WaPo: The information about the veteran is scant, clinical in tone, yet disturbing.
“At the time of his death, the patient was a male in his forties with a past medical history significant for PTSD, chronic low back pain, obstructive sleep apnea, obesity, and depression,” the Department of Veterans Affairs inspector general reported.
The veteran is identified as “Patient 1.” He was “hospitalized twice for suicidal ideation and a reported suicide attempt.” But only later, in a case of a buried lead, does the report say another attempt was successful — “suicide caused by toxic levels of sertraline, morphine, and gabapentin.”
This veteran — one of 20 who kill themselves every day, a frightening figure — received medical care from the Department of Veterans Affairs (VA) and a non-VA doctor who prescribed opioids for his chronic pain.
While psychological factors were the reasons and drugs were the tools, the suicide was facilitated by a hole in a system designed to give vets the choice, in same cases, to obtain outside medical care at government expense. With Patient 1, “there is no evidence in the medical record that any of his VA providers were aware of the new opioid prescriptions,” according to the inspector general.
That gap in coordination, added to differing clinical standards among VA and non-VA community providers, can be deadly. Health professionals outside VA are not required to follow departmental guidelines.
Veterans receiving opioid prescriptions from private clinics “may be at greater risk for overdose and other harm because medication information is not being consistently shared,” Inspector General Michael J. Missal said when the report was released Tuesday. “That has to change. Health-care providers serving veterans should be following consistent guidelines for prescribing opioids and sharing information that ensures quality care for high-risk veterans.”