VA Medical Centers May Be Hurting The Agency’s Veteran Suicide Prevention Efforts

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Employee shortages and opioid surpluses are severely hindering the Department of Veterans Affairs from effectively fighting the scourge of veteran suicide, according to a new report from the American Legion.

  • Just after the departure of ex-VA Secretary Dr. David Shulkin in mid-February, the VA had more than 33,000 vacancies, according to a spokesman; in June, the American Legion told Congress that this shortage could reach 100,000 personnel from nurses and assistants to doctors and psychologists, according to one study.
  • This shortage doesn’t just limit access to critical physician expertise, but “can lead to overworked staff, poor patient experiences and lower quality of care,” according to the American Legion report. “Exemplary patient experience is vital to keeping veterans in the VA care network, which studies have shown significantly decreases risk of suicide.”
  • That exhausting work environment can extend to sloppy handling of potentially addictive substances, namely benzodiazepines like Xanax and Valium. According to the Legion report, a full quarter of veterans newly diagnosed with PTSD “are still being prescribed harmful and potentially deadly amounts of medications;” a whopping 16% of veterans are prescribed “a morphine-equivalent dose of opioids” concurrently with their Benzo.
  • This is horribly risky and irresponsible behavior. There exists “growing evidence of negative side effects, including an increase of PTSD symptoms, risk of suicidal thoughts and of accidental overdose,” the Legion report cautions. “According to a 2013 study, 43 percent of servicemembers who attempted suicide between 2008 and 2010 had taken psychotropic medications.”
  • The instinct to dope agitated veterans to the gills is only doing harm. Research indicates that benzos “have no health benefit in treating PTSD and that there is extreme concern for overdose among veterans who misuse alcohol while on them” — a major risk for a full 50% of the veterans who are prescribed these dangerous substances but booze on them anyway.

If there’s some silver lining to the dangerous overprescription trend detailed in the American Legion’s veteran suicide report, it’s that, according to USA Today, almost every VA facility has experienced a steady drop in its prescription rates since 2012, with an overall decline of 41%. Sure, part of this decline indicated that this is more of a return to relatively “normal” prescription levels than a concentrated drop, after a mid-2010s spike in prescriptions. But as my colleague James Clark noted back in January, it’s certainly a step in the right direction — especially when it comes to making a dent in the veteran suicide rate.

Read the full American Legion report below:

American Legion White Paper on Veteran Suicide by Jared Keller

If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the Lifeline network is available 24/7 across the United States. Call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press “1” to reach the Veterans Crisis Line.

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Jared Keller

Former Managing Editor

Jared Keller is the former managing editor of Task & Purpose. His writing has appeared in Aeon, the Los Angeles Review of Books, the New Republic, Pacific Standard, Smithsonian, and The Washington Post, among other publications.