Spike in opioid thefts seen at VA hospitals
Lax oversight worries U.S. auditors
WASHINGTON — Federal authorities are stepping up investigations at Department of Veterans Affairs medical centers because of a sharp increase in opioid theft, missing prescriptions and unauthorized drug use by VA employees since 2009, according to government data obtained by The Associated Press.
Doctors, nurses and pharmacy staff members at federal hospitals — the vast majority within the VA system — siphoned away controlled substances for their own use or for street sales, or drugs intended for patients simply disappeared, according to data collected by the AP.
Aggravating the problem is that some VA hospitals have been lax in tracking drug supplies. Congressional auditors said spot checks found that four VA hospitals skipped monthly inspections of drug stocks or missed other requirements. Investigators said that signals problems for the VA’s entire network of more than 160 medical centers and 1,000 clinics, coming after auditor warnings about lax oversight.
Reports of drug losses or theft at federal hospitals jumped from 272 in 2009 to 2,926 in 2015, before dipping to 2,457 last year, according to DEA data obtained by
the AP. “Federal hospitals” include the VA’s more than 1,100 facilities as well as seven correctional hospitals and roughly 20 hospitals serving American Indian tribes.
“Drug theft is an area of concern,” said Jeffrey Hughes, the VA’s acting assistant inspector general for investigations. He said the monthly inspections could help the VA uncover potential discrepancies and root out crime.
Both the inspector general’s office and the Drug Enforcement Administration said they have increased scrutiny of drug thefts from the VA, with the DEA reporting more criminal investigations.
It’s not clear whether the problem is worse at the VA than at private facilities where, medical experts and law enforcement officials say, drug theft is also becoming increasingly common in a time of widespread opioid
abuse in the U.S. But the VA gets special scrutiny from lawmakers and the public given Americans’ esteem for ex-service members and because of past problems at the VA, including a scandal in which patients died while waiting to receive care.
“Those VA employees who are entrusted with serving our nation’s wounded, ill and injured veterans must be held to a higher standard,” said Joe Davis, spokesman for Veterans of Foreign Wars.
The drug thefts will be among the challenges facing new VA Secretary David Shulkin, who served as the department’s undersecretary of health while the drug problem was growing. At his confirmation hearing this month, Shulkin said he was proud that the VA identified the opioid addiction problem before others did and “recognized it as a crisis and began to take action.”
Still, the VA acknowledges that it has had problems keeping up with monthly inspections, saying it was taking steps to improve training.
It also said it was requiring hospitals to comply with inspection procedures and develop plans for improvement.
The agency did not respond to requests made three weeks ago to provide a list of VA facilities where drugs had been reported missing or where disciplinary action was taken, saying it was still compiling the information.
The inspector general’s office estimates that there are nearly 100 open criminal investigations involving theft or loss of controlled substances at the VA.
Three VA employees were charged this month with conspiring to steal prescription medications including opioids at the Little Rock VA hospital. The inspector general’s office said a pharmacy technician used his VA access to a medical supplier’s Web portal to order and divert 4,000 oxycodone pills, 3,300 hydrocodone pills and other drugs at a cost to the VA of $77,700.
Christopher Thyer, the U.S. attorney overseeing
the case, said the employees were abusing their positions to steal from taxpayers and “poison the communities we live in with dangerous drugs.”
The drug thefts from the VA also raise the possibility that patients will be denied medication they need or that they will be treated by drug-impaired staff members.
In one case, a former VA employee in Baltimore pleaded guilty to charges that he injected himself with fentanyl intended for patients heading into surgery, then refilled the syringes with saline solution. Patients received solution tainted with the hepatitis C virus carried by the employee.
Dr. Dale Klein, a VA pain management specialist, said some of his patients suspected that they weren’t getting the drugs they needed, including one patient with an amputated leg who had to do without morphine because a VA pharmacy said it did not have enough in supply.
Klein, who is part of a
whistleblowers network called VA Truth Tellers, ran a VA pain clinic from 201516 and has filed a retaliation claim against the VA, saying the agency restricted his work after he voiced complaints. The VA has said it was looking into the claims.
Klein described several of the VA’s inventory lists as inconsistent or a “slapdash rush job.” That concern was underscored by findings from the Government Accountability Office, released last week, that drug stockpiles were not always being regularly inspected. Klein’s attorney, Natalie Khawam, said she’s heard similar complaints from other clients about their VA hospitals.
The GAO review, covering January 2015 to February 2016, found the most missed inspections at the VA’s hospital in Washington, D.C., according to a government official familiar with confidential parts of the audit. At that hospital, monthly checks were missed more than 40 percent of the time, mostly in critical patient care areas,
such as the operating room and intensive care units.
The Washington hospital also missed inspections of the facility’s pharmacy for three straight months, violating VA policy, according to the official, who insisted on anonymity to reveal findings that weren’t public. In the past year, the hospital had at least five reports of controlled substances that were “lost” or otherwise unaccounted for, according to the DEA.
Other problems were found in VA hospitals in Seattle, Milwaukee and Memphis. Milwaukee had fewer than the other three hospitals the GAO flagged, which the accountability office attributed to a special coordinator put in place to ensure inspection compliance.
Responding to the findings, the House Veterans Affairs Committee planned a hearing on the inspection issue. Its chairman, Rep. Phil Roe, R-Tenn. and a physician, said failing to follow protocol is serious and “should not be tolerated within VA.”