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.
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
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
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.
led the hearing, said the problems at Tomah were not isolated and
without proper supervision they could occur elsewhere.
system is like Swiss cheese, it's just so full of holes,"
Blumenthal said of the VA's programs for monitoring opioid
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.
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.
Tammy Baldwin, a Democrat, and Ron Johnson, a Republican, also
questioned experts Thursday and asked them to fairly investigate
the Tomah VA medical center.