FEDweek

VA Tackles Opioid-Abuse Epidemic

Alarmed that too many veterans are dying from opioid overdoses, the Department of Veterans Affairs is taking steps to oversee the drugs’ use more thoroughly.

In a July 31 report, VA’s inspector general pointed to the 14,000 opioid-related deaths nationally in 2014, and that veterans constitute a higher proportion of victims when compared to the overall civilian population. VA statistics show that more than 50 percent of all veterans under the department’s care are affected by chronic pain. Additionally, more than 63 percent of all veterans treated by VA for pain also are diagnosed with mental health-related conditions – including post-traumatic stress disorder (PTSD), depression, traumatic brain injury (TBI), or substance abuse-related issues.

Dr. John D. Daigh Jr., VA’s assistant inspector general for healthcare inspections, cited in the report that many veterans are using opioids to treat chronic pain. Even though VA has implemented several protocols to address the problem, Daigh wrote, more action is necessary. The need for changes focuses largely on relations between VA and community-based civilian providers outside the department’s system. Given the constraints on resources within VA, veterans increasingly are made to rely upon civilian providers under the department’s Choice Program. Better coordination among
The IG recommended that VA’s health officials take these steps:

* All VA purchased-care providers review the department’s existing evidence-based guidelines for opioid prescription.

* Care providers should ensure that consultations for care veterans get that are not VA-related will include a “complete, up-to-date list of medications and medical history.” In time, such records would be included in electronic-records sharing, once it becomes available.

* Health-care providers outside of VA should submit all opioid prescriptions directly to a VA pharmacy for dispensing. This would help ensure that veterans’ records within VA will have a record of such prescriptions.

* VA facility managers should take notice when opioid prescriptions outside the VA system come in conflict with existing department guidelines. When such instances occur, managers should take steps to “ensure the safety of all veterans receiving care from the non-VA provider.”