Native Americans at risk for opioid abuse
FLAGSTAFF, Ariz. (AP) — 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 U.S. 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.
The overdose epidemic that has killed more people than any other drug epidemic in U.S. history has hit indigenous communities hard. Native Americans and Alaska Natives had the second-highest rate of opioid overdose out of all U.S. racial and ethnic groups in 2017, according to the federal 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.
The report made more than a dozen recommendations to the Indian Health Service to better track patients’ health records and pain management, ensure opioids are stored under tighter security and update its information technology systems. The agency agreed on every point and said changes are coming.
Among the report’s other findings:
• More than two dozen records showed no evidence patients were screened for drugs with urine tests when they started opioid treatment and periodically after. Providers did not have an alert system to know when patients were due for the urine tests.
• Pharmacists are supposed to review patients’ files before filling prescriptions from an outside provider, but that was not done at four of the hospitals. In one case, Fort Yates filled a prescription from an outside provider despite the hospital discontinuing treatment because the patient violated a pain management agreement. The Indian Health Service said it would issue a directive in December for prescribers to track that information.