Jan Jekielek is a senior editor with The Epoch Times, host of the show “American Thought Leaders” and co-host of “FALLOUT” with Dr. Robert Malone and “Kash’s Corner” with Kash Patel. Jan’s career has spanned academia, international human rights work, and now for almost two decades, media. He has interviewed nearly a thousand thought leaders on camera, and specializes in long-form discussions challenging the grand narratives of our time. He’s also an award-winning documentary filmmaker, producing “The Unseen Crisis: Vaccine Stories You Were Never Told,” “DeSantis: Florida vs. Lockdowns,” and “Finding Manny.”

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[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 NTD.

RUSH TRANSCRIPT
Jan Jekielek:

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

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

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?

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.

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?

Correct.

That seems to be a very significant statistic.

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.

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

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.

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.

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.

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.

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.

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

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.

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

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.

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

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.

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

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.

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

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.

Correct.

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

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.

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?

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.

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.

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.

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

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.

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.

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,

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

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.

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Is Overprescription Fueling Veteran Suicides? | Derek Blumke