VA officials say they will work to end overprescribing

 

March 27, 2015

MADISON Department of Veterans Affairs officials are trying to put solutions in place to limit narcotic overprescribing practices in VA hospitals, they said Thursday, but lapses still happen.

At a U.S. Senate hearing in Washington, Sen. Richard Blumenthal, D-Conn., called the VA system of prescribing narcotics "abysmally inaccurate" and prodded VA officials on how they would fix programs used to monitor such prescriptions.

Interim VA Undersecretary for Health Carolyn Clancy said the agency is launching computer programs aimed at tracking opioid prescriptions across the VA system, but that software in 29 states doesn't work with similar state-run programs. As a result, she said, some patients can get prescriptions from both VA and other doctors.

Clancy said she is working to address the gap and the program has seen success elsewhere.

The two-hour hearing focused on the Tomah VA medical center, targeted in multiple probes for allegations of narcotic overprescribing practices and retaliatory behavior among staff. An agency report earlier this month found that patients at Tomah were more likely than patients at other VA hospitals to receive high doses of narcotics, and a culture of fear among employees affected patient care.

Jason Simcakoski, a 35-year-old Marine, died of an overdose in the hospital's inpatient care unit last year. The facility director was re-assigned out of the hospital last week and the chief of staff David Houlihan earlier this month was placed on administrative leave pending the conclusion of ongoing investigations.

Clancy said she is deeply concerned about the allegations against the hospital, and said if employee misconduct is found, those responsible will be held accountable.

Blumenthal, who led the hearing, said the problems at Tomah were not isolated and without proper supervision they could occur elsewhere.

"And the system is like Swiss cheese, it's just so full of holes," Blumenthal said of the VA's programs for monitoring opioid prescription.

John Gadea, director of the Connecticut Department of Consumer Protection drug control division, said patients in his state have participated in drug diversion practices because the VA does not upload all patient data into the state's prescription monitoring program.

Clancy and Gavin West, VA assistant for clinical operations, said earlier in the hearing that they were working to patch up problems in the technology that has yielded glitches in some states.

But Clancy also said the VA has succeeded at medical centers in Minneapolis, Cleveland and Tampa, Florida, in limiting use of narcotics to treat pain. She said the Cleveland facility received an award from the American Pain Society for using "complementary and alternative medicine to lower (patients') reliance on opioids."

But G. Caleb Alexander, co-director of the Johns Hopkins center for Drug Safety and Effectiveness, said the issue of opioid overprescribing may not be solved with increased monitoring.

"I'm not convinced we can engineer our way out of this problem," Alexander said, adding that though physicians need to look to alternative treatments for chronic pain management, opioids may be the best for some patients.

Wisconsin Sens. Tammy Baldwin, a Democrat, and Ron Johnson, a Republican, also questioned experts Thursday and asked them to fairly investigate the Tomah VA medical center.

 


Associated Press