JOHNSON CITY, TN (WJHL) – Mountain Home VA Medical Center went from being one of the highest opioid prescribing Veterans Affairs facilities in the nation five years ago to now more in line with the national average, according to newly released federal data.
The prescribing numbers show the percentage of veterans on opioids at the facility dropped from 19% of all patients in 2012 to 10% in 2017. Mountain Home cut its opioid prescribing nearly in half with one of the largest reductions in the VA system, according to the data.
“We’re very proud of that,” Chief of Staff Dr. David Hecht said. “It’s been a hard effort, not just on one group, the primary docs who are on the frontline, but a whole range of people that have made this happen.”
According to Dr. Hecht, just under 3,900 of the facility’s 39,000 veterans remained on opioids at the end of 2017. The facility now prescribes fewer opioids than its counterparts in Nashville and Memphis, according to the data. Before Mountain Home started its opioid reduction initiative in 2016, the facility prescribed more opioids than most facilities.
“Some of these safety issues were not outwardly apparent and as they became more apparent, as the effects of chronic opioid use have become apparent with the details and just significant side effects, we made a concerted effort to try to reduce those,” Dr. Hecht said. “Our job is to do no harm as physicians and so when we find out that a medication that we’re prescribing is doing harm or has the potential to do significant harm even if it hasn’t done so already, our job is to try to find alternatives.”
The VA has moved to an approach that focuses mainly on alternative treatments, including acupuncture, therapy and yoga. Army veteran Sid Daugherty says he’s tried two of the three and plans on trying chair yoga in the near future, but says so far, no other treatment has provided relief for his chronic back pain.
“It didn’t improve anything,” he said. “It didn’t help anything. It actually made matters worse. Nothing helps except for the pain medication.”
Daugherty is one of the veterans who received a letter in September 2016, warning Mountain Home planned on reducing doses to safer levels for some and tapering others off of opioids altogether after new evidence found the long-term use of the medication for non-cancer pain was not as safe as once thought.
Dr. Hecht says Mountain Home continues to receive some complaints about the decision, but overall, he believes veterans are coming around.
“Actually, some of our biggest skeptics, especially when it comes to something like acupuncture, have been so pleased after they’ve gone to that therapy,” he said.
Dr. Hecht says he has no regrets about the way Mountain Home reduced opioid prescriptions, but said if he had to do it all over again he would provide more advance notice to veterans.
“The short answer would be no, no regrets,” he said. “The only thing I would have done is send out notification even sooner…I think we’ve really done things in a safe, correct way.”
While the VA reduced opioids overall, administrators maintain they still look at each veteran’s individually before making a decision. Veterans have the ability to appeal any opioid tapering decisions. As a result, Dr. Hecht said the appeals board has reversed some tapering decisions.
House Veterans Affairs Chairman Congressman Phil Roe (R) applauded the VA for releasing the prescribing data.
“Opioid abuse is a public health emergency, and it’s clear from these figures that VA is taking effective action to curb opioid abuse and dependency,” he said in a statement. “As a physician, I am keenly aware of the fact that every patient has different needs and preferences, and I believe this is a positive step in the right direction.”Copyright WJHL 2018. All rights reserved.