Rebel base names, statues disgrace U.S. military facilities and Congress

White nationalist demonstrators walk into Lee park surrounded by counter demonstrators in Charlottesville, Saturday. (Steve Helber/AP)

With all the attention on the white nationalist terrorist attack in Charlottesville, let’s not forget Uncle Sam’s curious comforting of treasonous confederates.

While places like Maryland, New Orleans and Charlottesville have taken action against proslavery and Confederate statues, 10 U.S. military bases continue to honor the rebels by carrying names of their leaders.

Consider the irony — American military facilities are named after Confederate generals who waged war on the United States government and killed its troops. How crazy is that?

All 10 bases are located in the former Confederacy, according to a Southern Poverty Law Center list. They are:

  • Fort Rucker (Gen. Edmund Rucker), Ala.
  • Fort Benning (Brig. Gen. Henry L. Benning), Ga.
  • Fort Gordon (Maj. Gen. John Brown Gordon), Ga.
  • Camp Beauregard (Gen. P.G.T. Beauregard), La.
  • Fort Polk (Gen. Leonidas Polk), La.
  • Fort Bragg (Gen. Braxton Bragg), N.C.
  • Fort Hood (Gen. John Bell Hood), Tex.
  • Fort A.P. Hill (Gen. A.P. Hill), Va.
  • Fort Lee (Gen. Robert E. Lee), Va.
  • Fort Pickett (Gen. George Pickett), Va.

More comfort comes in the form of state flags that include Confederate symbols and decorate congressional hallways.

More shameful are the statues of confederates that disgrace the Capitol complex. A story by colleague Mike DeBonis, aptly headlined “A field guide to the racists commemorated inside the U.S. Capitol,” lists these white supremacists who are venerated by Congress:

  • Jefferson Davis of Mississippi, Confederate president and former U.S. senator and representative
  • Alexander Hamilton Stephens of Georgia, Confederate vice president
  • John C. Calhoun of South Carolina, proslavery senator
  • Wade Hampton III of South Carolina, Confederate general
  • Charles Brantley Aycock, a North Carolina governor who worked to disenfranchise African Americans and bragged that we have solved the negro (sic) problem. … We have taken him out of politics and have thereby secured good government …”

Confederate military officers honored with statues on the Capitol grounds are:

  • Robert E. Lee of Virginia
  • James Zachariah George of Mississippi
  • Edmund Kirby Smith of Florida
  • Joseph Wheeler of Alabama.

“We will never solve America’s race problem if we continue to honor traitors who fought against the United States in order to keep African Americans in chains,” said Congressional Black Caucus Chairman Cedric L. Richmond (D-La.) “By the way, thank god, they lost.”

No help in solving the “race problem” comes from President Trump, who continues, appallingly, to comfort white nationalists by leveling “blame on both sides” for the Charlottesville violence.

The Confederate tributes — base names, statues and flag representations — revere those who supported the enslavement of African Americans. The display of Confederate symbols today is an affirmation of white supremacy and black oppression. But that is not the only reason all Americans should be outraged.

Even Confederate flag waving racists who consider themselves patriotic should consider the treason the symbols represent.

Many of these memorials honor those who, although not tried as traitors, certainly fit this Constitutional definition: “Treason against the United States, shall consist only in levying War against them, or in adhering to their Enemies, giving them Aid and Comfort.”

Removing the military base names and the statues is not erasing history. In fact, more people need to know the true history of the Confederacy, so they won’t get stuck in the “that’s my heritage” trap. How can any self-described patriot glorify those who killed American troops?

Patriotic organizations of veterans’, whose professional ancestors were killed by Confederates, have been slow to condemn the rebel symbols. But the largest group, the American Legion, now has done so.

In reaction to the attack in Charlottesville, where Nazi sympathizer James Alex Fields Jr. allegedly rammed his Dodge Challenger into a crowd, killing Heather Heyer, the American Legion issued this condemnation: “Americans fought fascism and crushed the Nazis in World War II, and anyone who waves a Nazi flag on our soil is, by very definition, anti-American. The disgusting displays of hatred and bigotry on display in Charlottesville dishonor all veterans who fought and died to stamp out fascism. We have one flag: the American flag. We are one people: the American people.”

Two Virginia State Police officers, H. Jay Cullen and Berke Bates, who had monitored the demonstrations related to the planned removal of a Lee statue also died when their helicopter crashed.

The Legion’s statement did not mention the Confederate flag, which also was displayed by those protesting the statue’s removal. So, I asked if the Legion considers those displaying the Confederate flag to be “by very definition, anti-American.”

It took some prodding, but the Legion answered “yes.” That was the first time the Legion has condemned the flag of treason. Other major veterans’ groups have remained silent. The Legion had nothing to say about changing the base names.

Neither did a Pentagon spokesman, who offered “at this time, there is no discussion on this topic.”

There needs to be, and Congress is the ideal place. But no one is leading the charge on this point.

Rep. Jared Huffman (D-Calif.) did lead an effort to ban the flying of Confederate banners on Department of Veterans Affairs and National Park Service cemetery flagpoles. His legislation did not pass, but VA decided not to allow Confederate flags on permanently fixed flagpoles. Last month, the Black Caucus filed a Supreme Court brief in support of a Mississippi resident’s complaint that incorporating a Confederate emblem in the state flag denies him “equal treatment and dignity under the law.”

That emblem also denies the dignity of the United States. Honoring the traitors and racists of the Confederacy particularly by the U.S. government, should be unthinkable.

Read more:

[VA moves to restrict treason symbols at cemeteries]

[House takes action against Confederate flag, a symbol of treason]

 [The Confederate flag isn’t just offensive. It’s treasonous.]


Can Jeff Flake survive the role of chief Republican antagonist to Trump?

By ,

PRESCOTT, Ariz. — Over two months, Sen. Jeff Flake has dodged bullets on a baseball field, buried his elderly father and watched one of his political mentors, Sen. John McCain, battle terminal brain cancer.

And that was all before he published a book that doubles down on his criticisms of President Trump, which in less than two weeks since its release has once again put him at odds with members of his own party.

The best-selling book may make Flake (Ariz.) the most high-profile Republican casualty of the Trump era. Or, he may prove that embracing one’s core principles can still be appealing to voters. 

He was already facing a primary challenge from a nationalist who campaigns with sharp-edged, Trump-style bombast when his party launched a revolt against his 160-page critique on the president. On Friday, a Democratic congresswoman who has a sizable campaign war chest also signaled that she is likely to run against Flake. 

For now, he is laughing off his newfound challenges. 

 “It’s been quite a summer, it really has,” he said after meeting with business executives here, explaining later, “We knew from the beginning that we’d have a tough primary, we’d have a tough general” election.

Confronted with the challenge, Flake added, “You just do it.”

That approach helps explain his new book, “Conscience of a Conservative: A Rejection of Destructive Politics and a Return to Principle.” Not even his closest political advisers knew that he’d been working on the book for more than a year. After its Aug. 1 release, the book quickly jumped on to the New York Times bestseller list — although a far funnier, less serious tome by a colleague, Sen. Al Franken (D-Minn.), currently outranks him. 

Page after page, Flake lobs strong broadsides against Trump, like how he wooed voters with “easy answers to hard questions, sweetened by free stuff” — basically a “late-night infomercial” that was “free of significant thought.” 

Flake became “heartsick,” he said, as Republicans embraced Trump. Now, there’s “more nastiness and dysfunction in the election’s wake,” he writes. 

But the challenges Flake faced in recent months helped temper some of that nastiness and dysfunction, at least temporarily.

In mid-June, Flake was on the baseball field in Alexandria, Va., when House Majority Whip Steve Scalise (R-La.) was shot. After ducking out of the line of fire, Flake ran onto the field to help treat a wounded congressional aide and Scalise. Congress quickly resumed its duties after the shooting, and Flake has taken time to reflect on what happened.

“When the volley of shots rang out, I remember turning to the dugout and seeing where I had to run and bullets hitting the gravel,” he said. “And I just remember for some reason — the thought just seemed to last awhile — but: Why? Us? Here? It just seemed so incongruent, and I still have a hard time understanding how somebody can look out at a bunch of middle-aged men playing baseball and see the enemy.”

Flake acknowledged the irony of being the target of a political assassination attempt while he was putting the finishing touches on a book that conveys his worry about how the coarse nature of modern politics could spark violence.

“It’s just — it’s just got to stop,” he said.

Less than two weeks after the shooting — and just after his book went to print — Flake’s 85-year-old father died, and the Arizonan’s absence further stalled the Senate’s consideration of a GOP health-care overhaul plan. Without Flake, it was impossible for Republicans to hold a procedural vote to advance the bill.

Flake quickly returned to Washington, but then another life event interrupted the health-care debate — the unexpected cancer diagnosis of McCain, who eventually derailed the bill by blocking further consideration of it. In the final minutes before McCain’s dramatic late-night vote against the measure, Flake tried one last time on the Senate floor to persuade his senior colleague to support the bill. 

It didn’t work — and then Flake released his book. 

Now, the most partisan of Arizona Republicans believe that Flake — despite supporting the Republican effort to repeal the Affordable Care Act and supporting Trump’s judicial and Cabinet nominees — is among those most responsible for blocking Trump’s legislative agenda. They don’t like that he supported a bipartisan immigration plan in 2013, flew to Cuba at President Barack Obama’s request to help relaunch diplomatic relations in 2014 and supports global trade pacts such as the Trans-Pacific Partnership.

“The Flake model is you have to be conservative every six years,” said Constantin Querard, a conservative Republican campaign consultant based in Phoenix who does not support Flake. 

“What is unusual from the break in his normal behavior is that this time, instead of campaigning as a conservative that conservatives would recognize, he’s chosen to redefine it and tell all the conservatives that they’re wrong and not really conservatives and that he’s not only a conservative but he’s going to teach us what conservatism is,” Querard said. “And he just doesn’t have any credibility among the grass roots to attempt that.”

That’s why Kelli Ward believes she has a chance to defeat Flake. An osteopathic physician and former state lawmaker, Ward tried and failed to defeat McCain in a primary two years ago by making his age an issue. This time, she will use Flake’s dislike of Trump against him in a state that supported the president last year by 3.5 points.

Ward is unapologetically strident in her approach, embracing the tone and temperament that Flake repeatedly abhors in his book and describes as “a shatter politics.” She recently sent a fundraising letter to supporters with envelopes emblazoned with the widely rebuked image of comedian Kathy Griffin posing with what appears to be Trump’s severed head. 

Inside the envelope, Ward wrote that she used the image because, “it’s important to see what we’re up against.” 

In an interview, Ward said that Flake’s national television interviews to promote the book are helping her. “Every time he’s on, I’m gaining money and manpower.” 

While she won nearly 40 percent of the primary electorate in 2016, Ward says her support will grow this year because of Flake’s decision to lash out at Trump. Much of her financial support comes from out of state, she said, because Republican voters “want somebody that is strong with a backbone, with a brain who will go do the job.”

Did she mean to suggest that Flake has no backbone or brain?

“You said it,” Ward said. “I don’t think that Jeff Flake has represented — his values don’t align with those of his constituents.”

Trump has vowed that Flake will lose his reelection fight next year, and some of his allies are falling in line behind Ward. On Friday, she hired consultants Eric Beach and Brent Lowder, who in 2016 ran the Great America PAC, which spent nearly $30 million to back Trump. And a super PAC launched to support her bid recently picked up a $300,000 donation from Robert Mercer, the secretive billionaire who supported Trump’s campaign. 

But Ryan O’Daniel, who managed McCain’s 2016 reelection campaign, said that Flake faces a political dynamic similar to the one that McCain faced two years ago. Despite Ward’s concerns, Flake is likely to earn the support of national conservative groups because of his solid conservative voting record, he said.

“He’s always fought against earmarks and for smaller government, so it’s going to be very hard for anyone to out-conservative Jeff Flake in this primary,” O’Daniel said. “Especially somebody who doesn’t have the positive name ID, infrastructure or money.”

Democrats, meanwhile, might have caught a break in their bid to unseat Flake. On Friday, Rep. Kyrsten Sinema, who represents a Phoenix-area district, said in a statement that she is “seriously considering” entering the race, and several Democrats now think she is all but certain to run.

Despite coming up short in statewide races since 2010, Democratic leaders think that Sinema’s moderate voting record and $3 million campaign war chest can help them capitalize on the growing anti-Trump and anti-Washington sentiment among voters. 

As he travels the state this month, Flake is eager to remind voters about his book — and that despite its content, he does occasionally agree with Trump. 

“I haven’t always agreed with this administration. There’s a book out there,” he said during the meeting with business leaders. He explained that he’s “more than pleased” with how the Trump administration is handling regulatory issues and how the Environmental Protection Agency is now working to ease Obama-era federal oversight of western lands. 

In an interview afterward, Flake noted that after being elected to the House in 2000, he opposed George W. Bush’s “No Child Left Behind” education bill and his Medicare prescription-drug benefit plan. “But I was with him on other things.”

The situation with Trump “is the same,” he said. “You shouldn’t be a rubber stamp. I think that’s what Arizona voters expect of me.”

Or, as Flake writes in his book, “We must be willing to risk our careers to save our principles.”


White House confronts backlash over Trump’s remarks on Charlottesville

By , , and ,

BEDMINSTER, N.J. — The White House on Sunday sought to quell criticism of President Trump’s failure to denounce by name the white supremacists behind a spate of violence in Charlottesville, a response that associates said was based largely on Trump’s own read of the hate-fueled melee with counterprotesters.

In a statement, and through aides appearing on Sunday talk shows, the White House defended Trump’s general public condemnation Saturday of the events that led to three deaths and dozens of injuries in the picturesque college town in Virginia.

“Of course that includes white supremacists, KKK, Neo-Nazi and all extremist groups,” the White House said in a brief statement, elaborating on Trump’s remarks from his golf club here Saturday in which he decried an “egregious display of hatred, bigotry and violence on many sides” but did not explicitly call out any party for blame.

[Alleged driver of car that plowed into Charlottesville crowd was a Nazi sympathizer, former teacher says]

The Justice Department, meanwhile, faced continuing questions Sunday about why it took Attorney General Jeff Sessions as long as it did Saturday to announce a hate-crime investigation and why the FBI has not labeled a deadly car-ramming incident Saturday as an act of “domestic terrorism.”

Sessions did not announce that the department would open a civil rights investigation until nearly 11 p.m. Saturday night, after Democratic and Republican lawmakers called for the action. It gave no indication of how broad that investigation will be.

Sessions is scheduled to appear on three network morning shows Monday to talk about his department’s response.

Sunday’s White House efforts did little to tamp down criticism, including from many Republicans, who said Trump had missed an opportunity for moral leadership and to distance himself from white nationalist groups that embraced his presidency.

Sen. Lindsey O. Graham (R-S.C.) said on “Fox News Sunday” that Trump needs to “correct the record here.”

“These groups seem to believe they have a friend in Donald Trump in the White House, and I would urge the president to dissuade that,” Graham said.

[Trump didn’t call out white supremacists. He was rebuked by members of his own party.]

National security adviser H.R. McMaster, among the Trump officials to fan out on the public affairs shows, said on NBC’s “Meet the Press” that Trump was committed “to bring all Americans together.”

“I’m sure you will hear more from the president about this,” McMaster said.

Aides said Trump would continue to get updates on events in Charlottesville, but it was unclear what other steps the White House might take. Trump stayed out of public view and remained uncharacteristically silent on Twitter through Sunday afternoon.

The president plans to return to Washington on Monday for part of the day and could face additional reporter questions if he conducts a promised news conference.

The development of Trump’s statement Saturday afternoon offered a revealing window into how the White House works in such situations, according to two people familiar with the response. They said that when Trump was first briefed on Charlottesville, he was told that various groups had entered the city and were protesting.

That early context — that many groups were involved in violence and not just white nationalists — quickly colored his thinking and prompted him to comment to others in broad terms about the crisis, the people said, requesting anonymity to describe private conversations with White House officials.

[Charlottesville victim: ‘She was there standing up for what was right’]

Trump’s approach Saturday — trusting his instincts, averting talk of white nationalism and feeling no obligation to grapple with its consequences — echoed how the president responded last year to an endorsement from David Duke, the former Ku Klux Klan leader who appeared in Charlottesville, the people said.

During the Duke episode and over the weekend, Trump relied almost entirely on his own read of the controversy and responded in his own way rather than reading from talking points from communications aides, the people said.

Trump disavowed hate but did not delve into details. He shrugged off calls from Republicans and others to do so as a politically correct distraction that would not give him credit for his original statement.

The backlash over Trump’s public statement Saturday also posed an early test for new White House Chief of Staff John F. Kelly. But Trump associates played down Kelly’s role, saying the retired Marine general was brought in to bring discipline to the staff and wasn’t a driving force behind Trump’s choice of words.

Few of the president’s top aides were with him in Bedminster as he composed the Charlottesville statement Saturday.

[One group loved Trump’s remarks about Charlottesville: White supremacists]

Press secretary Sarah Huckabee Sanders left the area Friday morning, and reporters who tried to email her received an “out of office” response.

The president delivered his statement during an awkward bill-signing ceremony on veterans health-care legislation in a club ballroom at his golf club. As he started to leave, reporters shouted questions at him, asking if he would condemn white supremacy. Trump realized he had yet to sign the legislation, so he returned to a small desk to do so. He then left a second time, again ignoring questions.

On Sunday night, protesters gathered on a busy corner here near the public library and a community garden to protest the president, who was staying down the road. One woman held an orange sign that read: “Say it: Domestic terrorism.” Other signs read: “Impeach Trump,” “No hate,” and “Make America Kind Again.”

Civil rights leaders and other activist groups not only urged Trump to speak out more forcefully Sunday but also to fire White House chief strategist Stephen K. Bannon and others whom they accused of having connections to the white national groups. Bannon formerly ran the right-wing Breitbart News and advocated for what he calls the “alt-right” movement.

Bannon was not in New Jersey as events unfolded Saturday. Instead, he was in Washington over the weekend, working at the White House on the rollout of new trade measures that would punish China for intellectual property violations, according to a longtime Bannon associate.

While Bannon has harsh critics within the West Wing who disagree with his hard-line nationalism and have urged Trump to remove him, he has purposefully kept a lower profile in recent months that has helped him hold on to his post, the associate said. In an awkward exchange, McMaster deflected multiple questions during a “Meet the Press” interview Sunday to say whether he can continue to work with Bannon.

On Sunday morning, Ivanka Trump, the president’s eldest daughter and a top White House adviser, offered a more direct condemnation of the white nationalist groups than her father, writing on Twitter: “There should be no place in society for racism, white supremacy and neo-nazis.”

While the White House elaborated on Trump’s remarks in the Sunday statement, three of Trump’s top advisers went on television to offer defenses of the president.

Tom Bossert, Trump’s homeland security adviser, who has been in direct contact with Charlottesville authorities, repeatedly praised the president on CNN for not naming the groups involved and instead focusing on an overarching call for Americans to love one another.

Bossert said that people “on both sides” showed up in Charlottesville “looking for trouble” and that he wouldn’t assign blame for the death of a counterprotester on either group, although he said the president would like to see “swift justice” for the victim.

McMaster said on ABC’s “This Week” that the president was “very clear” in his statement and “called out anyone, anyone who is responsible for fomenting this kind of bigotry, hatred, racism and violence.”

Later in the morning, McMaster added on “Meet the Press” that it “ought to be clear to all Americans” that Trump’s comments about bigotry and hatred included white supremacists and neo-Nazis. He also said that he considers the death of a counterprotester in Charlottesville on Saturday an act of terrorism.

CIA Director Mike Pompeo said on CBS News that the president was “frankly, pretty unambiguous” in responding to the violence. He added: “When someone marches with a Nazi flag, that is unacceptable, but I think that’s what the president’s saying.”

Among those critical of Trump on Sunday morning was Anthony Scaramucci, the president’s short-lived former communications director, who said on ABC’s “This Week” that he believed Trump “needed to be much harsher as it related to the white supremacists and the nature of that.” Scaramucci’s White House stint lasted only 10 days.

Sen. Cory Gardner (R-Colo.), among the growing number of lawmakers critical of Trump’s statement, appeared on CNN’s “State of the Union” and urged the president to speak out directly on the issue and “call this white supremacism, white nationalism evil.” He said the president should do so with the same kind of conviction that he has had in “naming terrorism around the globe as evil.”

Throughout the day Saturday, former Justice Department officials — including former Manhattan U.S. attorney Preet Bharara, former attorney general Eric H. Holder Jr. and former head of the civil rights division Vanita Gupta — called for Sessions to announce that the department would conduct a federal investigation into the Charlottesville violence.

Sen. Ted Cruz (R-Tex.) called not only for a federal investigation but also for the Justice Department to designate the car-ramming incident an act of “domestic terrorism.” The department has not done so.

Late Saturday night, Holder sent out two tweets. Among them: “If ISIS rammed a car into a crowd this would be labeled quickly & logically. Charlottesville — call it what it is, domestic terrorism.”

At about 11 p.m., the Justice Department announced that a federal civil rights investigation had been opened “into the circumstances of the deadly vehicular incident that occurred earlier Saturday morning.”

A person familiar with the probe said the investigation is not limited to the car’s driver, and agents will investigate whether others were involved in planning the episode.

The investigation will be conducted by the Richmond FBI Field Office, the Civil Rights Division and the U.S. Attorney’s Office for the Western District of Virginia, headed by acting U.S. attorney Rick Mountcastle.

Wagner, Costa and Horwitz reported from Washington. Karoun Demirjian and Philip Rucker in Washington contributed to this report.


Laverne Cox Will Show You the Long, Intense Fight for Transgender Rights

Every day, people question why we advocate for trans rights. “How many trans people are there, really?” we are asked. Or, “Isn’t this just a new niche issue that serves as a distraction from the issues that really matter?”

But trans people have always existed, and our lives have always mattered. And though we have and continue to face rampant discrimination, so too have we built beautiful communities and movements of resistance and love.

Through a collaborative video from the ACLU, Transparent producer and artist Zackary Drucker, Emmy-nominated actress Laverne Cox and the creative team of Molly Crabapple and Kim Boekbinder, we are telling the story of trans history and resistance.

This video comes on the heels of the President’s tweets seeking to ban transgender individuals from military service and in the midst of continued legislative efforts in states like Texas to ban transgender individuals from public restrooms. The consequences of this discrimination from our government are deadly.

In one comprehensive survey of over 27,000 transgender individuals in 2015, almost one in three respondents reported living in poverty, over half reported being denied health care related to their gender transition, one of every four indicated that they did not seek medical attention at all due to fear of discrimination and more than three of every four reported experiencing harassment in school because they were trans, ultimately leading to 17% of respondents dropping out of secondary school altogether.

All of this contributes to a cycle of discrimination and violence that leads to homelessness, incarceration and ultimately, for many — particularly trans women of color — premature death. Indeed, at least 15 trans people, almost all women of color, have been murdered so far this year in the United States. And two of every five American trans people attempt suicide at least once in their life.

Without accurate information about trans people, our lives and our rich histories, the impulse to push us out of public life will continue. But we continue to tell our vivid, vibrant and critical story of trans resistance. Time marches forward, and so do we. —Chase Strangio


Veterans' health-care gap creates 'greater risk' for opioid abuse

A visitor leaves the Sacramento Veterans Affairs Medical Center in Rancho Cordova, Calif., in 2015. (Rich Pedroncelli/AP)

The information about the veteran is scant, clinical in tone, yet disturbing.

“At the time of his death, the patient was a male in his forties with a past medical history significant for PTSD, chronic low back pain, obstructive sleep apnea, obesity, and depression,” the Department of Veterans Affairs inspector general reported.

The veteran is identified as “Patient 1.”  He was “hospitalized twice for suicidal ideation and a reported suicide attempt.” But only later, in a case of a buried lead, does the report say another attempt was successful — “suicide caused by toxic levels of sertraline, morphine, and gabapentin.”

This veteran — one of 20 who kill themselves every day, a frightening figure — received medical care from the Department of Veterans Affairs (VA) and a non-VA doctor who prescribed opioids for his chronic pain.

While psychological factors were the reasons and drugs were the tools, the suicide was facilitated by a hole in a system designed to give vets the choice, in same cases, to obtain outside medical care at government expense. With Patient 1, “there is no evidence in the medical record that any of his VA providers were aware of the new opioid prescriptions,” according to the inspector general.

That gap in coordination, added to differing clinical standards among VA and non-VA community providers, can be deadly. Health professionals outside VA are not required to follow departmental guidelines.

Veterans receiving opioid prescriptions from private clinics “may be at greater risk for overdose and other harm because medication information is not being consistently shared,” Inspector General Michael J. Missal said when the report was released Tuesday. “That has to change. Health-care providers serving veterans should be following consistent guidelines for prescribing opioids and sharing information that ensures quality care for high-risk veterans.”

His office recommended that VA:

  • “Require non-VA providers to submit opioid prescriptions directly to a VA pharmacy for dispensing.”
  • Ensure those providers have “a complete up-to-date list of medications and medical history.”
  • Require community providers to review VA opioid guidelines.
  • Ensure that if community facilities don’t meet VA opioid standards that “immediate action is taken to ensure the safety of all veterans receiving care from the non-VA provider.”

VA agreed, at least in principle, with all the recommendations.

“With America facing a looming doctor shortage and demand for veterans health care outpacing VA’s ability to provide it in-house, better coordination between VA and non-VA providers is absolutely essential,” said VA press secretary Curt Cashour.

It’s absolutely essential considering that about 142 Americans die daily from a drug overdose, “a death toll equal to September 11th every three weeks,” said a report by the President’s Commission on Combating Drug Addiction and the Opioid Crisis issued the day before Missal’s. Declaring opioids “a prime contributor to our addiction and overdose crisis,” the commission called on President Trump to declare a national emergency empowering the government to take “bold steps” against drug abuse.

In response to the report, VA Secretary David J. Shulkin issued a statement noting that “recent studies and stories have pointed to VA’s success in its approach to pain management and responsible use of opioids with our Veteran patients.”

Since launching the Opioid Safety Initiative in 2013, VA says, the number of its patients receiving opioids fell by 27 percent and the number on long-term opioid therapy dropped 33 percent. Shulkin said VA is widely sharing its eight best practices to balance pain management and opioid use under the acronym S.T.O.P. P.A.I.N.

Missing from that list is cannabis. It could be an ally in the fight against opioid abuse, as the nation’s largest veterans’ service organization recognizes, except for Uncle Sam’s outdated and repressive view of marijuana. Citing data showing that states permitting medical marijuana have an opioid mortality rate almost 25 percent below that of other states, the American Legion has urged the government to acknowledge the potential medical value of cannabis and to reclassify it to expand research into its use for patients.

“We also want to point out that the increased focus on addiction is, in some cases, hurting veterans who suffer with chronic pain and have been on long-term narcotic-based pain relievers,” said Louis J. Celli Jr., veterans’ affairs and rehabilitation division director at the American Legion. “For some patients, lifelong pain management through prescription medications is all they have that allows them to function. For some, removing these medications can lead to depression, decreased ability to care for themselves, and, in some cases, suicide.”

While supporting flexibility in care, veterans’ groups are cautious about the department’s Choice program, which funds private-sector health services for vets. On Tuesday, Congress approved $2.1 billion for Choice to help VA build Shulkin’s vision for “an integrated system that allows veterans to receive the best health care possible.”

But the integration isn’t as good as it needs to be, which is a danger when care is fragmented among VA and private providers, said Garry Augustine, executive director of the Disabled American Veterans.

The outside providers might not know all they need to know about a patient or share their records with VA. Coordination is key, he said, but not always present.

“Under the current Choice program, it isn’t as tight as it should be,” Augustine added. “That should be addressed.”

And soon — before another vet, like Patient 1, falls through the gap.

Read more:

White House opioid commission to Trump: ‘Declare a national emergency’ on drug overdoses

Many veterans would suffer under Republican health-care plan

Will VA chief be voice of reason on climate change and medical marijuana in Trump administration?