Tomah VA knew about spike in opiate prescription rate

Medical Center Director says internal investigation was done before report was released

TOMAH, Wis. (WKBT) — The allegations first came to light two weeks ago after a story from the Center for Investigative Reporting was published showing the number of opiate prescriptions at the Tomah VA more than quintupled from 2004 to 2012, even as the number of veterans at the hospital declined.

Medical Center Director Mario DeSanctis said the Tomah VA knew about the rise in opiate prescriptions and conducted its own internal investigation because of it.

He said the allegations made in the report only show data up until 2012; it doesn’t show the progress that has been made at the VA since.

DeSanctis said the allegations of over-prescribing opiates made against his hospital are concerning and he knows something needs to be done about it.

“It says we definitely need to look at it and review our practices, again, to see if there are alternatives,” DeSanctis said.

But before the report from the CIR was released, the Tomah VA had begun addressing the issues.

“Many of the problems that were identified in those articles had been investigated and as a result of those investigations, or that investigation, we’ve taken, I think, many positive steps towards rectifying the problems that were found,” DeSanctis said.

DeSanctis said following its own internal investigation, several different committees were put in place to monitor prescription rates at the VA.

“In our approach to pain management we instituted our Pain Management Committee. It’s a multidisciplinary team of professionals made up of providers, nurses, pharmacists to really review our overall approach from a multidisciplinary standpoint and taking care of pain,” DeSanctis said.

The Tomah VA also created an Opiate Safety Committee.

“They meet weekly with the providers to go over veterans’ care to really look to see if we can taper off opioid medications,” DeSanctis said.

The safety committee also gives providers targeted education on pain management and tries to find alternatives to opiates for pain.

“There is a bright future for the Tomah VA. The veterans want our care, we want to provide it to them, we want to be the facility of choice for veterans,” DeSanctis said.

A Chronic Pain Management Consultative group made up of pain management physicians and a person focused on opiate safety has also been created. This group works with not only health care providers, but also veterans to set up treatment plans and find alternatives to medicine, like aquatic therapy and meditation.

Dr. David Houlihan, the doctor at the center of the report, has been reassigned and barred from giving out prescriptions until the investigation is complete.

A federal investigation into the Tomah VA is expected to begin sometime next week.