Marine’s Overdose Death Sparking VA Opiate Debate

WASHINGTON — Nearly a year after his death, Marine Corps veteran Jason Simcakoski was at the center of a debate on Capitol Hill on Wednesday over new regulations for opioid prescriptions at the Department of Veterans Affairs.

His parents, widow and daughter watched as a Senate committee weighed an overhaul bill, sponsored by a Wisconsin senator, designed to curb overdose deaths at the state’s Tomah VA and other medical centers across the country. It was a crucial first step for the legislation, though many hurdles remain and its future is uncertain.

Simcakoski died at Tomah in August after a toxic reaction to more than 12 medications including opiates. He has become the face of what veteran groups and other advocates say is an epidemic of dangerous opioid prescriptions to VA patients.

“I just saw too much medication. My son had an addiction with pain meds and yet they put my son back on pain meds,” said Marv Simcakoski, his father. “They sent him home with 50 some [pills] and told him to take them regularly.”

Simcakoski served in the Marines from 1998-2002 and suffered a head injury. Anxiety attacks led him to seek care at the Tomah VA, where his family said he struggled for over four years with no improvement despite a long list of medications. An autopsy found the mix of drugs in system resulted in his death while an in-patient at the facility.

His death and years of other whistleblower allegations about over-prescription of narcotics have triggered congressional hearings and investigations in recent months, as well as an earlier probe by the VA inspector general.

The bill sponsored by Sen. Tammy Baldwin, D-Wis., calls for an update to guidelines for the use of opioids for pain management, new safety training for health care providers, and real-time reporting and tracking of veterans’ narcotic prescriptions. Sen. Shelly Moore Capito, R-W.V., cosponsored the bill.

“Unfortunately, I believe the VA’s prescribing practice and over reliance on opiates has resulted in getting our veterans hooked rather than getting them helped,” Baldwin said.

Sen. Johnny Isakson, R-Ga., chairs the Veterans Affairs Committee and said it will consider the bill to make sure it does not duplicate any narcotic safety measures already in use by the VA.

The new regulations are supported by the VFW, American Legion, Paralyzed Veterans of America, Vietnam Veterans of America and others.

Ian de Planque, the American Legion’s legislative director, told the Senate committee that a study by the group last year found that “staggering numbers” of veterans are being prescribed cocktails of 10 or more medications for conditions such as post-traumatic stress disorder and traumatic brain injury.

The medication regimens can be confusing and overwhelming to veterans, especially when not appropriately explained or tracked by VA health care providers, de Planque said.

“You can’t just say no treatment and no medication,” he said. “You need to have updated guidelines on how to treat these veterans.”

Despite being widely recognized by veteran groups, dangerous overuse of narcotics at Tomah remains controversial inside the VA. Its inspector general, which is meant to be an independent watchdog for the department, conducted an investigation between 2011 and 2014 of claims of overprescription of opiates and other wrongdoing but said it found no evidence to back the allegations.

The conclusion was not at first released after being closed last year and when it was discovered drew harsh public criticism. The Senate recently subpoena the IG to turn over its investigative documents.

VA representatives, including the head of patient care, said on Wednesday the department already has a “multi-pronged” approach to ensuring safe narcotic prescriptions but Simcakoski’s death has persuaded it to support some of the measures in Baldwin’s bill, especially stronger monitoring of health care providers.

“Clearly the unfortunate incident in Tomah and other experiences are telling us we need to do more,” said Rajiv Jain, VA assistant deputy undersecretary for health for patient care services.