Veterans Often Being Given Risky Combinations of Opioids and Psychotropics


The vast majority of veterans who are taking opioids for pain are also being prescribed one or more psychiatric medications, according to a study in Psychiatry Research. And many of these drugs, the authors wrote, have harmful side effects “especially when combined.”

The Yale University School of Medicine researchers used national veterans health data for 2012. “Of the 328,398 Veterans who filled at least 10 opioid prescriptions, 77% also received psychotropics, of whom: 74% received antidepressants, 55% anxiolytics/sedatives/hypnotics, and 26% three or more classes of psychotropic medications,” they wrote.

“Veterans treated in a mental health clinic were prescribed more psychotropics and were more likely to have a documented psychiatric or medical indication than those treated solely in other settings,” the researchers added. “Since psychotropics and opioids can produce harmful side effects, especially when combined, and since they are likely prescribed by separate providers in different settings, coordinated consideration of the risks and benefits of co-prescribing these medications may be needed, along with further study of related adverse events.”

Barry, Declan T., Mehmet Sofuoglu, Robert D. Kerns, Ilse R. Wiechers, and Robert A. Rosenheck. “Prevalence and Correlates of Co-Prescribing Psychotropic Medications with Long-Term Opioid Use Nationally in the Veterans Health Administration.” Psychiatry Research 0, no. 0. Accessed March 28, 2015. doi:10.1016/j.psychres.2015.03.006. (Abstract)


  1. Just to be clear, “Anxiolytics” includes benzos like Ativan, Klonapin, Valium, and Xanax. Taking these with opiates can absolutely kill a person – very similar to drinking and taking opiates. If a person drinks and takes both of these – well, I’d be pretty scared for them. That this is even allowed shows how low our medical professionals have sunk in terms of taking any kind of responsibility for their own patients’ safety.

    —- Steve

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  2. The V.A. has a problem with different prescribers not coordinating. For my MS pain, my GP says it’s my neurologist’s job, and I don’t have to tell you what my neurologist says.

    The V.A.’s own studies demonstrate that none of these drugs are effective for PTSD, but the V.A. uses the same general guidelines as everyone else. I got of oxy myself, and am down to 30 mgs of amitriptyline daily from 150 mg. After I’m done with that, I’m tapering off trazodone. Am also running my own personal campaign to cut down on unnecessary MRIs, other screening, and appointments. I’ve been through two prescribing cascades with the V.A. One for psyche meds, and one for MS. Before I started cutting down last years, I had amasses so many scrips that it was physically bothersome to swallow all the pills.

    Much better now. I have time to do a lot of research on my conditions and my medications, but the V.A. staff is swamped with so many patients and bureaucracy has always been its Achilles Tendon.

    I think the ruling guidelines need to be ironed out by pharmacologists and that they need to be involved with clinical prescribing to prevent drug reactions, risks multiplied by multiple drugs with the same risks, and unnecessary and inappropriate prescriptions.

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  3. I remember when I was massively being drugged, that Walgreens was fraudulently advertising they would automatically do drug interaction checks. Now that I have the medical proof I was being put on lots of major drug interactions simultaneously, I can say they did not. But there’s tons of fraud within the pharmaceutical industry funded “evidence based medicine” based literature that is now only being discovered.

    I highly recommend all those on multiple drugs use the drug interaction checker, since the medical community is seemingly utilizing their right to harm people via major drug interactions, rather than helping people, and sickeningly this goes for those within our military, as well.

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  4. hpostpsychiatry – Andrew White, one of the “Charleston Four” mentioned in the article you posted, was the son of friends of mine – Stan and Shirley White. The Whites lost two soldier sons – one killed in action and the other (Andrew) sent home with a diagnosis of PTSD and put on Seroquel and other meds – a witch’s brew of polypharmacy. He died of Sudden Cardiac Arrest – from the Seroquel .
    I met them at an FDA advisory committee hearing which was being held to consider expanding the patent of Astra Zeneca’s Seroquel, and I’ve been in touch ever since.
    They have been battling to get the VA and military to stop throwing lethal drugs at soldiers given the PTSD diagnosis – and instead to concentrate on methods that are humane and effective in helping vets back into their stateside lives.

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