Ralph H. Johnson VA Medical Center
Opioid reduction at Charleston VAMC
Earlier this year, the Department of Veterans Affairs (VA) became the first and only health-care system in the country to publicly post opioid prescribing rates when it launched its new data website.
According to the most recent information, released on Jan. 15, 2018, Ralph H. Johnson VA Medical Center has seen a 46 percent reduction in opioid prescriptions in the five-year period from 2012 to 2017, which is better than the national 41-percent decrease. Charleston’s rate dropped from an estimated 12 percent in 2012 to just 6 percent in 2017.
According to Charleston VAMC’s Chief of Pharmacy Sharon Castle, the transparency about opioid dispensing rates at VA sites of care nationwide underscores VA’s commitment to the safe and appropriate prescribing of these medications.
“I think it sets the tone for how we feel about opioid prescribing,” she said. “We really try to improve the Veterans’ understanding of the process and alternative therapies that are available to them.”
Charleston VA physicians work with Veterans to evaluate their pain levels and offer alternative methods for managing that pain. These methods include prescribing non-opioid medications and supplements, group therapy through the facility’s Pain Management Clinic, acupuncture, physical therapy, yoga, tai chi, mindfulness training and even aromatherapy. Charleston VA doctors also follow tapering protocols and closely monitor those Veterans who have an appropriate reduction in their opioid prescriptions.
According to Castle, the prescribing data includes both medications dispensed long-term for chronic pain and short-term for incidences such as an injury or surgery.
“It’s really a balancing act with these situations because they do have legitimate pain syndromes,” she said. “Working with them to ultimately prescribe things or offer alternative therapies that treats their pain is really what they want.”
Though the data reporting website may be new in 2018, the responsible assessment and proactive reduction of opioid prescriptions has been occurring at Charleston VA for the last decade – since 2008. According to Castle, VA’s Opioid Safety Initiative, which was introduced in 2012 as a multifaceted approach to reduce the need for the use of opioids among Veterans, played an important role in encouraging doctors to think more critically about their prescribing methods.
“Our physicians and pharmacists have worked really hard to help us get where we are today and we are always looking for ways to improve and help our Veterans,” Castle said.
And she’s seen an encouraging response from Veterans, too.
“Our Veterans have been overall pretty happy with the initiative,” said Castle. “They’ve been positive about the work we’re trying to do to resolve their pain.”
VA’s prescribing rate information will be updated semi-annually, on January 15 and July 15 of each year.