The U.S. Department of Veterans Affairs (VA) is under scrutiny for its widespread practice of prescribing multiple psychiatric drugs to veterans, particularly those with post-traumatic stress disorder (PTSD). Known as “polypharmacy,” this approach—often dubbed the “combat cocktail”—involves administering powerful combinations of medications that can tranquilize patients, cause severe side effects, and, alarmingly, increase suicide risk. With veteran suicide rates roughly double that of the general U.S. population, this growing public health crisis demands urgent attention.
A recent investigation by The Wall Street Journal revealed that nearly 60% of VA patients with PTSD in 2019—over 520,000 veterans—were prescribed two or more central nervous system drugs simultaneously, a 62% increase from a decade earlier. These drugs, including antipsychotics, antidepressants, and anti-anxiety medications, are often combined despite limited understanding of their interactions. The VA defines polypharmacy as five or more such medications, though some researchers argue even two can be risky. Reports describe veterans feeling “like zombies,” experiencing weight gain, numbness, and heightened suicidal thoughts, with some tragic cases ending in overdose or suicide.
The issue is not new. As early as 2013, families and advocates reported veterans receiving dangerous drug cocktails, with one case involving a veteran whose death was linked to six psychiatric medications, including duloxetine, known for its suicide risk. A 2017 study noted that veterans on five or more psychotropic drugs were four times more likely to die by suicide, highlighting the lethal potential of overmedication. The VA’s own data from 2016 flagged these risks, yet the practice persists, driven by a surge in PTSD diagnoses from prolonged combat tours and improved screening.
Chronic pain compounds the problem. About 60% of post-9/11 veterans and 50% of older veterans suffer from chronic pain, compared to 30% of the general population. Historically, the VA relied heavily on opioid painkillers, with prescriptions spiking 270% from 1999 to 2011, leading to a 33% rise in overdoses by 2011. While the VA’s Opioid Safety Initiative has reduced opioid prescriptions, the shift to psychiatric drugs for pain and PTSD has fueled polypharmacy concerns. Veterans like Joshua Renschler, who was prescribed a 13-drug regimen after a mortar blast injury, reported severe side effects, including liver damage.
Social media platforms like X reflect growing outrage. Posts describe veterans being “tranquilized to numbness” or “treated like guinea pigs,” with some alleging the VA prioritizes quick fixes over comprehensive care. One veteran, who consulted on a recent exposé, shared their experience of being prescribed over 40 medications, claiming it nearly cost them their life. Critics argue the VA’s resource constraints—only two pain specialists per 100,000 patients—force reliance on medication over tailored treatments like therapy or alternative pain management.
The VA acknowledges the issue but defends its practices, stating clinicians discuss side effects and monitor patients closely. Efforts to curb overmedication include deprescribing opioids and benzodiazepines, with a 2019 study showing a drop in veterans on five or more CNS drugs from 12% to 7%. Innovations like genetic drug sensitivity tests, approved but underutilized by the VA, could reduce harmful prescriptions, potentially saving lives and costs.
Advocates, including former VA officials, call for systemic reform. Dr. Shereef Elnahal, former VA health system head, described polypharmacy data as “pretty concerning,” citing cases of veterans on excessive medications dying by suicide. Veterans’ groups and Congress are pushing for better oversight, with some urging the VA to mandate drug sensitivity testing for those on multiple prescriptions or high-risk drugs like opioids.
The stakes are high. In 2017, nearly 17 veterans died by suicide daily, with 30% linked to substance abuse. Overmedication not only exacerbates mental health struggles but also fuels addiction, with 11% of veterans visiting VA facilities diagnosed with substance use disorders. As one advocate on X put it, “It’s time to stop throwing pills at PTSD and start addressing the root causes.”
For veterans struggling with overmedication or mental health, resources are available. The National Veteran Crisis Hotline (988, Press 1) offers 24/7 support. Share your story with us at info@street.co.ke or join the conversation.