Derek Blumke was on a cocktail of six different medications prescribed by doctors with the Department of Veterans Affairs. It was 2017 and the 12-year veteran of the Air Force and Michigan Air National Guard was taking Adderall for attention-deficit/hyperactivity disorder (ADHD), Ambien for insomnia, Gabapentin for anxiety, and others.
“My life was now on fire, [my start-up] company in rubble and I was struggling to keep a job and maintain my sanity. Instead of looking at the list of meds I was already prescribed, the VA psychiatrist said, ‘Let’s try an antidepressant,’” he wrote in an essay on his experience in Mad In America, a non-profit online magazine focused on “rethinking psychiatric care.”
Blumke took Zoloft, an antidepressant medication, for a year and a half. While coming off Zoloft, Blumke had an array of symptoms: flu-like symptoms, feeling like the room was spinning, brain zaps, and missing gaps of time.
Frustrated by his doctor’s approach, Blumke started studying the issue of overprescription — when doctors inappropriately or excessively prescribe pharmaceuticals in lieu of other treatments.
What Blumke has found is a gap in federal data that lawmakers have been trying to close for years: the VA does not maintain a system that tracks whether or not a vet who dies by suicide while under VA care may have been overprescribed pharmaceuticals.
Blumke now investigates overprescription and other relevant data as a fellow with the Grunt Style Foundation.
“The thing that put me down this path was when I was trapped on Zoloft,” Blumke told Task & Purpose, adding that “it shouldn’t take a bill for the VA to turn over this data” about veteran suicide and prescribed medications.
Reps. Vern Buchanan (R-Fla.), Gerry Connolly (D-VA) and other members of Congress have introduced the “Veteran Overmedication and Suicide Prevention Act” four times since 2019, at some points gaining just over a dozen sponsors. A version of the measure was introduced in 2016 by the late Republican Sen. John McCain from Arizona.
“It’s not enough to just know the number of veteran suicide deaths, which is tragically high — we must understand whether there is a relationship between treatment methods and suicide. The new data generated from this legislation will be used to better treat veterans suffering from both mental and physical injuries moving forward,” a spokesperson for Buchanan’s office said in a statement.
The bill calls for a study to tackle “overmedication” by VA doctors by investigating the number and types of medications that vets were prescribed, how many were offered non-medicated treatments before doctors turned to pharmaceuticals and the rates of veterans who were given medication as their first-line of treatment.
VA officials declined to comment on pending legislation.
The damage of overprescription by VA doctors has also been cited by groups working to get the department to study the effectiveness of alternative therapies like cannabis or psychedelic-assisted therapy for veteran mental health treatment.
A 2021 letter by Buchanan and Connolly to the House Veterans Affairs Committee noted the importance of prescription data for understanding the problem by referencing the VA’s “history of freely prescribing opioid pain medication” to veterans, reaching just under half a million long-term patients in 2012.
“Despite the VA taking steps to reduce the number of opioid prescriptions it dispenses by 70% between 2012 and 2020, veterans are still committing suicide at a startling rate,” they wrote in the letter.
In a similar fashion to the VA’s targeted reduction of opioid prescriptions post-opioid epidemic, Patrick Murray, policy director for Veterans of Foreign Wars said veteran advocacy is now focused on reducing the VA’s “over-reliance on pharmaceuticals when dealing with mental health issues.” But without government data to understand the scope of the problem, there’s little that veterans’ organizations can do to tackle the issue and advocate for solutions.
“There isn’t an official federal government study that says enough of these things,” Murray said. “There’s plenty of data out there, but it’s not written by Uncle Sam. That’s what we need to change.”
The bill specifically calls for the VA-funded study with the National Academies of Sciences, Engineering, and Medicine on suicides as well as violent and accidental deaths of veterans who received care through VA hospitals or medical services in the last five years before their death. The measure calls for the study to include data on prescribed medications and legal or illegal substances, medications with black box warnings, and others that were off-label prescriptions, psychotropic, or had suicidal ideation warnings.
The study would look at an array of medical diagnoses by VA doctors for the treatment of post-traumatic stress disorder, traumatic brain injury, military sexual trauma, and other anxiety and depressive disorders that led to prescriptions or non-medicated treatment like cognitive behavioral therapy before being “determined to be ineffective,” and turning to medication.
“We have to have a VA that’s open to allow us to truly get their true numbers: where are the areas where they’re prescribing more, what VA facility prescribes the most, what is the key drug, what’s the tie between the manufacturer of that drug and the VA facility. All of these things are things we’ve got to look at,” Rep. Mike Bost (R-Ill.) chairman of the House Veterans Affairs Committee said in a Jan. 28 interview with the Grunt Style Foundation.