The Department of Veterans Affairs has begun publicizing information about how often its doctors prescribe opioids to help ease patients’ pain. It’s a move led by VA Secretary David Shulkin to increase awareness. Efforts spearheaded by former Fayetteville Mayor Nat Robertson and former Fayetteville VA Medical Center Director Elizabeth Gooslby helped to significantly reduce local VA prescription rates beyond those of the other three VA medical centers in North Carolina.
In 2017, for the first time, department officials began publicly listing information on VA disciplinary actions, hospital wait times and leadership travel. Those data were often misleading, according to Fayetteville VA records. This latest move for transparency makes the department the first hospital system in the country to disclose details on opioid use. Nationwide, the abuse of opioids has risen dramatically in recent years and has caused as many as 90 overdose deaths a day.
There is persuasive evidence that the task force headed by Robertson and Goolsby reduced local opioid abuse. Since 2012, when the Veterans Affairs Department instituted its new opioid safety initiative, dispensed prescriptions dropped more than 41 percent systemwide. The Fayetteville VA did far better than that. In 2012, the prescribing rate of opioids dispensed at the Ramsey Street VA hospital was 21 percent. In 2017, it fell to 8 percent – a 65 percent reduction. At the VA Medical Centers in Asheville and Salisbury, the decline was 42 percent; Durham was 39 percent.
In an interview with The Military Times, Shulkin said he hopes the move will provide a clearer picture of VA facilities that are successfully responding to the problem.
“I think VA is among some of the best work in the country on this,” he said. “We also have the responsibility to share what we learned with the rest of the country.”
Late last year, Shulkin invited members of the White House commission on opioids to visit the Cleveland, Ohio, VA Medical Center to discuss their medication management techniques. Shulkin said the hospital now has only 3 percent of its patients using opioids. Shulkin acknowledged, however that prescribing rates remain high at some other VA facilities.
In a statement, Kellyanne Conway, counselor to the president and a lead official on the opioid commission, praised the VA’s move as “an innovative way to raise awareness, increase transparency and mitigate the dangers of overprescribing.”
Shulkin called the department’s new transparency efforts part of a broader cultural change at the department over the last year, a permanent change in how VA physicians approach their responsibilities for years to come.
“When you begin to start disclosing and publicly sharing information, it’s very hard to stop,” he said. “That’s a commitment that’s going to be at VA for a long time. And that’s part of what we need to do to transform this organization to regain the trust of those we serve, our veterans.”