VA opioid prescriptions are down but there’s still work to be done

Matt Saintsing
May 30, 2018 - 2:08 pm



In the midst of a national opioid epidemic, of which veterans are twice as likely to accidentally overdose than non-veterans, the Department of Veterans Affairs has cut its opioid prescription rate by hundreds of thousands, according to a government report released Tuesday.

The federal watchdog Government Accountability Office (GAO) finds that while veterans are overrepresented with opioid overdoses, the VA’s own programs to reduce prescriptions of these potentially fatal medications seem to be working as the agency prescribed nearly 267,000 fewer opioids this year than it did in 2013. 

The report examined the VA’s Opioid Safety Initiative, launched in 2013 to scale back the amount of pain pills the department was prescribing, to promote alternative therapies for pain, and to mitigate the risks of long-term opioid treatment.

Between 2013 and 2018, the VA reduced its opioid prescription rate by 41 percent, and today, only 10 percent of VA patients are given these highly-addictive medications, the report says.

Opioid deaths have been steadily rising for years, and in 2016 alone, more than 42,000 people died from an opioid overdose—more than any other year on record, according to the Centers for Disease Control and Prevention (CDC).

And 40 percent of all opioid overdose deaths involved a prescription opioid.

Veterans, who often come to the VA with chronic pain and other service related ailments, are twice a likely to die from an accidental overdose, than their non-veteran counterparts, according to the VA.

But while VA has made strides in reducing prescriptions, the report found places where the department has made shortfalls.

By reviewing a sample of 103 medical records, the GAO found that VA physicians don’t always follow their own protocol to reduce risks with opioids.

Of note, some doctors failed to input patient names in databases intended to monitor these drugs and to identify those veterans who have been prescribed opioids multiple times. Additionally, some veterans who were prescribed these medications didn’t always have to submit a urine drug test, which the VA conducts to ensure patients are taking their medication.

What contributed to these systemic failures? The GAO says staffing shortages.

When reviewing medical records and facilities, investigators found that four out of the five VA facilities they focused on were lacking a “pain champion,” a doctor who is charged with ensuring other physicians followed the requisite safety regimens.

This role was created in 2015, when the VA required all of its medical facilities have someone in place.

The GAO made five recommendations to ensure that every facility is in line with their own opioid safety strategies, even in an era of opioid prescription reductions with the agency.

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