Audit: Native Americans face higher opioid risk at hospitals
FLAGSTAFF, Ariz. — U.S. government hospitals put Native American patients at increased risk for opioid abuse and overdoses, failing to follow their own protocols for prescribing and dispensing the drugs, according to a federal audit made public Monday.
The report by the Department of Health and Human Services’ Office of Inspector General does not say whether patients suffered because of the hospitals’ practices. But all five Indian Health Service hospitals that were reviewed had patients who were given opioids in amounts exceeding federal guidelines, the report said.
“There are vulnerabilities with this particular population in the opioid prescribing and dispensing practices,” said Carla Lewis, one of the auditors.
Native Americans and Alaska Natives had the second-highest rate of opioid overdose among U.S. racial and ethnic groups in 2017, according to the Centers for Disease Control and Prevention.
Navajo Nation President Jonathan Nez called the audit’s findings “very concerning” and said the tribe plans to reach out to its congressional members and the Indian Health Service to ensure the recommendations are addressed.
Sen. Tom Udall, D-N.M., vice chairman of the Senate Indian Affairs Committee, said the report “is a deeply troubling indication that structural issues at the IHS are potentially worsening the opioid crisis in Indian Country.”
The report made more than a dozen recommendations to the Indian Health Service to better track patients’ health records, ensure opioids are stored under tighter security and update its information technology systems. The agency agreed on every point and said changes are coming.
The Indian Health Service, the federal agency that administers primary health care for Native Americans, has put an increased focus on opioids lately with a new website and the creation of a committee focused on decreasing overdose deaths, promoting culturally appropriate treatments and ensuring that communities know how to respond.
The Centers for Disease Control recommends that patients be prescribed no more than 90 morphine milligram equivalents per day, a measure used to compare an opioid dose with morphine.
The audit found each of the five hospitals that were reviewed met or exceeded that amount at times. At Northern Navajo Medical Center on the Navajo Nation in Shiprock, New Mexico, the daily dosage was more than four times as high.