Sen. Manchin sends letter about VA opioid database use

West Virginia

BECKLEY, W.Va. (WOWK) — Senator Joe Manchin sent an urgent letter to the US Department of Veterans Affairs Secretary Robert Wilkie on Wednesday, October 30, 2019. The letter is in response to a new report that the Beckley VA Medical Center failed to regularly check the state Prescription Drug Monitoring Program databases when prescribing opioids to Veterans.

The PDMP databases track the prescription and distribution of medication to patients, ensuring Veterans are not prescribed opioids both by the VA and a private doctor. Sen. Manchin wrote in part, “One study found that use of PDMPs has been associated with more than a 30 percent reduction in the rate of prescribing opioids. That’s what makes this documented V-A system failure so egregious.”

The full letter from Sen. Manchin to Secretary Wilkie is posted below:

Dear Secretary Wilkie,

The opioid epidemic has wreaked havoc through West Virginia and working to fix this crisis has been one of my top priorities as a Senator. West Virginia has the highest overdose rate per capita of any state in our nation and the impacts of this epidemic can be felt in every family, every community and every corner of our state.

Last year alone, our country lost more than 70,000 people to a drug overdose – that’s more than the number of people that we lost during the entire Vietnam war: 58,200. As you know well, Veterans are particularly vulnerable to the opioid epidemic. Recent research has found that Veterans are more likely to die from opioid overdoses than civilians. That’s why I was outraged when I read the newest VA Office of Inspector General report and learned that the Beckley, WV VAMC regularly failed to check the state Prescription Drug Monitoring Program (PDMP) databases when prescribing opioids to Veterans. Additionally, the report found that at least 19% of all VA patients prescribed opioids were at risk, because the clinicians did not perform the required queries of the PDMP databases and were unaware of controlled substance prescriptions the patients obtained from non-VA clinicians and pharmacies. In other words, Veterans lives are at risk.

We have been fighting with all our might to contain and manage this horrible health crisis, and requiring the use of safeguards such as the PDMP databases has been a key tool in our efforts. PDMPs are electronic databases used specifically to track the prescribing and dispensing of prescription drugs to patients. One study found that use of PDMPs has been associated with more than a 30 percent reduction in the rate of prescribing opioids. That’s what makes this documented VA system failure so egregious. It’s clear from this report that the VA has failed to effectively implement and train its staff to follow through on PDMP policies and laws passed by Congress.

Mr. Secretary, we have spoken before about my concerns about VA patients who are receiving care in the community. You have given me assurances that the VA was doing everything to ensure that Veterans were not “double-dipping” and getting prescribed opioids both at the VA and by a private doctor. This is a greater concern with the launch of the MISSION Act earlier this year, which allows more Veterans to receive care outside of the VA. With the history of bad actors in my state, using the PDMP database are the least we can do to safeguard our population.

As a member of the Senate Veterans Affairs Committee, I will continue to do everything in my power to make sure that the laws we passed to prevent the spread of the opioid crisis are effectively and efficiently implemented by the VA. I request your prompt and thorough responses to the questions below to ensure that VA is taking the appropriate steps to fix the failures that the report revealed:

1. What is the VA doing to ensure 100% compliance with VHA Directive 1306, Querying State Prescription Drug Monitoring Programs?

2. How is the VA revamping training of clinicians and pharmacists, such as the Pain Management and Opioid Safety training course, so that there is 100% compliance?

3. How is the VA working to ensure consistency across local and VISN level with VHA Directive 1306?

4. How is the VA holding providers accountable who do not adhering to opioid prescription guidelines?

The opioid epidemic is taking countless lives. It is bankrupting families, communities and my state. We have truly reached a crisis point and we need all hands on deck in order to fight this epidemic together. I look forward to your timely response, and I stand ready to work with you to fix the deficiencies in the VAs drug monitoring programs as soon as possible.

Sara Yoke, the Public Affairs Officer for the Beckley VA Medical Center, responded with the following statement.

VA appreciates the lawmaker’s views and will respond to him directly.

Regarding the OIG report referenced in the Senator’s letter, the Beckley VA Medical Center has taken steps to ensure staff follows VA guidelines and receives training specific to controlled substances and monitoring their use. In fact, from 2012 to 2018, the facility has reduced opioid prescriptions by 42 percent.

In 2018, VA became the first hospital system in the country to publicly post its opioid dispensing rates.

If you’d like to track opioid prescriptions by individual VA facility you can do that online here:https://vaopendata.carto.com/builder/74f45d51-cc44-4d29-b852-c1a2b39f303d/embed

As outlined in VA’s official response to the report, the department concurs with all of the OIG’s recommendations and has a comprehensive plan in place to implement them in less than a year’s time.

For more information on the department’s plan, view pages 34-38 of the report.

Copyright 2020 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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