Audit calls for more oversight on opioid prescriptions by Indian Health Services


A federal audit now confirms what our KELOLAND News investigation uncovered about opioid prescriptions on South Dakota’s Indian Reservations.

An Office of Inspector General report has determined that doctors who were audited at Indian Health Services Hospitals weren’t following their own rules when it comes to opioid prescriptions.

This latest audit was a follow-up to an earlier report which found high volumes of opioids were being given out in communities served by IHS.

Last spring, KELOLAND Investigates talked with a woman from the Rosebud Sioux Indian Reservation.  She told us how IHS over-prescribed opioids for her pain. 

“The more I went in to address the pain I was dealing with, the more prescriptions they kept giving me. At that time I think I was taking at least five or six,” Tamara Stands and Looks Back–Spotted Tail said in March of 2019.

The Inspector General found that Indian Health Service Hospitals were not following their own health manual when prescribing opioid drugs. The OIG found that IHS hospitals didn’t do proper screenings or review patients’ records before filling an opioid prescription. The findings show poor record keeping and that IHS hospitals didn’t fully use States’ prescription drug monitoring programs when dispensing opioids. We checked with the South Dakota Department of Health and were told IHS is taking part in the monitoring program here.

Tamara weaned herself off opioid pain pills on her own, but she saw the devastation over prescribing and lack of oversight took on family and friends.

“I think it’s affected our culture; I think it’s affected our health. I think it’s affected who we are as a people,” she said in March of 2019.

The federal report calls on IHS to work with hospitals to ensure they follow the Indian Health Manual when prescribing and dispensing opioids.  It also asks IHS to centralize and update its technology to keep better records and increase its cybersecurity.

“The report is based on an Office of the Inspector General audit in 2017 that was a planned exercise intended to strengthen our clinical practice. A range of hospitals and clinics were selected from across the IHS to participate in the in-depth review of our opioid prescribing and monitoring processes as well as the security of our IT systems. IHS fully cooperated with the OIG in this review because we believe it highlights important issues and we want to ensure the best care for our patients. The report highlights some of the challenges IHS still faces in regards to best practices in managing opioids. We continue to evaluate situations where there may be increased risk for patients, and we are working on improved policies regarding accountability, receipt, management, and dispensing of opioids. Actions taken to date and those planned in the near future to implement the report’s recommendations are included in IHS’ response enclosed within the report. The IHS also offers many alternatives for pain treatment other than opioid therapy, including referrals for physical therapy, specialty care, and behavioral health therapeutic services specific to addiction for our patients.” — Indian Health Services

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