{"id":81501,"date":"2016-07-14T18:14:25","date_gmt":"2016-07-14T18:14:25","guid":{"rendered":"https:\/\/one.sightlinemg.com\/militarytimes\/uncategorized\/2016\/07\/14\/tougher-guidance-on-va-narcotics-prescriptions-headed-to-obama-s-desk\/"},"modified":"2026-08-08T07:46:20","modified_gmt":"2026-08-08T07:46:20","slug":"tougher-guidance-on-va-narcotics-prescriptions-headed-to-obama-s-desk","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/militarytimes\/veterans\/2016\/07\/14\/tougher-guidance-on-va-narcotics-prescriptions-headed-to-obama-s-desk\/","title":{"rendered":"Tougher guidance on VA narcotics prescriptions headed to Obama&#8217;s desk"},"content":{"rendered":"\n<p>A new law designed to curb <span class=\"rte rte-comment\">prescription <\/span>opiate and heroin abuse includes tougher prescription guidance for\u00a0<span class=\"rte rte-comment\">provisions to guide prescribing practices at <\/span>Veterans Affairs medical facilities nationwide.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sought by the family of Marine veteran Jason Simcakoski, who died of an accidental overdose at the Tomah, Wisconsin, VA Medical Center in 2014, the changes are designed\u00a0to strengthen VA pain management guidance\u00a0and training, improve prescription oversight and promote alternative therapies.<\/p>\n\n\n\n<p>Under the bill,\u00a0VA must ensure that its prescribers are schooled in the latest <span class=\"rte rte-comment\">most up-to-date <\/span>practices and that all medical facilities stock overdose countermeasures such as naloxone and establish pain management teams to oversee opioid prescriptions for veterans with non-cancer-related pain.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&#8220;The bill recognizes that too often, these drugs have been used inappropriately and ineffectively, and because they are so powerful and so addictive, this inappropriate use is very dangerous,&#8221; said Sen. Tammy Baldwin, D-Wis., who\u00a0sponsored the veterans provisions along with Sen. Shelley Moore Capito, R-W.Va.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The Comprehensive Addiction and Recovery Act,\u00a0which passed the Senate on Wednesday by a vote of\u00a092-2 and is\u00a0expected to be signed by President Obama,\u00a0authorizes $181 million\u00a0in new funding for a range of measures designed to fight the national opiate abuse epidemic.<\/p>\n\n\n\n\n\n<p>The bill\u00a0requires the VA to ensure health care providers <span class=\"rte rte-comment\">have <\/span>can access and provide information to state prescription databases. It also gives patient advocates more independence by providing an avenue for reporting patient concerns outside the hospital\u2019s chain of command.<\/p>\n\n\n\n<p>It <span class=\"rte rte-comment\">also <\/span>promotes alternatives to incarceration for those with substance abuse issues, to include grants to expand veterans treatment courts, and it\u00a0broadens the number of health care providers who can oversee patients prescribed medications for opioid addiction by allowing some nurse practitioners and physician assistants to facilitate treatment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Simcakoski\u00a0died Aug. 30, 2014, in the Tomah hospital&#8217;s short-stay mental health unit from\u00a0&#8220;mixed drug toxicity,&#8221; having taken 13 prescribed\u00a0medications, including several that cause respiratory depression,\u00a0in a 24-hour period.<\/p>\n\n\n\n\n\n<p class=\"wp-block-paragraph\">Staff psychiatrists\u00a0had added new medications to Simcakoski&#8217;s lengthy list of prescriptions\u00a0in the days preceding his death and according to Baldwin, both Simcakoski and his family members had questioned staff whether the treatment was appropriate.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Veterans also told a Center for Investigative Reporting journalist that distribution of narcotics was so rampant at Tomah, they\u00a0nicknamed the place &#8220;Candy Land&#8221; and the center&#8217;s chief of staff Dr. David Houlihan the &#8220;Candy Man.&#8221;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">According to Baldwin, the patient advocacy measures in the new legislation\u00a0were most important to the Simcakoski family.<\/p>\n\n\n\n\n\n<p class=\"wp-block-paragraph\">&#8220;In Jason&#8217;s case, he and his family questioned the treatment. But nevertheless, the patient advocate answered to the prescribing physician and the hospital chief of staff. That&#8217;s not independence,&#8221; she said.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">According to a 2014 VA inspector general report, the\u00a0Veterans Health Administration issued 1.68 million prescriptions for opioids to 440,000 outpatients, or 7.7 percent of all VA patients, in 2012.<\/p>\n\n\n\n<p>The IG found that 13.1 percent of those prescribed opioids\u00a0had an active substance use issue and 7.4 percent of patients taking opioids also had a prescription for <span class=\"rte rte-comment\">a <\/span>benzodiazepine\u00a0\u2014 a combination that can cause\u00a0respiratory depression and death.<\/p>\n\n\n\n<p>In 2012, the Center for <span class=\"rte rte-comment\">of <\/span>Investigative Reporting published an analysis showing that VA prescriptions for opiates such as hydrocodone, oxycodone, methadone and morphine have increased 270 percent over the past 12 years.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The investigation also found that on average, VA has issued more than one opiate prescription per narcotic-prescribed\u00a0patient for the past two years.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Baldwin said the Simcakoski family worked hard to make sure the VA provisions were included in the final bill, and she\u00a0praised their efforts.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">&#8220;This bill may\u00a0have a real impact on the chances of [a veteran] becoming addicted,&#8221; Baldwin said. &#8220;My goal is to prevent Jason&#8217;s tragedy from happening to other veterans and their families.&#8221;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Patricia Kime covers military and veterans health care and medicine for Military Times. She can be reached at <a href=\"mailto:pkime@militarytimes.com\">pkime@militarytimes.com<\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>New legislation designed to curb prescription opiate and heroin abuse includes provisions to protect 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