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Opioid Therapy

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Veterans Affairs Medical Center has for years been prescribing unusually high amounts of opiates to veterans, in dangerous combinations with other drugs. Whistleblowers who raised concerns about the prescription practices were fired, disciplined or quit, creating a culture of fear of retaliation and leaving problems to fester and harm veteran patients. At least two veterans and possibly more have died because of alleged mismanagement and poor care at Tomah, WI.
“Clinicians were being monitored now. A pain-management committee had been revamped to prevent over-prescription of narcotics. Relationships between doctors and pharmacists were on the mend. Everything was under control. The independent inspectors had had "serious" concerns about "unusually high" amounts of opiates being prescribed to vets at the center”
In recent years, a number of VA practitioners and clinics have used locally created OPCAs to document discussions with patients regarding long-term opioid therapy. A number of benefits have been proposed for OPCAs, including their potential to improve adherence, reduce misuse and diversion, and clarify treatment goals, …show more content…
VHA’s strategic plan stresses patient-driven health care, defined as “an engagement between a patient and a health care system where the patient is the source of control such that their health care is based in their needs, values, and how the patient wants to live.” To achieve this vision, practitioners prescribing long-term opioid therapy for pain must educate patients about the risks, benefits, and alternatives to long-term opioid therapy and engage them in a discussion about a proposed long-term opioid therapy management

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