Calais VA clinic’s opioid history is on law enforcement radar in Washington County

Posted Aug. 24, 2012, at 4:19 p.m.

MACHIAS, Maine — Washington County Sheriff Donnie Smith said Friday the VA Maine Health Care System’s Community Based Outpatient Clinic in Calais is, like other regional clinics and physicians who dispense opiate-based painkillers, on his department’s radar in an ongoing effort to reduce recreational use and abuse of those drugs.

A recent U.S. Department of Veterans Affairs investigation substantiated irregularities related to prescribing and monitoring opiate-based painkillers at the clinic. That investigation found evidence in medical records that the clinic’s providers did not appropriately assess chronic pain patients on opioid therapy and did not adequately monitor them for the misuse of the powerful and potentially addictive drugs, including hydrocodone and oxycodone products.

“Every clinic is on our radar screen from time to time when opiates are being over-prescribed,” Smith said Friday. “I have received information from providers at the [veterans] clinic about the amount of opiates that are being prescribed there. Every VA provider can see the amount of opiates the veteran is getting [from the VA] by just looking at their medication profile. The provider cannot see what the veteran is being prescribed by non-VA providers, because the VA does not allow the provider to participate in the State of Maine Prescription Monitoring Program.”

The monitoring program involves a statewide database designed to track the dispensing and use of certain classes of prescription drugs that are commonly abused.

Abuse of opioids has evolved into a major public health and law enforcement problem in Washington County, as it has beyond Down East. According to the U.S. Centers for Disease Control and Prevention, the number of deaths each year in America attributed to overdoses of prescribed opioids now exceeds the death rate from heroin and cocaine overdoses combined.

A VA investigation into the clinic’s history of writing and monitoring prescriptions for opiate-based drugs cited a “chronic” shortage of staff for whatever abuses have occurred. The clinic has been without a full-time physician since January 2011. Smith agrees that’s a problem.

“The people at the Calais clinic do the best job they can without a full-time provider,” Smith said. “Informants have told us that certain doctors are now afraid to prescribe because of actions taken by law enforcement.”

Smith said Friday that the Washington County Sheriff’s Department is working closely with the Seminole County Sheriff’s Office in Florida in seeking guidance on how to attack the problem of opioid abuse.

“They have a task force that deals with doctor over-prescribing,” Smith said. “I certainly commend the VA for taking this action and their ongoing investigation. Like I always say, you can be part of the problem or part of the solution. This is a step in right direction.”

The Community Based Outpatient Clinic in Calais is now undertaking steps to address and resolve the findings of a recent Department of Veterans Affairs investigation that substantiated irregularities related to prescribing and monitoring opiate-based painkillers.

Among the steps, Calais clinic veterans receiving opioid treatment are being asked to provide written consent for participation in the Maine Prescription Monitoring Program.

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