Since the 9/11 terrorist attacks, the number of opiate prescriptions by the Department of Veterans Affairs has skyrocketed, feeding addictions and contributing to a fatal overdose rate among VA patients that’s nearly double the national average, according to data obtained by The Center for Investigative Reporting through the Freedom of Information Act.

In interviews, advocates and experts said the rising prescription rate confirmed their worst fears: that the VA is overmedicating its patients as it struggles to keep up with their need for more complex treatment.

But how many opiate prescriptions is the VA giving to veterans in your area? Although the surge in prescriptions varies widely across the country, the issue affects veterans everywhere. That’s where you come in. Similar to CIR’s investigation into the VA’s backlog of disability claims, there is ample opportunity for journalists to localize this story.

The following is a reporting guide to the information CIR has published that can be used to find data relevant to your area. For starters, here are the overall findings for national context:

●      Since 2001, VA prescriptions for four opiates – hydrocodone, oxycodone, methadone and morphine – have increased by 270 percent.

●      That surge far outpaced the growth in VA patients, which rose 41 percent over the same period.

●      For the last two years, the data shows the VA has issued more than one opiate prescription per patient, on average.

With those points in mind, you can use CIR’s interactive map to find out how the numbers look in your area. The map begins by displaying each VA hospital system, with circles sized to correspond with their opiate prescription rate. Click on an individual circle to get data for that system.

Although the app displays data for hospital systems when you first click on the individual circles, three geographic levels of data are available:

●      The first level of detail is for the VA’s 23 health care regions, which include large swaths of the country, like New England or the Pacific Northwest.

●      The second level of detail is for the VA’s hospital systems, a network of hospitals and clinics that roughly corresponds to a metropolitan area. There are 130 of them.

●      The third level is for facilities, which includes a count of prescriptions of each of the four opiates covered for each hospital and clinic.

The red box highlighted in the screenshot below shows where to toggle among those levels:

At the regional and system levels, CIR’s data set contains four main statistics, outlined in the screenshots below:

1. The overall opiate prescription rate per 100 patients. For context, the national average has been more than one opiate prescription per patient for the last two years. If the number in this field for those years is greater than 100, then that system has a greater prescription rate than the national average.

For perspective, the VA Roseburg Healthcare System in southern Oregon is the hospital system that currently has the highest rate of opiate prescriptions: more than 210 prescriptions per 100 patients in 2012.  

2. Number of patients receiving care in the hospital system. This number includes patients who have been seen at any VA facility within the system, including the main VA hospitals and their affiliated clinics.

3. Total number of prescriptions given for hydrocodone, oxycodone, methadone and morphine. You can use the radio buttons in the “Explore the data” section to toggle among the four opiate drug types we analyzed.

4. The percent change in opiate prescription rates over different time periods. After first clicking into an individual system, this area will display the percent change from 2001 to 2012. If you move the slider in the “Explore the data” section to different years, the “% change” field will display the change from year to year.

You also can go a step further by clicking on the icons for individual facilities within each hospital system to see data at that level, showing the number of opiate prescriptions by facility and the percent change over the time period you select. There is no reliable VA patient data at the clinic level that can be used to compute a rate, however, because individual veterans typically visit more than one facility for health care. For example, if you click on the facility in Santa Rosa, Calif., which is within the San Francisco system, you can see the following data:

As you explore the data, take note of the year selected for the data. As mentioned above, when you first click on a hospital system, the data shows cumulative totals from 2001 to 2012. When you move the slider in the “Explore the data” section, the numbers change to represent data for that year and the percent change from the previous year.

Each region, hospital system and facility has a unique URL, which can be used to link directly from your site or shared on social media. You’ll find buttons embedded below the data that enable you to share easily:

Please note: All data in this interactive was provided by the Department of Veterans Affairs in response to requests made under the Freedom of Information Act. In some cases in which we suspect the VA has not kept accurate data, we have included a highlighted note above the data for the clinic or hospital system:

Looking for veteran sources in your area? CIR has created a query through the Public Insight Network that asks veterans to tell us about their experience with opiates and other medication prescribed by the VA. If your newsroom is a PIN member, you can copy a version of the form with your branding to solicit local sources. Contact your newsroom’s PIN analyst to find out how you can create your own version of the query.

We also can help connect newsrooms that aren’t PIN partners with potential sources in their area. If you’re interested in finding out whether CIR has heard from a veteran near you who is willing to share his or her story, email Cole Goins, CIR distribution and engagement manager, at cgoins@cironline.org. Remember that these will not be vetted sources, so you will need to check out their stories with the VA, with their medical records and potentially with other sources through your own reporting.

If you’re interested in booking CIR reporter Aaron Glantz for a media appearance, contact Meghann Farnsworth, senior manager for distribution and engagement, at mfarnsworth@cironline.org. For all other questions regarding this story or localization efforts, contact Goins at the email address above or call him at 510-809-3160, ext. 365.

Cole Goins is the director of community engagement for Reveal, where he cultivates partnerships that blend in-depth journalism and creative public engagement. He has built and supported distribution networks, spearheaded arts-based initiatives such as the Off/Page Project, led social media and audience strategy, and facilitated statewide media collaborations. He was a senior fellow in the 2015 USC Annenberg Health Journalism Fellowships, mentoring five journalists on approaches to community engagement. Previously, Goins was the engagement editor at the Center for Public Integrity, where he led audience development initiatives and multimedia features for award-winning investigative projects. He earned a degree in journalism from the University of North Carolina at Chapel Hill, where he worked as music director for WXYC, the student-run radio station. He is based in Reveal's Emeryville, California, office.