VA Can Enhance Reporting of Its Progress to Reduce Drug Overdose Deaths

The Office of National Drug Control Policy (ONDCP) is responsible for coordinating and overseeing the nation’s drug control policy, including the President’s National Drug Control Strategy, across the federal government to reduce substance use disorder rates and overdose deaths. ONDCP asked the VA OIG to review the accuracy of VA’s fiscal year 2023 reported progress for four measures related to reducing overdose deaths: measure 1, patients with nonfatal overdoses with case reviews; measure 2, patients estimated as very high‑risk risk for overdose or suicide and a substance use disorder who were actively engaged in substance use disorder treatment; measure 3, the number of patients receiving contingency management; and measure 4, the percentage of patients receiving medication for an opioid use disorder. The OIG found that VA’s reporting was accurate for measures 3 and 4 but omitted for measure 1 patients receiving community care for overdoses and for measure 2 patients receiving residential treatment. These populations were overlooked because VA’s Office of Mental Health and Suicide Prevention lacked quality controls to verify and archive data before reporting to ONDCP. Additionally, the OIG found that facilities struggled with laboratory testing requirements for contingency management, in which veterans are rewarded for abstaining from substance use. The OIG requested that VA inform ONDCP and the OIG what actions it would take to update the accuracy of its future reporting for measures 1 and 2 and noted that VHA should coordinate with ONDCP to determine whether datasets used for reporting should be archived to some extent for tracking, testing, and verification, as well as for compliance with VA policy on records management.