much needed meds for us that we have to think very hard on what to do. I had actually considered moving back to WA just to get my meds back. I had my chronic pain med cut off with no weaning. To show how messed us this VA is. I went to the Indy VA to be enrolled in this VA and my first PCP prescribed me my morphine with no problem. The only problem I had with him was I could not understand him so I asked for a change of provider. I should have stuck with him as no other PCP would prescribe the med and they would not look at my Seattle VA records and I had to start over from the beginning to “prove to them” that I did in fact have a disability. I have had this disability for 30+ yrs. My med was stopped and I had to jump through their hoops and after all of that, they still stated they could find nothing wrong. After they could not find anything wrong, I still was prescribed Hydrocodone and I have yet to sign the pain contract. My PCP stated that he did not want to see me again until my next scheduled appointment which is in Aug, this yr. How can he not find anything wrong, prescribe a narcotic pain med, not want to follow-up to see how it is doing, not want to see me until Aug, and not have me sign the pain contract.
      I wish I could get private ins. as I would be trying to contact you to see about getting some better help. Thanks for helping those of us who have been treated so badly by this VA.

    • Tim, I for one fully commend you for having the integrity to post your sharings here. You are the first person to confirm what is happening in regards to the chronic pain patient being cut from their pain meds and then having to find those meds on the street; which may begin with pills but soon moves to heroin because of the affordability factor. A veteran cannot afford to buy pills on the street due to pricing being to high, but Heroin is affordable enough that a veteran can buy it, maintain some sense of livelihood and functionality. But again, the heroin is so dirty and the strengths so inconsistent that it is nearly impossible to regulate during use. Needless to say what your posting does is confirms what I am saying is true. That is that there is a model at play here that i have coined, “the perpetuation of war”. This is how it is going down:

      The model for perpetual war is quite simple:

      You go to war against the country that can produce the greatest amount of opiates and heroin and you secure and protect that crop. You help guard that crop and even assist the farmers in quality and quantity of output. You control the borders of that nation, as well as the maritime routes in and out of that country.

      Meanwhile, back at home, you instruct the DEA to begin to place great heat upon the most senior level doctors in the nation, threatening those doctors with taking their licenses to practice and giving them prison time. You make several public examples of those doctors who write more narcotic prescriptions than others by imprisoning them. You essentially create a storm of fear in the national heart of medicine and care, that if you, your doctors, or your pharmacy are going to prescribe these narcotics, that you WILL be held accountable and ALL are risking losing everything and never being able to practice medicine again, or even work again for that matter.

      So the patient is cut from their meds. They change doctors and while all is well for 3-6 months, the same thing happens. In the case of veterans, they now summon up enough resources to see a private doctor. All is well for 3-6 months, then, WHAM, they again are cut from their narcotic medicine. The veteran, being no dummy, realizes that the only place left to attain their livelihood is from the streets. They find meds for a while but many are far to over priced, in some cases fetching more than a dollar a mg. Meaning for an Oxycodone 30mg you will pay $30. Realizing that you would have to be rich to afford your meds on the streets next stop is heroin. An affordable solution that no one likes but that will actually deliver the outcome they need in order to regain their livelihood.

      As you hand over those 1 O’CLOCK Benjamin’s to get your medicine many don’t stop to even think about it, but you are now funding the criminal cartels, the terrorists, and the ISIS’s. And hence there you now see the full cycle and utter perpetuation of endless war. And to think that it is being built on the backs of good people, in pain, and in need of care. Upon the backs of guys that have taken an oath to protect and defend this nation. But to defend this practice? To honor these people? I THINK NOT!

      If I hadn’t the discipline and training I’m not sure I could stand to watch this all unfold without making a scene of it. Big Bully Brother DEA needs to be slapped down. The leadership behind this wakeful dark cancer must be found and operated on. Let’s deliver them in pain, not give them any relief, and see how they fair. Better yet, since an eye for eye leaves us all blind, instead, how about just executing a thorough disinfection, sterilization and complete surgical removal of said sources. Ya, me thinks this is the new prescription. I’m just wondering how high this trail will go.

      • Scott I could not have said it any better. I posted something along the same lines Heroin has hit our small city here in Missouri and along with it more killings than I can ever remember since Dec last year we have had many mass murders here ,it crazy i got to thinking about whom gave the DEA there orders since you and I know we all answer to somebody ,there is something called the KALEO foundation it has to do with the Clinton’s someone had to give the order .But I totally agree with everything you said .and you said it so well

      • No you are NOT ADDICTED! You are DEPENDENT!
        If you walk on a sprained ankle you can’t heal so are “dependent” on a crutch! You are NOT addicted to crutches!
        There is absolutely no virtue in enduring horrid suffering it will shorten your life!

  9. i would contact your federal rep first and then also go to the media and have them run your heartfelt story. if you cant get an appt in 30 days you are allowed to get help in the private sector, also ask for fee basis to pay for a pain management clinic or doctor. Most of all dont let va bully you. You served ,you deserve better!!

  10. Mr. Rogers , Go down to a local tv station and give them your infomation. If know one will report it then how did this information come out that we know right now ??

  11. A very close friend of mine went to this clinic and had this doctor as his primary physician. Dr.Houlihan & the Tomah Va did nothing wrong. The 800 oxycodone pills a month was a low dose oxycodone so that a patient could take very low dose up to maximum safe amount for his tolerance level. I myself was on 540 pills a month (private clinic) until the doctor told me he was discontinuing pain patients due to fear of the DEA. The doctor told me the government wants doctors to stop prescribing, particularly for chronic pain, and the doctor believed the government will phase (or attempt to) out narcotic use by media blasting addiction stories, while sweeping under the rug stories of people whose lives hugely benefit from narcotics. Addicts are very few in comparison to those who need and benefit from controlled substances. And addicts will find another substance or source. Example being methadone clinics. It would be considered cruel and inhumane to deny an addict of methadone (to treat his addiction), often being kept on it indefinently as to avoid a relapse. Does a chronic pain patient have a route as this? I have read of some that HAVE tried methadone clinics, not for addiction, but for severe pain. They are turned away. How is it that sympathy is given (and opiates) to addicts, but pain patients are being told to go home and learn to live with pain? I have given up trying to find a compassionate (and brave) doctor that is willing to prescribe pain medication. My activity has decreased by 80%, gained weight, housebound, blood pressure is high and now am on disability.

    These pompous asses have really helped me…..maybe helped me come to the end of life. We should be able to sue the doctors, clinics and the DEA/government for what they are doing to us. I am certain many people have already died due to this inhumane treatment of patients who need help.

    I cannot believe I am in 2016 and hearing doctors tell me they no longer can treat anxiety/panic attack and/or pain. Even in the beginning of 1900’s (until ’40s somewhere I think) opium was available for patients to buy. To hear the DEA and doctors who agree with the DEA speak about addictions, I am confused to how anyone was NOT addicted when opium was available over the counter. Maybe because then, as is now, few people become addicts compared to those who use common sense.

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