For nearly four decades, the Department of Veterans Affairs had prescribed James Andrews narcotic painkillers for back pain. But last year, the VA sent the Vietnam veteran a terse letter informing him that it had canceled his prescription for hydrocodone.

His doctor told him he'd tested negative for opioids — a sign that patients might be hoarding and selling their pills — but Andrews said he had no hydrocodone in his system because he took the medication only when his pain was unbearable.

"I was extremely upset. You can't do that to somebody, especially someone with a failed spinal fusion," he said. "Ask me how I'm taking them rather than cutting me off and assuming I'm doing something illegal, because I'm not."

In response to public pressure over escalating overdose deaths, the VA has dramatically decreased the number of patients receiving long-term opioid painkillers since 2012. In Central Texas, the number has dropped by nearly 30 percent in three years.