ArticleJournal of general internal medicine2020
Opioid Prescribing and Opioid Risk Mitigation Strategies in the Veterans Health Administration.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 69 citations in OpenAlex.
- Age differences in demographic and clinical characteristics among veterans with chronic low back pain: a cross-sectional study of baseline findings from the Veteran Response to Dosage in Chiropractic Therapy (VERDICT) trial.Chiropractic & manual therapies · 2025Trial
- A Cluster-Randomized Clinical Trial to Decrease Prescription Opioid Misuse: Improving the Safety of Opioid Therapy (ISOT).Journal of general internal medicine · 2022Trial
- Associations of Cannabis and Tobacco Use With Suicide Attempt, Suicide Death, and Overdose Death Among Veterans Prescribed Opioid Analgesics.American journal of preventive medicine · 2026Article
- Clinical and translational science award hubs in learning health systems: development of the engine-drivetrain model.Journal of translational medicine · 2026Article
- Trends in unintentional injury death among post-9/11 Army Veterans who do and do not use Veteran Health Administration services.Injury epidemiology · 2026Article
- Exploring Sex Differences in Irritable Bowel Syndrome Prevalence, Environmental Risk, and Comorbidities: A Population-Based Cohort Study of Veterans.Clinical and translational gastroenterology · 2026Observational
- High-risk emergency department visits and risk of all-cause mortality, suicide, and fatal overdose among US military veterans.American journal of epidemiology · 2026Article
- The Impact of Chiropractic Care on Opioid Prescriptions in Veterans Health Administration Patients Receiving Low Back Pain Care.Journal of general internal medicine · 2025Article
- Potentially Inappropriate Medications, Frailty, and Outcomes in Patients With Cancer Managed in a National Health Care System.Journal of the National Comprehensive Cancer Network : JNCCN · 2025Article
- Substance use and use disorders among Veterans on long-term opioid therapy.Drug and alcohol dependence reports · 2025Article
- Demographic, Social, Behavioral, and Clinical Characteristics Associated with Long-Term Opioid Therapy and Any Opioid Prescription in High-Risk VA Patients.Journal of general internal medicine · 2025Article
- Factors Associated with Initiation of Opioid Use in a US Department of Veterans Affairs Pain Clinic: A Retrospective Study.Brain sciences · 2025Article
- Dangerous Variation or Patient-Centered Care? Palliative Care and Pain Providers' Comfort, Experiences, and Approaches when Treating Cancer Pain With Coexisting Aberrant Behaviors.The American journal of hospice & palliative care · 2025Article
- Opioid Prescriptions for Low Back Pain among Military-Connected Older Adults Across Multiple Care Systems.Drugs & aging · 2025Article
- Access to Firearms and Opioids Among Veterans at Risk for Suicide.JAMA network open · 2025Article
- Co-use of opioids and cannabis versus single-substance use: a national analysis of US adults.Frontiers in public health · 2025Article
- The Role of the Multidisciplinary Team for Opioid Stewardship: A Scoping Review.Journal of multidisciplinary healthcare · 2025Review
- Association between chiropractic spinal manipulation for sciatica and opioid-related adverse events: A retrospective cohort study.PloS one · 2025Article
- Trends in Opioid Use Disorder in the Veterans Health Administration, 2005-2022.JAMA network open · 2024Article
- Integrating Buprenorphine for Opioid Use Disorder into Rural, Primary Care Settings.Journal of general internal medicine · 2024Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe Veterans Health Administration (VHA) has taken a multifaceted approach to addressing opioid safety and promoting system-wide opioid stewardship.
aimTo provide a comprehensive evaluation of current opioid prescribing practices and implementation of risk mitigation strategies in VHA.
settingVHA is the largest integrated health care system in the United States. PROGRAM DESCRIPTION: VHA prescribing data in conjunction with implementation of opioid risk mitigation strategies are routinely tracked and reviewed by VHA's Pharmacy Benefits Management Services (including Academic Detailing Service) and the Pain Management Program Office. Additional data are derived from the Partnered Evidence-Based Policy Resource Center (PEPReC) and from a 2019 survey of interdisciplinary pain management teams at VHA facilities. Prescribing data are reported quarterly until first quarter fiscal year 2020 (Q1FY2020), ending December 31, 2019. PROGRAM EVALUATION: VHA opioid dispensing peaked in 2012 with 679,376 Veterans receiving an opioid prescription, and when including tramadol, in 2013 with 869,956 Veterans. Since 2012, the number of Veterans dispensed an opioid decreased 56% and co-prescribed opioid/benzodiazepine decreased 83%. Veterans with high-dose opioids (≥ 100 mg morphine equivalent daily dose) decreased 77%. In Q1FY2020, among Veterans on long-term opioid therapy (LTOT), 91.1% had written informed consent, 90.8% had a urine drug screen, and 89.0% had a prescription drug monitoring program query. Naloxone was issued to 217,469 Veterans and resulted in > 1,000 documented overdose reversals. In 2019, interdisciplinary pain management teams were fully designated at 68%, partially designated at 28%, and not available at 4% of 140 VA parent facilities. Fifty percent of Veterans on opioids at very high risk for overdose/suicide received interdisciplinary team reviews. IMPLICATIONS: VHA clinicians have greatly reduced their volume of opioid prescribing for pain management and expanded implementation of opioid risk mitigation strategies. IMPACTS: VHA's integrated health care system provides a model for opioid stewardship and interdisciplinary pain care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.