Roseburg Veterans Affairs Medical Center officials told local veterans Tuesday they’re making progress on reducing opioid overuse and abuse.
The comments were made at a town hall meeting on the Roseburg VA campus Tuesday evening.
A January report by the U.S. Department of Veterans Affairs found that Roseburg VA had the highest rate of opioid prescriptions of any VA in the country. However, it also indicated that prescription rate was down 30 percent from five years ago.
The Roseburg VA is following the national VA’s 18-point program to continue reducing opioid use, Chief of Pharmacy Dan Neal said Tuesday.
The guidelines address opioid treatment of chronic pain, defined as pain lasting longer than three months, which is not related to cancer or end-of-life care.
VA doctors are now supposed to recommend other pain drugs or alternative therapies over opioids, and if opioids are chosen, to keep the dosage as low as possible. The risk of overdose increases with the dosage.
Neal said the VA has never been as willing to consider alternative therapies as it is today, and that’s partly because while opioids reduce pain, they may not be helping patients function better in their daily lives.
“They may be reducing pain, but if the patient’s not getting out and taking care of themselves, possibly exercising, interacting socially, things like that, are the opioids really helping?” he said.
They’re also asked to avoid prescribing opioids with benzodiazepines like Valium. The combination of those two types of medication greatly increases the risk of an overdose.
The VA has also increased its prescriptions of naloxone for patients on opioid therapy, Neal said. Naloxone is a rescue drug that can save the life of a patient who has overdosed on opioids.
The Roseburg VA has increased the number of random drug screenings, Neal said. Now, about 90 percent of veterans on long-term opioid therapy receive urine tests at least once a year.
Neal said the VA hopes to partner with Adapt to treat patients who have become addicted to opioids.
Melissa Heard, health behavioral coordinator, said the VA is also offering an array of alternative therapies for pain management. Those include a beginning yoga course tailored for veterans, an eight-week mindfulness program, a six-week cognitive behavioral therapy program, and battlefield acupuncture, which uses small, dry needles placed in the ear. A swimming pool and fitness center are also available.
A veteran in the crowd asked about chiropractic care for back pain. VA Nurse Executive Barb Galbraith said the VA will pay for chiropractic care in the community if the veteran gets an order from his or her doctor.
In other news, Interim Director Dave Whitmer said the VA will soon have more flexibility to send veteran patients to doctors in the community, following the passage of the VA Mission Act, signed by President Donald Trump on June 6. He said the Roseburg VA has already started planning for the change, which he said they’re calling Choice 2.0, a reference to an earlier act that first allowed veterans to obtain private care on the VA’s dime.
Whitmer also announced the VA is working to develop a general practitioner residency program, which will allow recent medical school graduates to train at the VA. He said part of the plan involves refurbishing housing on campus for between 12 and 16 of these new doctors to stay.
He also announced plans to provide an office in Building Two on the VA campus for three permanent staff members from the Veterans Benefits Administration, who will be able to assist patients with their benefit claims.