Letter to the Hon. Robert Wilkie, Secretary of the Department of Veterans Affairs - Kuster, Walorski Lead Bipartisan Letter Calling on VA Clinicians to Check State Prescription Drug Monitoring Programs

Letter

Dear Secretary Wilkie,

As members of Congress who have been actively involved in crafting policy to prevent the overprescribing of opioids to veterans, we write with concern over a recent report (#18-02830-164) from the Office of Inspector General (OIG) that found most Department of Veterans Affairs (VA) clinicians are not adhering to requirements to check state prescription drug monitoring programs (PDMPs) for patients engaged with opioid therapy.

Specifically, the report found that from April 1, 2017, through March 31, 2018, VA clinicians failed to check PDMP databases for 567,000 of the 779,000 VA patients who are currently undergoing treatment with opioids. It is estimated that 107,000 of the 567,000 patients for whom VA clinicians failed to make the required PDMP checks were at risk for opioid abuse or addiction due to poorly managed opioid treatment. Even more concerning, two-thirds of the 66 VA clinicians who were interviewed said they were unaware of the department policy regarding PDMPs, and only a quarter received training on PDMPs.

As you are aware, Veterans Administration Medical Centers (VAMCs) previously had the option to voluntarily report data to PDMPs, but were not mandated to do so as are all other doctors and pharmacists. This created a glaring void in reporting that left veterans, already at an increased risk of abuse, even more vulnerable. In response to this situation, we worked together to enact legislation during the 114th Congress requiring the VA to report to state PDMPs. In light of the nationwide epidemic of prescription drug abuse, which has had a significant impact on veterans, we firmly believe that PDMP databases have proven effective and are valuable tools in tracking the coordination of prescriptions, preventing drug abuse and diversion, and reducing doctor shopping.

We request an update on the actions VA is taking to carry out the recommendations outlined in the OIG report in order to ensure that VA clinicians are in full compliance with the law and providing the level of care our veterans deserve. If you have any questions, your staff can contact Stephen Simonetti at stephen.simonetti@mail.house.gov or 202-225-3915, or Melanie Spears at melanie.spears@mail.house.gov or 202-225-5206.

We look forward to your response.

Sincerely,