Central Texas VA reports big drop in narcotic prescription rates


Highlights

The rate of VA opioid prescriptions in the Austin area fell 55 percent over the last five years.

The VA is the first hospital system to post its opioid prescribing rates.

Department of Veterans Affairs doctors are prescribing significantly fewer narcotic painkillers to patients than they did five years ago, according to recently released numbers.

On Thursday, the VA became the first hospital system in the country to publicly post its opioid prescription rates as it seeks to reduce the use of narcotic painkillers that have been blamed for deadly overdoses among veterans.

Prescribing rates in the Central Texas VA system fell 55 percent between 2012 and 2017, the sixth-largest decline in the nation. Opioid prescriptions now make up 8 percent of all VA pharmacy prescriptions in the region, compared with 18 percent in 2012.

Of the 12 VA systems with the greatest declines, five are in Texas. The El Paso system had the biggest decline of the 146 VA systems across the country, with a 66 percent decrease. Across the country, total VA opioid prescribing fell by 41 percent.

READ: Investigation finds corruption, intimidation at Temple VA campus

The Houston VA has the lowest prescribing rate in Texas, at 6 percent, while Amarillo had the highest at 16 percent.

“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,” VA Secretary David Shulkin said in a statement.

The department is trying to shift patients to other pain therapies, including physical therapy, meditation, yoga and cognitive-behavioral therapy.

The highest VA opioid prescribing rate was in Roseburg, Ore., with 20 percent; VA systems in Puerto Rico and Cleveland had the lowest prescribing rates at 3 percent.

Presidential adviser Kellyanne Conway praised the data release, saying, “This is an innovative way to raise awareness, increase transparency and mitigate the dangers of over-prescribing.”

In 2012, an American-Statesman investigation revealed the explosive growth of VA narcotic prescribing: Between 2002 and 2011, VA oxycodone prescriptions increased 150 percent. Prescriptions for hydrocodone jumped 360 percent. The newspaper’s investigation found that 1 in 5 deaths of Iraq and Afghanistan war veterans in Texas was the result of an overdose, far higher than among their civilian counterparts.

Under pressure from lawmakers, the VA embarked on an opioid safety initiative in 2014 to reduce the number of narcotic prescriptions its doctors dole out.

That process has proven painful for a number of VA patients who have claimed the VA canceled their prescriptions on dubious grounds, forcing them to quit cold turkey and without offering them alternatives to opioids as VA policy requires, according to a 2015 investigation.

That same year, Disabled American Veterans, an influential advocacy group, called for more “humane” pain management treatment as the VA sought a balance between giving the painkillers to those who need them to function and reducing or discontinuing them for those who don’t.

Last summer, the VA’s Office of Inspector General released a report finding that the increased use of non-VA care, through the VA’s Choice Program, presented “significant risk” for patients receiving opioids from private doctors who might not be aware of VA guidelines.



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