The Department of Veterans Affairs continues to struggle with how it dispenses opioid medications for vets in chronic pain.

A new VA Inspector General report faults the VA San Diego Healthcare System for failing to care for a patient with traumatic brain injury and post-traumatic stress disorder before he took his own life on a California gun range in October 2014.

According to the VA Office of Inspector General report released Jan. 5, VA doctors treating the former Marine did not follow department guidelines for prescribing opioid medications and ignored his request to discontinue using the painkillers.

Among the findings, first reported by Military Times: The veteran continued to receive refills of the opioid hydrocodone for 22 months without a face-to-face assessment. The VA also failed to follow up when the vet left a message indicating he wanted to discontinue the hydrocodone, and never followed up to assist him in tapering off the drug or to suggest alternative treatments.

In another case, the Fayetteville (N.C.) Observer over the weekend documented the story of a 24-year-old Army veteran who had served two tours in Iraq and had secretly been using heroin after becoming addicted to painkillers.

For a 2013 series it called "Bitter Pills," the newspaper looked at the amount of painkillers prescribed by a VA hospital and a hospital at nearby Fort Bragg. In 2001, the VA prescribed hydrocodone to 1,130 patients. By 2012, those prescriptions had soared to 47,586 patients, a 4,100 percent increase in 11 years.

Prescriptions for painkillers also had increased for active-duty soldiers at the Fort Bragg hospital, the newspaper found. In 2012, more than 18,000 soldiers — about a third of the installation's active-duty population — received a total of 46,870 opiate painkiller prescriptions through the hospital.

The Star Tribune last year examined how vets in chronic pain were left to fend for themselves after the VA's new painkiller policy was instituted.