VA becomes first hospital system to release opioid prescribing rates

Interactive map expands transparency, shows opioids dispensed among VA health care centers


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Today U.S. Secretary of Veterans Affairs Dr. David J. Shulkin announced that VA has begun publicly posting information on opioids dispensed from VA pharmacies, along with VA’s strategies to prescribe these pain medications appropriately and safely.

With this announcement, VA becomes the only health-care system in the country to post information on its opioid-prescribing rates.

The disclosure is part of VA’s promise of transparency to Veterans and the American people, and builds on VA’s strong record of transparency disclosures — including on wait times, accountability actions, employee settlements and the Secretary’s travel — under the leadership of President Donald J. Trump over the past year.

“Many Veterans enrolled in the VA health-care system suffer from high rates of chronic pain and the prescribing of opioids may be necessary medically,” Secretary Shulkin said. “And while VA offers other pain-management options to reduce the need for opioids, it is important that we are transparent on how we prescribe opioids, so Veterans and the public can see what we are doing in our facilities and the progress we have made over time.”

Counselor to the president Kellyanne Conway said, “Declaring the opioid crisis a nationwide public health emergency was a call to action by the president.  His administration is exploring all tools and authorities within their agencies to address this complex challenge costing lives. Veterans Affairs Secretary Dr. Shulkin is heeding that call; the VA is now the first hospital system in the country to post information on its opioid prescribing rates.  This is an innovative way to raise awareness, increase transparency and mitigate the dangers of over-prescribing.”

The interactive map shows data over a five-year period (2012-2017) and does not include Veterans’ personal information. The posted information shows opioid-dispensing rates for each facility and how much those rates have changed over time.

It is important to note that because the needs and conditions of Veterans may be different at each facility, rates may also be different for that reason, and cannot be compared directly.

The prescribing rate information will be updated semi-annually, on January 15 and July 15 of each year.

As a learning health system using the current best evidence to learn and improve, VA continually develops and refines best practices for the care of Veterans. Releasing this data will facilitate the sharing of best practices in pain management and opioid prescribing among doctors and medical center directors.

Highlights from the data include:

  • A 41-percent drop in opioid-prescribing rates across VA between 2012 and 2017
  • Ninety-nine percent of facilities decreased their prescribing rates.
  • San Juan, Puerto Rico, and Cleveland, Ohio, top the list of medical centers with the lowest prescribing rates, at 3 percent.
  • El Paso, Texas, and Fayetteville, North Carolina, are most improved, and decreased prescribing rates by more than 60 percent since 2012. El Paso’s prescribing rate decreased by 66 percent, and Fayetteville’s decreased by 65 percent.

VA currently uses a multifaceted approach to reduce the need for the use of opioids among Veterans. Since 2012, the Opioid Safety Initiative has focused on the safe use and slow and steady decrease in VA opioid dispensing. VA also uses other therapies, including physical therapy and complementary and integrative health alternatives, such as meditation, yoga and cognitive-behavioral therapy.

Information about the VA Opioid Safety Initiative may be found here. A link to the interactive map on VA’s opioid use across the nation may be found here.

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Comments

  1. Sue sharman    

    I think that acupuncture, massage therapy and chiropractic services would benefit veterans , many suffer from chronic pain, ptsd as does my husband , he has been to a chiropractor and has relief and I feel he would benefit from acupuncture. This could drive down the need for opioid use. Relaxation is a benefit from the above 3 forms of therapy. You should cover these for veterans and I know you would see a decrease in the need for opioids, maybe give it a try. Thank you

    1. George Brunner    

      I have spent 6 months trying acupuncture and massage therapy but there was no significant help with my chronic pain. Since I am currently in Thailand, I have tried what you suggest. I paid for my own treatments. I think your ideas have been tried before as in my case, The opiates I take as needed have provided me enough relief so as to function somewhat normally. My pain is not the lack of relaxation but from activity such as walking! You do not seem to understand the pain we deal with daily! Leave the opinions to those qualified to make them!

  2. Edward A Swisher    

    Opiods have been used effectively to treat chronic pain for over 100 years. The immediate effect of the knee jerk reaction to take all opiods away from vets was and is misguided. Medical marijuana has also been known to be effective for quite some time as well.

  3. Deborah VanderHamm    

    While it’s true many Drs. are prescribing pain meds too freely, creating a National Crisis, there is a parallel issue that is not getting sufficient attention: THOUSANDS of U.S. Veterans and civilians are living in life-long chronic pain with no relief in sight. How are they to follow the rule of law, AND get adequate pain relief?
    There is a Catch-22 between Big Pharma and the end user. Funding for medical R&D is necessary, but large corporate gains from the dying poor is socially immoral.

    1. Sammy    

      My Hydrocodone was taken away in 2015 after several years of being pain free and since then I have been in constant pain and seeing a private doc at a pain clinic. I have taken all the nerve drugs that there is and still have pain! The private doc wants to implant a pain pump with pain meds where I can function! I am due to get it implanted in the next few weeks! The VA has been taking all our pain meds away and NOT trying to research what to do to help us! I’m at the point to where I have no choice due to severe pain!

  4. David Douglas zamlich    

    After19 yrs of va prescribed opiate use I took two weeks cold turkey afterward admitted SFVAMC for multi organ failure. 2011- present opioid free and poop every day. Took a while now I have my life back.
    Ps. Was treated at SFVAMC and 7 months later left the nursing home and now I live in Key West Florida

  5. Danny Wayne Combs    

    Yea, this is how the VA gets their numbers, they just cut you off, period. They do not care about the welfare of veterans, they only care about numbers. I know this first hand

  6. Ken Davidson    

    The rate has dropped because the VA has dropped the amount of Opioids used by veterans across the board with out regard to individual cases. I for one have an inoperable back condition. Using 90mg daily I was living with out back pain. I have been cut to 60mg and live in constant pain. At 71 years old it isn’t the way I pictured my life being. No one should be forced to live a lower quality of life.

    1. Donna Hart    

      If you don’t mind me asking what kind of back problems do you have? I had back surgery back in ’03 and have been on vicadon since ’07. They had me on up to 60mg a day and now down to 40. I am not a vet but I am still living in pain everyday so I know what you are talking about. I will be 61 next month and like you I didn’t see living the rest of my life in pain. I hope they don’t drop you any lower. Will keep you in my prayers

  7. Keith Gentry Sr    

    we need help getting medical marijuana passed so that the disabled vet doesn’t have to pay for it. while using fentyal every 48 hours was more expensive than the medical marijuana. help us to be off the opioids, and costing the government more money.

  8. Wayne Castleberry    

    The VAMC had me on Tylenol Threes for almost 11 years. Not out of laziness, but out of a lack of ideas what to do with my conditions. It turned out my hepatitis C was multiplying my pain. Th GI Clinic asked that I wait for the new hepatitis drugs before treatment as few finished the old treatment due to side effects. Once the new drugs were administered and I completed the treatment, my pain level dropped to 85-90% less than before treatment. I urge the VA medical system to check all patients with chronic pain for hepatitis C. We older vets were given blood before it was tested for this disease. This could be a significant factor in treating chronic pain and lowering the use of opioids.

  9. ROY STARLING    

    I hate this they should also report the suicide rate increase or the ones that left VA care. I was almost one of suicides when they decided quality-of-life was not as important as their reduction record. Thank goodness I also have Medicare and was able to see a pain specialist and now for the people who follow all the rules I now can not get my prescription filled The pharmacist now can judge you and decide whether not to fill your prescription what has happened. The CDC and VA should offer some death with dignity instead of treating us as drug addict shame on them.

  10. Dennis Sutton    

    F(redacted)ing idiots”…..the f(redacted)ing problem is heroin…now what?

  11. Charles Ankner    

    Bravo. Tip of the spear. Now, let’s get medical cannabis for Vets…. Long overdue…
    The VA should also be leading the way to change FEDERAL LAW so Vets and others can home-grow their own cannabinoid medications. Besides the cannabis itself, the cultivation of cannabis is therapeutic in and of itself.

    SSGT Charles E. Ankner, USAF, Sep.
    SAINT Brand Cannabis
    A Veteran Owned Social Enterprise

  12. Glenn Davis    

    Yes, I saw the effect of the lowering opioid rates when I needed hip surgery because of the pain. The VA doctor told me he would prefer I go to a private doctor for pain relief. This is how government mamagers practice medicine. More good news for our vets,

  13. Leonard Edward Rothbaum    

    I have never seen such a bunch of crap.
    You are saying all these great things about a program that has shown such great success and it is à great LIE.
    Your reductions in the use of opieo use is probably true.
    NOW
    Ask your self how are they achieving this statistics.
    First …the doctor’s cut the vet off COLD.. With out notice they reduced the amount allowed to the Vet .
    The did not inform them they in most situations they cut them in half!!!!!
    The meet there quota and the Washington is happy.
    Now what happens to the Vet…. He or she goes though extreme withdrawals.
    Another thing they are doing is delaying sending out they pills. As an example I was to receive my pills on the 17,th of December to date (January 11) I have yet to receive them. Again pain and withdrawals. I represent 367 Vet s in Baja California …. Three have commited suicide so far… So your great plan Mr President is nothing but a sham or is it just a shame.

  14. Connie Shepherd    

    My Husband has pain, but his VA Dr blackmailed him off of 5mg oxycodone because he could not use the CPAP machine.
    He started taking 5mg 3 times a day, then they said he only needed 2 pills a day, then when he couldn’t use the CPAP he said he couldn’t give him the one a day??? He sent him 350 mg of Tylenol to take 2 four times in 24hour??? We just buy over the counter 500 mg and he takes those 4 times a day. He has a tear in his rotator cuff. Also pin in his wrist has worked out and wobbles around loose. He can’t have surgery because he has a bad heart. Some days he isolates himself because he is so grumpy from his pain….
    Very upset that his Dr has taken this stance. The Dr has said he didn’t want me (spouse) to sue VA if he died while on the oxycodone.

  15. Kevin J Churhill    

    President Trump needs to reel Jeff Sessions in and his onslaught on Medical Marijuana. He needs to re-schedule it. It is NOT worse than cocaine or morphine. It can replace Opiods and has many benefits to help treat many conditions. You don’t need to smoke it to get the benefits. There are over 600 edible and drinks now available, and more than half of the United States allow for the sale of these products.

    It’s time for the President to decide one way or the other. Or leave it up to the states to decide.

  16. Sherri Carter    

    I’m sure many Vets. Fear some sort of retribution if they post a reply here. I was taking opioids. Prescribed by the VA and even increased. When the big “scare” hit there was no decreasing of my meds. !
    I was taken off cold turkey and basically had to suck it up ! If our politicians and leaders shared our pain… I’m positive they would be treated with these medications by their Doctors. I was told that only Cancer patients would be given an narcotics at the VA but that’s not true. I used to be an Army trained Nurse. I have over heard many, many male Vets. Discuss what they were taking narcotics for pain in their knees, or back, or neck. Things are still not fair across the board. Thank God I have a civilian Doctor !

  17. Shirley Hilscher    

    The VA is severely restricting Pain Med’s to those people that actual NEED them because of some jerks who aren’t responsible or are selling them on the side. Target those people and leave those that need them, are responsible, give a good urinalysis. What your plan is doing for those who are severely restricted is forcing them to buy off the streets, which is not a great choice but what else are they to do.
    As far as the ‘other therapies’, that’s a joke. When asking about those, any of those choices, I get the same answer, NO FUNDS ARE AVAILABLE!!
    So what your advertising to the general public or unsuspecting veteran sounds good, but it’s a farce!! And of course, as usual, the veteran is the one that suffers the consequences!!!

  18. Fazz    

    Thanks for sharing useful information.

  19. Deborah L Pierce    

    Ok what will you do next, you can not just take them off a pain killer,
    A meeting with a Nurse ( since doctors are leaving his second in as many years) about such a thing, She was all to happy to cut a med away without giving any help or suggestions or what will happen next

  20. Michelle JACKSON    

    My best friend suffers excrutiating, debilitating hip pain,due to arthritis, no therapy, or meditation can possibly bring him relief, the pain has robbed him of any quality of life, and he is not long for needing disability pay as he cannot work. I cannot understand why he is denied the pain medication that will end his suffering and enable him to continue working until retirement age ( he is 60 yrs at present). What criteria met he meet in order to receive the necessary pain medications. I fear his ental state is being seriously compromised by his inability to get any relief. I am certain he will be able to meet the criteria, as he is an upstanding citizen in our community. Please send me any pertinent information to assist me in my search for some aid for him.
    Thankyou for your quick response
    Sincerely , Michelle R Jackson
    (Personal contact information redacted)

  21. Michael Raymond    

    The “Opioid Crises” has FORCED many of us to live in pain that most people could never tolerate. Meditation makes it sound as if it is all in our head. Does anyone really think if I could just focus, think hard about it, I wouldn’t be in pain? And if it were true, does anyone think I would have done it by now?!?! Yoga? Seriously? I have days that I barely can struggle through walking to the bathroom! I can’t sleep most nights because I am in severe pain, the numbness in my arms become debilitating pain, I can hardly use my hand for hours at a time. Mental Health has had the answer many times to help me sleep. Psychotropic drugs? I have PTSD, but that doesn’t mean I want to be a zombie on their drugs. But that is their answer every time. “Have you tried these”? So, along with the nightmares because I refuse to even TRY anymore pills for sleep, I am also forced to live in pain.
    And I too was just cut off. No substitutions, No explanation, they just didn’t refill it. I was only getting 5mg Hydrocodone and they continually reduced how many I received until I was already not getting enough relief. Looking back, I realize that all they were really doing was getting me used to living a life of severe pain. Without warning, I got NOTHING. When I called my Primary “Doctor”, all I got was his nurse. She said I was taking more than a cancer patient! I tried to explain that as far as chronic pain is concerned, a 5mg vicodin twice a day is the Baby Aspirin of pain meds!! That was a year and a half ago. I live each and every day in pain and when I see more BS propaganda on TV about the “crises”, I just get angry. As I’ve read in some of the other posts, I also must suffer due to someone else’s addiction, abuse or misuse of pain pills.
    I now do not have a PCP because I refused to see the one that was forced on me. I will not go to Mental Health because they only have interns that are there 3 months and leave and are afraid to get involved. And I still get to listen to Trump preach about taking better care of us on TV because I can no longer work.
    In one segment of the news, they can talk about the daily suicide rate of American Veterans, and in the next segment they have a story about eliminating our medication. Am I the only one who can see that we cannot stand the pain forever? Because whether its physical and/or mental pain or BOTH, I also cannot take much more of this great treatment!

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