Opioid Safety Initiative Drives Down Prescriptions for High-Dose Painkillers
By Brenda L. Mooney
Mark Ilgen, PhD, a research investigator at the VA’s Center for Clinical Management Research and an associate professor of psychiatry at UM.
ANN ARBOR, MI — Thanks to a national initiative begun at the VHA in 2013, fewer veterans are receiving prescriptions for risky dosages of opioid painkillers.
Over a two-year period, according to a recent study, high-dose opioid prescribing declined by 16% and very-high-dose opioid prescribing dropped by 24% at the healthcare system. Furthermore, the number of patients receiving both opioids and sedatives, which can be lethal when combined, dropped by 21%.
The report published ahead of print in the journal Pain looks at the effect of the Opioid Safety Initiative (OSI) launched by the VHA in late 2013 to promote safer opioid prescribing. The study reviews implementation of the initiative across all of the nation’s 141 VA hospitals.1
As part of the OSI, the VHA created a “dashboard” tool using its national computerized medical record system, which allowed local clinical leaders to systematically review opioid prescribing and give feedback to physicians.
The hope is that other large healthcare systems will begin to use their electronic medical systems as part of the fight against painkiller overdoses and opioid addictions, according to study authors from the VA Ann Arbor, MI, Healthcare System, the University of Michigan Medical School and Institute for Healthcare Policy and Innovation, both in Ann Arbor, MI, and Yale University in New Haven, CT.
The study of VA opioid prescribing actually begaN before the OSI rolled out and then extended through the program’s first year. While the national VA system had tried other efforts to stem risky opioid use, including guidelines for prescribing, the new research shows OSI greatly accelerated the downward trend.
“As our nation as a whole is learning, it’s important to reduce risky opioid-related prescribing,” explained first author Lewei Allison Lin, MD, an addiction fellow in the UM Department of Psychiatry who trained in the VA system. “We hope that these findings, showing the VA OSI was associated with a reduction in risky prescribing will encourage others to consider similar healthcare system interventions to address this complex issue.”
I went thru the OSI program at INDY VAMC chronic pain clinic.I was not given an option of going thru program.I was told I had to reduce my opioid intake or I would not be allowed to be seen by my physician who prescribed the opioids.I was also informed that I would not be prescribed opioids any longe.This was all told to me and 5 other veterans during orientation by the employee who managed the front desk and scheduled appointments.He was very rude and obnoxious and insulted us all by telling us there was no way we needed pain meds to help with pain.I told the NP in charge of treatment of veterans by this man and she said that he gets worked up at times.I was sent for CAM therapies which involved acupuncture and massage for my very chronic back issues. These CAM therapies did not help but I am still in severe pain and still required to reduce dosage of opioids no matter what.This happened almost 2 years ago and I am on a very minimal dosagethat I cannot even feel any relief what so ever !! I made complaints about the way things happened to my providers but they all acted like I should just shut up and live with it.If a veteran is in severe pain I suggest that you need to avoid the OSI program at all costs !! VA health care as a whole is sub par and the PCP’s at VA and especially surgeons and resident surgeons in neurosurgery clinic are totally incompetent and just do not care to do their jobs.
Mike Jarrett