Finally, he said, he confronted the emergency room staff, telling them Joshua had a severe drug addi...

1. A Navy Sailor's Desperate Last Act After Drug Addictions,
Depression
Finally, he said, he confronted the emergency room staff, telling them Joshua had a severe drug
addiction.
Nothing, he said, was done. Seconds passed. A long pause. Joshua's wife, Leslie, waiting at home in
Henderson, Texas, for his release from the Navy, called Don several times, alarmed at Joshua's
gradual decline. On the morning of March 15, he called a friend, a drug abuse counselor. "My heart
sank for him, knowing he had to leave," Don said. Felix L. Then he enlisted. At times, they felt they
had somehow failed him.
"What did I do wrong as a parent?" Don still wonders. "Respect, rank, honorable discharge, benefits
-- all of this weighed heavily on his mind."
On June 8, Joshua was discharged with a referral to the Navy's Level III substance abuse rehab
program.
But he didn't go to rehab, because there was no space, Don said. By that time the Virginia Beach
police had arrived and secured the site. He'd say, 'Dad, they take forever,' and I'd say, 'Josh, it's
gonna happen, we will get you home.'"
"When I looked him in his eyes that morning," Don said, "I thought, we have to get him home."
On Feb. Joshua admitted to having thoughts of suicide "over the past few months," but "he denied
any active plans or intent to kill himself."
Joshua's growing drug use between detox and when he checked into drug rehab on Aug. He was
always by himself, he just wanted to stay home."
Elliott remembers rushing Joshua to an emergency room several times because he was suffering
withdrawal symptoms when his supply ran out. He was scared about what to say, what not to say.
"He was afraid he would lose everything he had worked so hard to earn," Don told me. Then he looks
up at me, one father to another, and his eyes are luminous with pain.
"I knew," he said.
It was three hours, though, before it was official. The Navy declined to discuss Joshua's case. And he
was worried about having to support both households until his medical discharge.
He later denied to doctors that he tried to die by suicide. The training is making them tougher and
tougher. And left, in the desperation of that moment, unspoken.
"I said, 'Josh, what's going on?'" Don said. We need to take care of this," he said.
At some point that fall and winter, Joshua started using heroin.
"I thought rehab would take care of it," Don said, referring to Joshua's addiction. I'm so sorry!'"

2. "I knew I had to keep him on the phone. avoid caffeine, benadryl and other over the counter
medications. In the hospital's record of that visit, the section on "drug use" is marked "no." He was
given a prescription anti-anxiety drug, Ativan, and sent home with a handout advising him to "use
the Ativan as needed for anxiety ... "On the phone he sounded like he was good. "My son died by
suicide, but I loved him during his lifetime," he said. "I was in a state of shock for probably three
months. But how do we train them to be soft again?"
CORRECTION: This article has been edited to clarify the timeline of events surrounding Joshua's
death.
This article is part of a special Huffington Post series, "Invisible Casualties," in which we shine a
spotlight on suicide-prevention efforts within the military. He always put on a strong face for me.
They had a big fight; Joshua smashed the car windshield.
When Emily told her dad that Joshua was doing heroin, he was horrified. Joshua had to be back on
duty that Monday, Valentine's Day, a traditional family holiday when the Lipstein clan would gather.
But we don't do anything to reprogram them back. It provides peer-based emotional support for
those who have lost loved ones due to their military service, connects survivors with grief counselors
and other resources, and offers seminars and retreat camps for kids.
Don called and was put in touch with a trained survivor care team member. But I did the best I
could."
It was Joshua's wife, Leslie, late that afternoon, who alerted Don that Joshua was talking about
suicide.
After Joshua died, "I was in a frozen state," Don told me one day as we sat in his car in a parking lot
outside Wilmington. He thought the birth of Joshua's daughter, Jayden, in September, would change
Joshua's life, help him kick drugs. He later told Navy doctors he was despondent at the long delay in
getting his medical discharge from the Navy. He survives. 4 was not the Navy's fault, it said in a
statement to The Huffington Post. He was young, smart, capable and well-liked. He wore a polo shirt
emblazoned with the logo of Navy Riverine Squadron 1. "I don't understand why they weren't drug
testing him more frequently," Elliott said of the Navy.
Officially, the Navy requires each of its commands to conduct urinalysis tests of 15 percent of its
personnel each month. "I thought, the Navy isn't helping us," Don said. Don knew that reading
Joshua the riot act now was not the best way to handle the situation, a lesson he'd learned in dealing
with his wife's addictions. He and Joshua were battle buddies from Iraq. Celebrate the life that was.
He said he didn't want to make things worse between Joshua and Emily; could the counselor talk to
Joshua without mentioning the heroin? She agreed.
Hours later, Leslie called with her frantic warning, setting in motion the flurry of final calls.
'DROP THE SHAME'
Joshua's former commanding officer, Cmdr. But she and Joshua stayed in close touch.
That fall, she was diagnosed with colon cancer, and eventually she was taking fentanyl and Roxicet
for pain. He waited, silently begging Joshua to answer. Hopkins of the Oceana Naval Air Station,
who conducted the investigation. Anger. It just kept getting pushed back, the medical board. On his
patient care report, his smoking is indicated (half a pack per day), but the section on alcohol and

3. drug use is crossed out.
Joshua's roommate at the time in Virginia Beach, near the sprawling naval facilities in Norfolk, was
Elliott Miranda. Gary Leigh, came to the military funeral in Wilmington, where Joshua lay in an open
casket. If you or someone you know needs help, call the national crisis line for the military and
veterans at 1-800-273-8255, or send a text to 838255.
This story appears in Issue 67 of our weekly iPad magazine, Huffington, available Friday, Sept. In a
fog, he called Don. "When you hold her for the first time, you're going to love her so much -- just like
I loved you when I held you for the first time," Don told him. He was recently married and doted on
his infant daughter. His records show he was diagnosed with depression, thoughts of suicide,
addiction to benzodiazepines and opiates, and panic attacks. More confusing. We have to talk about
it or we're not going to be able to fix it."
"A lot of us [suicide survivors] get stuck in our shame," he said. But that night, May 28, he took a
Xanax and washed it down with three shots of whiskey. Finally, Joshua picked up the phone.
In that final connection, all the love, all of life's hopes and failures and regrets, the anger and
despair, the secrecy and deception, all telescoped into those few precious minutes. Finally, Elliott
heard back from the roommate, and called Don and broke the news: Joshua was dead.
Unraveling the skein of events that led to this end, it's hard to avoid seeing what experts say is a
major factor in suicide: the powerful influence of drugs and addiction that can deepen depression
and hopelessness.
Don and Emily came to see him during the 11 days he was in detox. It said a delay between detox
and rehab is "typical," and patients can choose to participate in outpatient care while they wait. But
he did allow that "there were things the military could have done to help make it less traumatic for
guys coming back and trying to get back into civilian society."
"They spend a lot of time to train them to be mentally and physically tough. Each time, Joshua
denied he was doing drugs.
It was a mystery to everyone that Joshua managed for five months to indulge his addiction and stay
on active duty. Avoid alcohol."
Ativan is a benzodiazepine, a common antidepressant to which Joshua had become addicted,
according to Navy medical records. "I wanted to make sure he was there and safe," Don said. For a
list of resources to get free and confidential help, click here. By the end of that year, Navy boot
camp had scoured away most of his boyish clowning, but not his enthusiasm for life. Withdrawal
symptoms -- muscle soreness, diarrhea and anxiety -- would kick in within four hours without a dose,
the Navy later determined.
Early that winter, on zofran settlement amounts Jan. I have to go,' and he hung up."
Quickly, Don dialed 911 and relayed the address, sending cops speeding toward the townhouse.
Later that fall, Elliott came back from deployment and was disappointed to find that Joshua had
taken up drugs again after his treatment. Then in a choked voice, Joshua said the address.
"Then suddenly his voice got real strong. From the time of his operation in December 2009 until the
end of May 2010, he never went longer than two days without opiate pain pills. He was close to and

4. loved by his dad, Don Lipstein, his sister, Emily, and brother, Andrew.
And yet, like many afflicted by thoughts of suicide, he was fighting an undertow so powerful that it
was largely invisible to those who loved him, until it was too late. 30, 2010, Joshua showed up at the
Naval Medical Center in Portsmouth, Va., complaining of nausea and vomiting, muscle pain, cramps
and anxiety. He was sick over the abrupt end of his Navy career. "Give it some attention. Elliott had
been frantically calling, but Joshua wouldn't pick up. Leigh bent over and tenderly straightened his
service ribbons.
Petty Officer Lipstein, the Navy concluded, "was under a significant amount of stress due to
separation from his wife, reoccurring panic attacks, depression, a long term addiction to drugs, the
death of his mother, brain surgery, loss of hearing, and a likely medical separation from the Navy."
"Looking at the evidence, his mental capacity was diminished at the time of his death, and he was
not able to comprehend the nature of his actions and, therefore, cannot be held mentally responsible
for his actions," wrote Navy Lt. Cmdr. By the time Joshua graduated from high school and went off
to Navy boot camp in Great Lakes, Ill., his mother had moved back in with her parents in nearby
Ocean City, N.J. Joshua was extremely close to his mother; there were periods when he managed the
family household in Wilmington, Del., for her. We have to get rid of the stigma of PTSD, depression,
substance abuse. "Here he's leaving his wife and daughter, family -- all the people he loves the most,
after his mom's memorial service, going back to a job he hates, living on a couch in someone's house
-- ''
"I thought, 'We gotta get the Navy to release him.' That's what I'd been praying for since I found out
what he was doing there. Warm, friendly, outgoing. He was lonely for his wife, Leslie. The family,
Don said, "was in bad shape." A memorial service was held two days later in New Jersey. "I don't
know what to do," she said in a call from their home in Texas. On his return from Iraq in 2009, a
routine physical turned up hearing loss, evidence of a brain tumor. When I tried talking to him he'd
say that nothing was going on, he didn't have a problem. 'Please tell me where you are, please give
me an address.'" Silence. A distinguished naval career beckoned.
Then, a setback. She was a good listener and he talked, slowly over the months absorbing the facts
of Joshua's life and death.
As he began to thaw, Don came to understand some things about the suicide of his son. They were
beyond best friends, bound together by shared combat. She didn't know where Joshua was, and she
was frightened. "How did that information not get passed on, that he was in the ER because he's
having withdrawal from opiates and he's active duty? There should be no ifs, ands or buts about this
-- the guy has a drug problem. "I just met a couple whose son died six years ago and they have never
been able to talk about it. "I will always miss my son and love him, but I don't want his death to
define my life," he said.
He began to understand that he would never comprehend precisely why Joshua took his life. "Yes,"
Joshua admitted. Anxious to get on with his life, but stuck until the Navy processed his discharge. It
was an easy step, when Joshua's own pain prescriptions ran out two months after his surgery, for
him to get the opiate pills from her.
According to a Navy investigation, when Joshua's prescription for Percocet expired, "he fed his
addiction by asking his mother to send him Roxicet." Roxicet, the report noted, is an oxycodone-
based painkiller that "can be habit forming."

5. Joshua's drug habit surged. He was more standoffish, not his old energetic self. But his hearing loss
and the surgery abruptly ended his dream of a Navy career. In the 30 months or so since Joshua
died, he has endured unimaginable suffering. 20 in the iTunes App store.
. Stop pretending it didn't happen. We are very close."
Don is now a peer mentor coordinator with TAPS, training other suicide survivors to approach newly
bereaved family members to offer a friendly ear and other resources.
"The best thing for those who have lost a loved one to suicide -- and for the rest of us -- is to talk
about suicide, he said. "However, patients cannot be compelled to participate in this care,
particularly since care is ineffective without the patient's cooperation in their [sic] recovery," the
Navy said.
He was not tested for drug use during that period because "such testing cannot be employed if the
patient is not complying with their [sic] treatment plan."
In other words, a potentially suicidal drug addict on active military duty cannot be asked to submit
to a urinalysis if he is using drugs.
Whatever happened in the Navy's five-week drug abuse rehab program -- and the Navy would not
release those records -- it didn't take. To see all the articles, blog posts, audio and video, click here.
For a review of warning signs someone may be at risk of suicide, click here. Joshua's best friend,
Elliott Miranda, had heard from the family that Joshua was in a bad place. "And he said, 'Dad, you
were right,' he absolutely loved her," Don said to me.
"And he said, 'Dad, you don't have to worry because the Navy is going to drug test me all the time so
it would show up.'"
"That made sense to me," Don thought, "because he's a known drug abuser so they would keep an
eye on him."
Joshua went back to his old job, staring at security cameras at Oceana Naval Air Station in Virginia
Beach. And the unanswerable questions: How could this have happened? How did we get to this
point? What was my own part in this? Where did I fail? Frantically searching for the understanding
that will never come.
Don Lipstein

6. Slowly, over the months, he has built a small space of acceptance, of peace. Its effects are magnified
by alcohol.
Two weeks later, in early March, Joshua came home for a quick visit. It meant he was stuck in what
he considered a dull job as a military security guard. He admitted to Emily that he was doing heroin.
He said, 'Dad, I love you. Easy, in retrospect, to spot the missed opportunities for intervention.
THE PERIL OF PAINKILLERS
Joshua had been voted class "party animal" when he graduated from Mount Pleasant High School in
Wilmington, Del., in 2005. Going home occasionally to hang out with Andrew and Emily and check in
on his mom.
She died Feb. Rodriguez, a Navy physician. More heartbreaking.
His story is unique, but it also reflects the http://www.medicinenet.com/ondansetron-oral/article.htm
struggles of the 301 active-duty military men and women who died by suicide that year, part of a
growing toll of invisible casualties.
It is difficult to reconcile Joshua's last desperate act with the outward blessings of his life. To pass
him on the street, to exchange neighborly pleasantries, you would not glimpse his torment.
But in coming to this part of the story, the moment his son hung up the phone, Don falters and goes
silent, eyes downcast. But I noticed he was making more frequent trips back home, I knew he had
people who could get him the painkillers."
All that spring, Joshua's drug dependence was deepening even as he remained on active-duty in a
military service with a "zero tolerance" official drug policy. Surgery, in December of that year, was
successful; the tumor was benign. "There may have been something I could have done to affect the
outcome. That he couldn't play what-if: what if Joshua's Navy buddies had been around, what if his
drug use had been detected earlier, what if his mother had not died...
"I don't think the military should be blamed completely," he said. Instead, Joshua went back to the
townhouse, back to his dead-end job, back to his addictions. "How could he be passing his drug
tests?" But he knew he had to do something. His buddies used words like "energetic" and
"optimistic" to describe him. I think he didn't want to worry me so he said he was doing good when

7. he really wasn't."
They'd all had Navy suicide-prevention training, but some described it as meaningless, a computer
exercise you had to click through in order to be granted time off.
It was 56 days before Joshua was admitted into the Navy's intensive drug rehab program at the
Portsmouth naval hospital. She was furious, reminding him that when their mom was doing heroin
he said he'd never do it. He was 23 years old.
The Navy, after an investigation, ruled that Joshua died "in the line of duty and not due to his own
misconduct."
The real story is more complicated. He had called Joshua's roommate, told him to go home and
check on Joshua. Each time, Don would call Joshua. Battered by shame, guilt, an agony of regret. 4
by William C. "I could hear him crying. Elliott saw pretty quickly that something was wrong.
"Once he had the surgery I noticed that he was doing a lot of pain medicine, and I never said
anything because I figured he knew what he was doing," Elliott told me. I said, 'Joshua, where are
you?'"
"I can't tell you."
"I said, 'Do you have a gun with you?'"
"Yes, I do."
"Could you just unload it, please?"
"I can't do that."
"I was clutching at straws trying to keep him on the phone. People saw him as a shining star. But in
response to questions from The Huffington Post, the Navy released a statement saying in part that
"service members cannot legally be singled out for drug testing" outside of "command-wide
inspections, probable cause tests, search and seizure, and examinations conducted as part of a
mishap or safety inspection."
Joshua (in black) with his mother and two of his boot camp, basic training and Riverine Squadron
brothers.

8. In late May 2010, Joshua's mother, Melinda, was rushed delirious to a hospital in New Jersey after
an overdose of fentanyl and Roxicet, according to Navy records.
On the early evening of March 15, 2011, in the bedroom of a two-story red brick townhouse in
Virginia Beach, Va., Navy Petty Officer Joshua Lipstein put a .45-caliber Glock 21 pistol to his right
temple and pulled the trigger. His Navy buddies were gone, deployed overseas or stationed
elsewhere. But when he pleaded with Joshua to acknowledge to Navy doctors the full extent of his
drug problem, Joshua told him: no way. But he was crying and he said, 'Dad, I'm so sorry, I love you.
Josh is a hero," said Navy Cmdr. I have an addiction. He planned to re-enlist. Gary Leigh, Joshua's
squadron commander in Iraq, who was "crushed" by Joshua's death.
Joshua, shortly after his first deployment, preparing to report to duty on base.
Joshua won promotions. "I tried reaching out to him and hanging out as much as possible, but he
didn't want to go out and do things. He loved his two combat tours in Iraq with a Navy river patrol
unit, Riverine Squadron 1, hunting insurgents and weapons caches along the Euphrates River in
bloody Anbar Province.
He made friends easily and was a good friend. "Is there someone there with you?" he asked." "Yes."
"Put him on the phone," Don ordered, and asked the friend -- whose name he does not recall -- to get
Joshua to Portsmouth naval hospital's emergency room.
From there, he was put into the Navy detox unit in Portsmouth's Ward 5. With the help and support
of many others, he works at enlarging that space. He was bored to tears, he told Don. In pre-
admission exams he tested positive for benzodiazepine, opiates and cocaine, according to notes
taken Aug. "Dad, I'm not doing well at all. But talking about it helps people who struggle with the
shame, and if you don't deal with that, the shame will eat you up."
He also learned how to move on. "He lived an awesome life. "An infectious smile, the men all adored
him, a great brother in arms. Instead, the Navy began the lengthy process of terminating his service
on medical grounds.
In recovery, Joshua was prescribed a cocktail of drugs for pain, anxiety, nausea and other side-
effects of surgery: diazepam (Valium), the anticoagulant heparin, the painkiller Percocet, and five
other drugs.
The Percocet, in particular, was a peril.
The Huffington Post has pieced together the trajectory of the next 15 months from Joshua's medical

9. records and Navy investigation reports shared by his father, from Naval Criminal Investigative
Service documents obtained under the Freedom of Information Act, from interviews with Joshua's
family and friends, and from statements issued by the Navy in response to questions.
Joshua's mother, Melinda, had struggled with narcotics for years, creating considerable turbulence
at home when the kids were young, Don said. Joshua was frantic with worry for her -- and anxious
that he would lose access to her painkillers. "I knew he was still using," Elliott said. 26, Joshua was
taken by ambulance to the Sentara Bayside Hospital emergency room in Virginia Beach, complaining
of panic attacks and chest pain. "Are you high now?" he asked. "But then things started getting
worse. 10 of colon cancer. "I tried calling him from Bahrain a few times," said one of Joshua's close
friends, who asked not to be identified because he is still on active duty. I want to stop but I can't,"
Don later recalled him saying.
Don didn't know about the whiskey, but he was deeply worried. I can't help but think of all the gifts
he left us, Leslie and Jayden and the whole family. Don thought, maybe there's hope.
Don, 54, is a strong person. He was a great kid. One was to drop the shame. There is a tremendous
amount of loss, pain and guilt, shame, anger."
A memorial for Joshua in the Lipstein house contains his wedding photo, the flag from his funeral,
his medals, his beret and a photo of his daughter at a TAPS event.
A Navy casualty assistance officer gave Don a batch of material after the funeral, including a
brochure from TAPS, the Tragedy Assistance Program for Survivors. He was given a dose of Zofran,
an anti-nausea medication, and sent home. "He doesn't sound good at all," she said.
"Call everyone you know and get them over there," he ordered.
Rattled, Don dialed Joshua's cell phone