Is Overprescription Fueling Veteran Suicides? | Derek Blumke

[RUSH TRANSCRIPT BELOW] “Veterans are not being told the risk of their medications,“ says Derek Blumke. “Doctors themselves are not aware of the risks of those medications.”

Derek Blumke served 12 years in the US Air Force and Michigan Air National Guard and is a longtime advocate for veterans. A bad experience with psychiatric drugs changed his life trajectory. He has been sounding the alarm about suicide and the overprescription of psychiatric drugs among veterans.

“If we’re going to treat a firearm with respect that we should and we do, which is making sure there’s a safety on, making sure the weapon is not always loaded, don’t point at people, this is a similar thing. If one of these medications can cause you to harm yourself or others, you should be told of that. And right now, we’re not,” he says.

Views expressed in this video are opinions of the host and the guest and do not necessarily reflect the views of The Epoch Times.

RUSH TRANSCRIPT

Jan Jekielek:

Derek Blumke, such a pleasure to have you on American Thought Leaders.

Derek Blumke:

Great to be with you, Jan. Thank you so much for the invitation.

Mr. Jekielek:

Until last year, the U.S. Department of Veterans Affairs, colloquially known as the VA, had never mentioned psychiatric drugs in their annual suicide report, which is something that’s mandated. It’s an important report that comes out every year. And you highlighted this to me as an incredibly important point. Why is this so unusual?

Mr. Blumke:

This is unusual because approximately 70 percent of all veterans under VA care are prescribed a psychiatric drug. Almost 30 percent are on antidepressants. Almost all these drugs have box warnings, a warning of suicidal thoughts and behaviors, and when you have a treatment modality being used for 70 percent of your population and you’re not even mentioning these medications that are your primary modality of treatment, almost all of which have risk profiles of suicidal thoughts and behaviors, this is alarming. 

In this last report, the first-ever mention of any psychiatric medication whatsoever was where they referenced sedative use disorder, which is primarily connected to those who have been prescribed benzodiazepines. The VA, for the past 10 to 15 years, has been actively deprescribing veterans from benzodiazepines because they know they’re contraindicated for veterans diagnosed with post-traumatic stress disorder.

In 2012, approximately 30 percent of all veterans under VA care who had been diagnosed with post-traumatic stress had been prescribed benzodiazepines, such as Xanax and Valium. They learned that these drugs were causing harm. During this entire period, they’ve been deprescribing veterans from these medications, leading to a prescription rate for vets with PTSD of under, I believe, 8 percent. As you’re deprescribing veterans from these medications, you’re increasing suicide risk because these drugs, when you’re coming off of them, can be very dangerous—benzodiazepines, antidepressants, and other drugs.

Mr. Jekielek:

I’m hearing that the VA is responsive when it sees problems, and that’s great. But 70 percent of veterans being treated by the VA are on some sort of psychiatric medication? 

Mr. Blumke:

Correct. 

Mr. Jekielek:

That seems to be a very significant statistic.

Mr. Blumke:

These prescription rates are about four times that of the civilian population. When you have suicide rates that high of what we’re seeing with veterans, with suicide rates almost two and a half times or more than that of the civilian population, you’ve got prescription rates four times that of the civilian population. You have medications that have multiple studies showing suicide risk goes up by three-and-a-half times, three times, two-and-a-half times compared to placebo. Suicide attempt rates go up two-and-a-half to three-and-a-half times while on these medications compared to placebo or non-treatment. This is a math problem that we’re looking at, and this is pretty much the only way you can really look at this problem at this point. 

Mr. Jekielek:

A math problem? This seems to be much bigger than a math problem. 

Mr. Blumke:

It’s a math problem, and the problem is not that we’re not doing enough outreach. We’ve spent 16 to 17 billion dollars in VA mental health in the past six years alone, I believe. We’re putting piles of money towards this problem, and the primary effort has been trying to get veterans into care. The problem lies when you start having your sole treatment modality of medication. 

I worked at the VA. I built a national mental health program for the VA from 2011 to 2013, and I learned the way we do mental health, which is to do outreach, screen the veteran if they have some type of mental health issue, whether it’s depression, anxiety, or post-traumatic stress. First, diagnose, then prescribe a medication to get the acute crisis under control so that the patient can accept therapy or treatment. It’s at that point where we’re putting this risk profile. This is where we’re causing problems. 

There’s research out of Austria that shows there’s about a 0.08 percent suicide risk during antidepressant starts, so like the first six weeks you’re on an antidepressant. This is not just for veterans; this is for everyone. So if you’ve got a 0.08 percent suicide risk during that first six weeks, and then you look at the number of veterans that have been prescribed antidepressants, about 1.75 million or so annually are prescribed antidepressants. 

Not all of those are started on that medication in that year, but say 150,000 might be. You just multiply that out by that 0.08 percent suicide rate, and you have about 120 dead veterans out of the VA’s 2,200, 2,400, or so annual suicides that happen while the veterans are under VA care out of the 6,000 and change that occur annually. 

Mr. Jekielek:

You are hoping there would be more care taken in those decisions to prescribe or not prescribe or offer some other kind of therapy, given that the cost is, at least by your calculations, 120 people, because of the current policies. 

Mr. Blumke:

And that’s just antidepressant stats; that’s not the tapering withdrawal of getting somebody off a medication that they may have been on for a year or years. I’ve been prescribed Zoloft after being given a six-drug cocktail for a period of time, and I was tapered off Zoloft for a year.

Mr. Jekielek:

There is generally an overprescription problem when it comes to psychiatric medications in many countries, including the U.S. But you’re saying that the VA is actually four times greater than this over-prescription reality. 

Mr. Blumke:

In 2019, I published a report with Robert Whitaker, author of Anatomy of an Epidemic, and we looked at the VA and suicides and medications. “Screening Plus Drug Treatment Equals Increase in Veteran Suicides” was the title of this report. As you start looking at the prescription rates, you start looking at how these medications interact, and then you also start looking at the failure to provide informed consent, which is the biggest issue here: veterans are not being told the risks of their medications. 

The reason I believe they are most commonly not being told is that the doctors themselves are not aware of the risks of those medications. When you start looking at the larger picture of seven in ten veterans under VA care prescribed these medications, you start realizing you just start multiplying out the suicide risk of these treatments. That’s not even including polypharmacy—three, four, five, six. My friend Angela Peacock was prescribed 18 different drugs at the same time. There’s no one that hears these things that can say that is okay. 

Mr. Jekielek:

These various mixes of drugs just aren’t studied at all for what the impact might be. 

Mr. Blumke:

Yes. There are no studies showing a six-drug, seven-drug, or eight-drug cocktail is safe. You will not find a single one. What you will find, though, is that leadership at the VA Office of Mental Health will tell you that with anything more than three psychiatric or CNS central nervous system drugs at the same time, you will start seeing diminishing outcomes. I’m not sure why there’s confusion when we’re also wondering why these suicide rates continue to increase when you just look at the prescription rates. If the prescriptions and these medications were working and are a treatment modality used for seven in ten veterans under VA care, you would think you’d actually see diminishing suicide rates. Instead, we’re seeing the inverse. 

Mr. Jekielek:

You have a fascinating story on how you became a leading advocate for this. Please tell us about it. 

Mr. Blumke:

I’m an Air Force veteran. I did six years of active duty and six years in the International Guard. I did three deployments, my first being right after 9/11. I was deployed to an air base in southern Uzbekistan called Karshi-Khanabad Air Base, or K2. It was an old Russian base. Only in 2019 would we learn that a tactical nuclear weapon had been detonated there and that it was a chemical weapons depot for the Russians as they were using their fighter bombers going into Afghanistan in the 70s and 80s. Myself and about 15,000 other troops would later learn we were exposed to all these horrific toxins. 

Fast forward to 2007, I wound up transferring to the University of Michigan. I started a student veterans group on campus because I was looking to connect other veterans in my transition, and this turned out to be a wildly popular idea. We ended up starting an organization called Student Veterans of America, and I helped to lead the efforts in our advocacy to help pass the post-9/11 GI Bill in 2008. 

During that time, we had the suicide of a student veteran at UC Berkeley, and I felt like a commander that did not have the tools to address this crisis or to help other vets on campuses with this issue. That one death really drove me to start building towards mental health programming. My degree was already in psychology. I’d started out with a passion; I wanted to work with troops with PTSD, and that was kind of the path that really set me down this road. 

During that time, I got introduced to the head of VA mental health and was recruited to build and run a national mental health program for the VA. Around that time, I was also invited to be a founding committee member of the National Action Alliance for Suicide Prevention, which is the group that really wrote the national strategy for suicide prevention in 2012 and then most recently last year. I ran that program for about a year and a half, two years, and then moved to New York City, got into technology startups, and then got put on a drug cocktail. I started with Adderall. 

Mr. Jekielek:

You’re working to help people, and then you experience the other side of it.

Mr. Blumke:

It’s been unfortunate and painful for me. As an example, Hunter Whitley is a 22 or 23-year-old former Marine. He was at Abbey Gate in Afghanistan during the withdrawal. He’d suffered a minor TBI during the bombing there. I wound up at the University of Alabama. I was a student veteran going to school full-time there. I was also volunteering at the mental health clinic on campus, a VA mental health clinic on campus. 

The program that I built was focused on helping veterans on college campuses access VA mental health care. Hunter took his own life about two-and-a-half years ago. The program that I built is basically what became that clinic, which was to help get veterans into care, and Hunter was prescribed the antidepressant mirtazapine along with hydroxyzine, and a month-and-a-half later, he was dead. The VA did an investigation into his death and found that they failed to provide informed consent and failed to provide safe medication management. 

My friends Brian and Kim Brumfield, whom we were with last night, along with Shannon, lost their son, Connor, who was 22-years-old. Both of these young men fit cleanly within the box warning by the FDA. But in both cases, it seems neither had been provided informed consent. Their families had been unaware that they were on medications that could increase their suicide risk. And both were gone far too young.

Mr. Jekielek:

You have encountered so many of these horrible stories, but you avoided becoming one yourself. Tell us what happened. 

Mr. Blumke:

I was in New York City. I got behind in some of my classes. I was trying to pad my resume to go to Harvard Business School because I believed at that time that if I didn’t go to Harvard, my life would be a failure. I think that’s really funny today, especially funny today. I was starting a technology company at the same time, and so I went to a psychiatrist, realizing that hey, maybe I do have a problem; maybe this ADHD diagnosis I had as a kid was real.  

I went and got prescribed Adderall and not long after, I was prescribed Ambien because I couldn’t sleep because of the stimulant, Gabapentin for anxiety, and two or three other medications. My life was falling apart, my career was falling apart, and my company was on fire. A friend packed me up and hauled me back to Michigan in a U-Haul, and I spent the next year and a half bouncing around from Airbnb, to not-so-great Airbnbs and hotels, and sleeping on friends’ couches and floors. That’s the story of many vets who struggle or have gone down that path. 

During that time, I met a friend, and they shared that they were going to get their antidepressant increased. I asked how their counseling was going, which is a common question you’d ask when working in mental health. She shared that she wasn’t getting counseling because her insurance didn’t cover that. That was the moment I started realizing, wait a minute, when’s the last time I saw a counselor? 

I started looking back through my time at the VA, almost three years of care at that point. Never once had I had a single counseling session. My care had primarily been just psychiatric drugs. Then I started realizing, wait a minute, how many medications am I on? I started counting, and then I hit my second hand. I realized what the hell was going on. 

That was the moment that I realized that what we’re doing is not working; what I was doing was killing me. What we did with some of these medications, getting them through the market, and the overprescribing of these drugs nationwide and, frankly, across the Western hemisphere is driving what we’re seeing today, and it’s resulting in tragedies every day.

Mr. Jekielek:

You mentioned the black box warning. There may be a number of viewers who don’t know what a black box warning is.  

Mr. Blumke:

Black box warnings are associated with medications that have an increased risk of harm, and antidepressants, benzodiazepines, and other classes of psychiatric drugs come with this warning that there can be an increased risk of suicidal thoughts and behaviors. They don’t call it suicide because the researchers like to split these terms between suicides, suicide attempts, thoughts, and behaviors. I frankly think it’s just because it sounds better than saying what it really is, which is causing suicides. You have these box warnings that are supposed to warn patients that there is an increased risk of possible harm. 

Mr. Jekielek: 

Not every drug gets a black box warning. 

Mr. Blumke:

Correct.

Mr. Jekielek:

But the warning says there is a significant risk to taking the drug. Anyone prescribing it should definitely be talking about this. 

Mr. Blumke:

In order to get any of these warnings on these medications by the FDA, they had to show causation. The studies that they had showed there was causation in the thoughts and behaviors of suicide. That’s what resulted in these box warnings. Kim Witczak helped to get these warnings on these drugs in 2004 and then in 2006 after her husband killed himself after a five-week sample of Zoloft. These warnings are serious. 

Unfortunately, the mental health industry as a whole has not treated them with that same respect. If we’re going to treat a firearm with the respect that we should, and we do, which is making sure there’s safety, making sure the weapon’s not always loaded, and not pointing it at people, this is a similar thing. If one of these medications can cause you to harm yourself or others, you should be told of that. Right now, we’re not.

Mr. Jekielek:

But how is it possible that a doctor that’s prescribing this might not even know that a black box warning is on there? Because that’s the purpose of the warning in the first place, isn’t it?

Mr. Blumke:

They know about the warning, but in their medical training—I’m meeting doctors fresh out of medical school today—they’re not even learning anything at all about antidepressant withdrawal. I was in a VA clinic just two weeks ago, and a doctor wanted to prescribe me an antidepressant. I shared my experience of being trapped on an antidepressant for a year, and she seemed as though it was the first time she’d ever heard of antidepressant withdrawal. 

If you’re not being trained on these things in medical school, and you don’t know, you come to believe that the patients that are coming in and out of your doors, when you start seeing mania or psychosis after you’ve been treating them for a little while with a medication, for example, they see increased diagnoses. They see bipolar disorder. They see schizophrenia. They see other psychotic disorders. 

Instead of identifying the side effects—mania and psychosis being among them for antidepressants, as an example—they’re seeing these other disorders, and you wind up going from one antidepressant to an antipsychotic in addition to the antidepressant, another mood stabilizer, benzodiazepine, and all of a sudden you’re on five, six, or more drugs. It’s this evolution that keeps creating these cascading effects of these medications. Intent is good, but unfortunately, in the way we do care, we’re causing more harm than we do good.

Mr. Jekielek:

It seems like there’s a kind of rush to prescribe when there might be some other approaches—like even maybe talk therapy or something like that being one of them, although that’s, I guess, expensive and maybe difficult for some. So there’s that aspect. And then there’s an aspect where, initially, I don’t know if I got this right, but I think you were saying that doctors might not even know about some of the side effects or don’t fully disclose those side effects. 

The next thing is they might not realize that there’s an interactive effect and that these side effects might actually be causing the symptoms. Finally, many of them don’t realize that you have to wean yourself off many of these drugs, and that going cold turkey could actually create these symptoms, suicidality, and so forth. There are many pressure points. along the way that doctors need to be educated about.

Mr. Blumke:

There’s another problem too, and I’ve heard this from psychiatrists. I’ve seen documents, internal markups of pieces of legislation about signatory informed consent, basically requiring the doctor to have a formal conversation, which is already law, and having the patient sign that they understand the risks and efficacy of the treatment they’re being provided. There’s concern from many doctors that if you tell the patient of all the side effects, they won’t take their medication. That sounds a lot like informed consent.

Mr. Jekielek:

Isn’t that what informed consent is about? The point is that someone gets to choose whether they want to take the risk.

Mr. Blumke:

Exactly. And the patients are being robbed of that because the doctor feels what they’re doing and what they’re saying and what they’re telling their patient is the best thing for their patient. And the patient, it’s not their decision; it’s the doctor’s decision to not not share these side effects, persistent sexual dysfunction [PSSD] is associated with SSRIs, and cranial and brain development issues of infants whose mothers have been prescribed SSRIs. 

You start looking at all these things and these patients have a right to know what they’re putting in their bodies, and they should know what to be looking for, and their family members should be aware so they can see the behavioral changes because the family and the friends around them are going to see those things first before the individual usually will.

Mr. Jekielek:

Part of it is just, you know, if everybody’s aware, if you’re deciding on a treatment method and you know there’s an increased risk of suicidality, by the way, of course it’s not that everyone will experience that. It’s just that there’s some significant percentage that might. You can kind of watch for that and pull the person off quickly if people are alert.

Mr. Blumke:

I think our big argument here is, and with my role at the Grunt Style Foundation, is we’re not calling for stopping prescribing these medications. There is a place for medications and care. What we’re calling for are safer and smarter prescribing policies that make sure that patients are aware of the risks and efficacy of their treatments, that the doctors are retrained and mental health counselors and psychologists are trained to look for these things, that we have slower, smarter tapering guidelines because right now we’re doing two-week reductions and just yanking people off medications they’ve been on for years and decades in some cases, and we’re causing harm. 

And another action is to release the data. The VA is sitting on probably the largest tranche of health data in the world on these issues of medications, adverse drug events, and you can actually see increased disability rates as you start seeing an increase in prescription rates, just like you can see increases in suicide rates, issues with the justice system. All these things are tracking line by line as these prescription rates continue to increase. So on the issue of informed consent,

Mr. Jekielek:

I understand that you advocate for written informed consent every time. Why does it need to be written? And why is that so important?

Mr. Blumke:

It’s important because right now it’s actually federal law. The VA’s 38-CFR-1732 requires informed consent policies for treatments across VA, not just medications, but all treatments. And in there, it actually describes if there is a potential for serious risk of harm or adverse events that there should be a signatory informed consent. If you go to get a colonoscopy, you’re required to sign that you understand that this treatment could kill you, but that’s the risk that you take based upon the conversation between yourself and your doctor. 

This is not happening even though federal law currently requires the VA to do this. And really this is more of an interpretation by folks in VA’s Office of Mental Health and the Health Administration saying we don’t need to do that because these drugs are safe and they work great and there’s no major problems here. In reality, if there’s a risk of killing yourself, I’d call that a major possible adverse outcome. And there should be a warning that goes along with that. And so that’s what we’re really calling for is more information for patients and more information for doctors across the board.

Mr. Jekielek:

What do you know about how psychiatric medication is prescribed very quickly right out of the blocks, as opposed to a broader assessment? This has become more the norm. Can you tell us about those patterns?

Mr. Blumke:

I think this has been a huge evolution. JFK actually shut down asylums nationwide in the 60s. This asylum system had been a great idea, and was more of a model by the Quakers. They brought people to these beautiful ranches or castle-like types of places. They had gardens and animals, and they tended the gardens, and they cared for the animals, and they milked the cows. And it gave them a sense of purpose, and gave them a sense of community. 

But fast forward into the 60s, we started cost-cutting. Over the years, over the decades, we’ve been cost-cutting to the point where we’re packing 10 or 15 patients into a two-room space. And as we’ve gone forward to the medications, that was kind of part of the arguments. We have these medications, benzodiazepines and other drugs that help these people. That’s why we can do outpatient care. They don’t need to be in the asylums anymore. And so we shut down the asylums, fast-forwarded a day with these medications. 

For decades, psychiatrists have actually spent a lot of time with their patients. You’d see your psychiatrist an hour a week or more in many cases, and when SSRIs first came to market in ’88 and with Prozac in ’91 and Zoloft, that was their approach. They were still spending a lot of time with the patient; they were monitoring them much more closely, and so as prescriptions of these medications began in the 90s, that was still the model. 

Move into the 2000s, all of a sudden, everybody’s on these medications because it’s quick, cheap, and easy. And I’d be all for that if these medications were safe and effective. But unfortunately, efficacy is not what we expect it to be. And the risk profiles are dramatic. And so as we have seen increases in prescription rates, we’re basically treating this as a cheaper, faster way of doing mental health treatment. 

In the short term, it’s cheaper. Long term, you start looking at my example being taken out of the workforce; you start seeing mental illness disability rates increasing. How much does it cost to care for a veteran and pay disability benefits for a veteran or any American than it is to actually do the hard work and the right treatments and give them the right care on the front end? And that’s where we’re at.

Mr. Jekielek:

You’re saying that the benefits are oversold and the risks are undersold, as a general rule of thumb. That’s a great way of summing it up.

Mr. Blumke:

And the data supports that. When these medications first came to market, Dr. Daniel E. Casey, a psychiatrist at a Portland VA at that time, he also was the chair of the FDA’s Psychopharmacological Drugs Advisory Committee. And in these hearings, the entire debate was about efficacy. The drug companies are required to submit two studies to the FDA for review. They could have done 20 others, but they just needed to show two that showed some level of efficacy. 

And when you read these entire transcripts, which have documented the entire debate for these multi-hour meetings, the hearings were solely about efficacy, and we have a belief that we can trust our government; we believe that these medications are studied rigorously, that we are looking for not just efficacy but safety, but what we now know is that that has not been happening and it never was, and now we have a suicide epidemic not just of veterans but of the entire American population. 

Suicide rates have continued to skyrocket for all groups; young women from 20 to 21 prescription rates of antidepressants went up by 130 percent; for young women to age 24, it went up by 60 percent, and during that period, suicides in those groups spiked. For young men, prescription rates stayed the same or declined slightly, and we did not see the suicide spikes that we did with young boys and young men. And so as we look at veterans, we look at similarly prescribed populations and you see the same story over and over again. 

Mr. Jekielek:

So there’s a signal that requires attention. You had a press event in the House Triangle, and quite a few veterans were sharing some really heart-wrenching stories. You told me that this is the first of its kind. But you’ve been doing this advocacy for some time, right?

Mr. Blumke:

When I first came out on this issue in 2019, no one wanted to hear it. I met the head of health policy at the House Veterans Affairs Committee during that time. And when I said, I’m Derek. I’ve been working on this issue of medication, antidepressants, and suicides. I started this organization, Studio Matters America. She pauses and looks at me and says, oh, you’re the one. This was the response, if not outright conspiracy theorist, it was the look. 

And today, unfortunately, it’s taken this many more years to start realizing that we have a crisis on our hands. It’s only because we have so many more bodies stacked up. And so the event that we held the past several days was, I think, the first the veterans community has held ever around this issue. I believe in 2015 there was a small protest where veterans threw their pill bottles over the White House fence onto the White House grounds, as a form of protest saying, we can do better than this. And that’s largely what we did for the past two days as a partnership between the Grunt Style Foundation, the Veterans of Foreign Wars, and the Disabled American Veterans, which was calling attention to this issue of overprescribing.

Mr. Jekielek:

Not throwing pill bottles. 

Mr. Blumke:

There were pill bottles involved, and the veterans in attendance at that press conference walked up to a translucent skull that we created and placed their pill bottles in the skull, and that skull sat there the entire time as this press conference went on, as these families went forward and talked to their loved ones. Congressman Bergman, who sponsored this press conference, was so passionate and so articulate, saying that we can do better and this overprescribing issue is causing problems and causing harm, and we can fix this by being smarter and safer in the way we prescribe.

Mr. Jekielek:

Whenever dealing with any medication, there really is, there’s always a cost-benefit, and you need to consider the potential cost given, you know, whatever that benefit might be, right? And that calculation is going to be different for different people. So it requires a very kind of personal approach. You can’t kind of blanket prescribe something. A psychiatric medication would be very useful for one person, but for another person, it could actually be highly problematic.

Mr. Blumke:

Tylenol.

Mr. Jekielek:

Yes, Tylenol.

Mr. Blumke:

Tylenol is a great example. There are huge benefits of Tylenol, but some people should not take Tylenol. And we know that we make those decisions on our own, knowing that we have the information to make those smart decisions.

Mr. Jekielek:

You offered a whole list of policy ideas. Is it as simple as more individualized care and doctors knowing that there are these risks and that they must disclose them? How much of the problem would that solve?

Mr. Blumke:

I believe for veterans under VA care, if we just provided more information to patients, retrained our doctors and our mental health clinicians, and provided slower, safer tapering guidelines, I believe we would probably see possibly a 25 percent reduction in veteran suicides at the VA alone. 

Mr. Jekielek:

How did you come up with that number, out of curiosity? 

Mr. Blumke:

Math. This is a math problem. This is not an outreach problem. This is not throwing another $577 million at this problem manually. This is, I believe that was one of their marketing budgets the past couple of years for mental health and suicide prevention. The more people you put into this machine under our current prescribing and care paradigm, the more cold bodies you’re going to be coming out of the back end. And I wish there were a nicer, gentler way of saying this, but these families, the country deserves to hear the truth and these families deserve to have their voices heard, like the Brumfields and Shannon McDaniel. Dr. Larry Miller lost his son just two months ago as he shot himself in front of the San Antonio VA Medical Center.

Mr. Jekielek:

For people who have had these tragedies happen, sometimes they’ll be quick to try to find a reason. And they might pick this, and maybe it’s not necessarily the reason.

Mr. Blumke:

I think where it gives a lot of these families solace is that there’s data and studies showing and supporting what they may have thought in the back of their minds.

Mr. Jekielek:

You’re saying they saw their son or daughter get on some kind of medication and then their behavior changes, and something’s wrong.

Mr. Blumke:

Yes, exactly. In the last week that Connor Brumfield was alive, he made some kind of bizarre phone calls to his mom. His roommate noticed significant behavioral changes before his death. Prior to that, this is a young man who was an Eagle Scout, went into the Army, and had a mild TBI from a vehicle accident.

Mr. Jekielek:

What is that?

Mr. Blumke:

Traumatic brain injury. I had a mild brain injury from a vehicle accident, which is actually the way most Americans get brain injuries. And it’s not a veteran problem. This is an everywhere problem. And so there are studies showing that you should not be prescribing Wellbutrin, which is the medication this young man was prescribed, if there is a traumatic brain injury involved. And that’s exactly what happened. 

Shannon McDaniel, with her son, Hunter Whitley, she didn’t know what to think when she lost her son, other than just outright despair and hopelessness. And it wasn’t until a VA employee had mentioned to her that somebody dropped the ball. The exact quote is what she shared. And when she made inquiries to the VA trying to get medical records, it took them like six months to provide her son’s medical records. 

And when she got them, they didn’t make a lot of sense because she’s not a clinician, and so she continued to ask questions, and that resulted in an office of investigation that resulted in the VA’s office of inspector general conducting an investigation, and so they found that the clinician failed to provide informed consent, failed to provide safe medication management, and failed to provide lethal means assessments, to make sure does this individual have firearms nearby, are there ways of storing them safely for now until we get this crisis averted, and these things were not done. 

And so I think the argument that we hear is that, oh, they were depressed, and we know that that is a precursor and is connected with suicides. No one will argue that. But when you have medications that we know increase the risk of suicidal thoughts, what else should you be looking at? I think most people hearing these conversations and looking at the numbers and looking at the charts and graphs and prescription rates skyrocketing and then suicide rates tracking right with them, disability rates increasing as prescription rates increase in over a dozen countries, you start seeing trends that track with the actual data that shows that suicidal thoughts and behaviors can be caused by antidepressant medications and other psychiatric drugs.

Mr. Jekielek:

Considering your career trajectory, it’s almost like you were made for this.

Mr. Blumke:

It’s terrifying, actually. My former boss at the VA, Jan Kemp, actually built the Veterans Crisis Line for the VA. I was just shared a report, which I see Jan’s name all the time, shared a report with her name on it, the author of it, talking about this issue related to medications and its overlap after overlap after overlap being invited to be part of the National Action Alliance on suicide prevention like I was a 26-year-old kid, 27, maybe 28, but just finished leading Student Veterans of America, no clinical background, but I found a passion for this because I realized it was the right thing to do. 

Unfortunately, that does come at a cost. Working with these families, working with those who’ve lost their loved ones, working with those who had their lives destroyed and totally turned upside down, and also dealing with your own recovery. Working on this issue is traumatic every day. Working on myself after having gone through a drug cocktail and a year-long withdrawal, never mind my exposures overseas in the military. And I’m very fortunate to be with the Grunt Style Foundation, working with the VFW and DAV and other national veterans organizations on this issue. 

But unfortunately, reform can’t happen fast enough. Every day that goes by is another day that another veteran is prescribed one of these medications with a conversation of, hey, how about we try this? and not having any discussion whatsoever of the potential catastrophic effects that can occur. And so while many people are benefited by many of these medications, many unfortunately have bad outcomes, and many have similar experiences as I did with my withdrawal. 

And when you have a VA that is aware that these conversations have been occurring. I met with former VA Secretary McDonough, briefed him for an hour in his office in March of last year. I briefed Allen Hall, the former Under Secretary of Health. He sent an internal email to his leadership introducing me to his chief medical officer, describing, hey, concerns have been raised about possible overprescribing and adverse outcomes resulting from prescribing practices at VA. I’d like to have a conversation with Derek, have this conversation, and again, no action. 

And the VA’s opinion up until now has been we can’t act. This is an HHS thing. We can’t retrain our clinicians. We cannot retrain our counselors on making these medication prescriptions safer. We can’t do signatory informed consent for lots of reasons, including it’ll take too much of our time, but really keep on pointing the finger at, oh, this is HHS, or this is SAMHSA [Substance Abuse and Mental Health Services Administration] , or this is FDA. I think anybody who’s prescribing 70 percent of all your veterans classes of drugs that can result in major adverse outcomes, has a responsibility to be smarter and safer in the way they do that. 

Mr. Jekielek:

There needs to be some sort of cooperation between HHS and the VA ultimately to resolve some of these issues. You’ve actually been speaking with people that are part of HHS or sub-agencies. There’s a whole new MAHA approach at HHS. How is that manifesting in your work in this roundtable you recently hosted with an HHS official?

Mr. Blumke:

The convening that we held the past couple of days, the roundtable, the Veteran Harm Reduction Roundtable, exploring the relationship between medications and veteran suicides, was basically a follow-up from the 2010 House Veterans Affairs Committee hearings where they discussed this issue, they focused on this issue, but unfortunately, the APA [American Psychological Association] and other psychiatric and psychological Associations came forward and testified and said, everything’s fine, nothing to see here. Don’t take any hasty action legislatively that might stop the prescribing of these medications that are life-saving. That was their argument. 

And so I think where we’re at today is that there is a huge point of hope because we have leaders in government that care about this problem. Secretary Kennedy has made public statements on this issue. The MAHA executive order is calling for investigations into the threat of selective serotonin reuptake inhibitors, antipsychotics, stimulants, and weight loss drugs. We’re at a point in time in history that I never thought I’d see. I thought that I’d wind up becoming a martyr over this issue. 

And I never believed that we’d have leaders come into government with President Trump and with RFK Jr. going in there and saying, we have a problem and we’re going to talk about it and we’re going to do something about it. And so having met Dr. Haridopolos, acting chief of staff and senior advisor at the Surgeon General’s office, she came and spoke at a roundtable yesterday, committing that this is a priority of this administration, meeting the former acting head of the FDA in tears as we’re talking about this crisis and the loss of these families, and her doubling down and saying, this is a priority of this administration, this is a priority of the U.S. Department of Health and Human Services, and finding myself high-fiving a senior FDA official was a moment in history that I never thought I’d ever see come or could have even dreamed of. 

And so I believe we’re in a place where we are going to see action, and I believe in the near future that these changes can occur through a very robust and detailed partnership between HHS and VA where we look to provide more information for patients and more information for doctors so we can make prescribing safer and smarter. And I believe we’re at a point in time where we’re going to see that in the very near future. And I do believe Secretary Collins is one of those leaders that can act on this and wants to work with Secretary Kennedy on these types of problems. Regardless of what your political affiliation is, Democrat, Republican, Independent, or whatever else it may be, we can do mental health better, not just for veterans, but for all Americans. And I believe that that’s the path that we’re on.

Mr. Jekielek:

Derek Bumke, it’s such a pleasure to have you on the show.

Mr. Blumke:

Thank you very much for having me.

 

This interview has been partially edited for brevity and clarity.