{"database": "press", "table": "releases", "rows": [["http://toomey.senate.gov?p=news&id=1660", "Toomey, Kaine Call On GAO To Review Pain Clinics' Narcotics Dispensing Practices", "2015-12-22", "2015", "2015-12", "Republican", "House", "PA", "Patrick Toomey", "T000461", "toomey.senate.gov", null, null, "legacy", "Govt Watchdog Would Also Examine Quality of Treatment, Patient Outcomes \n\t\t\t\t\t\tWASHINGTON, D.C. - U.S. Senators Pat Toomey (R-Pa.) and Tim Kaine (D-Va.) have formally requested that the U.S. Government Accountability Office (GAO) launch a review of pain management clinics in light of the growing national prescription opioid and heroin epidemic. The states of Pennsylvania and Virginia have both seen a dramatic rise in opioid prescribing and deaths from prescription painkillers.\nThe formal request, which was detailed in a letter to GAO sent on Thursday, comes as the Centers for Disease Control announced that opioid overdose deaths, from both prescription pain relievers and heroin, hit record levels in 2014. More than 47,000 people died from opioid overdose, an alarming 14 percent increase in just one year.\nSenators Toomey and Kaine are requesting that GAO review rates of opioid prescribing by pain clinics in relation to other clinical settings, an issue highlighted during an October field hearing convened in Pittsburgh by Senator Toomey, Chairman of the Senate Finance Subcommittee on Health Care. The letter further notes that testing laboratories have indicated to staff that pain patient specimen results are inconsistent with patients' drug treatment regimens 30 to 40 percent of the time, an indicator of possible diversion and/or substance abuse.\nThe bipartisan letter also asks GAO to review whether existing statutory and regulatory guidelines governing pain clinics has had an impact on prescribing practices.\n  A copy of the letter is below.\n  The Honorable Gene L. Dodaro  Comptroller General of the United States  U.S. Government Accountability Office  441 G Street NW  Washington, D.C.  20548\nDear Mr. Dodaro:\nThe United States is currently in the midst of a prescription opioid and heroin epidemic[1]. From 1999 to 2013, the rate for drug poisoning deaths involving opioid analgesics nearly quadrupled. The states of Pennsylvania and Virginia have both seen a rise in opioid prescribing and deaths from prescription painkillers. For example, Pennsylvania ranks above the national average in prescribing of long-acting extended-release opioids (9th), and high-dose opioid pain relievers (14th). The state's drug overdose death rate for 2010 (15.3 per 100,000 population) is above the national rate (12.4 per 100,000 population) [2]. Meanwhile in Virginia, the state's chief medical officer has said drug overdose deaths have surpassed automobile fatalities for the first time in 2014[3]. More than 3,000 Virginians have lost their lives to drug overdose deaths in the last five years[4].\nIn July 2014, the Centers for Disease Control and Prevention (CDC) released a \"Vital Signs\" report that questioned the high rate of opioid prescriptions in the context of an increasing number of prescription opioid overdose deaths. The CDC has noted that individuals who are addicted to prescription painkillers are forty times more likely to become addicted to heroin than those who have never abused prescription drugs. Unlike past periods of increased heroin abuse, nearly 80 percent of today's heroin users say they previously abused prescription opioids[5].\nIn addition to risks of addiction and overdose deaths, large doses of prescription opioids can have other adverse health effects. For example, prescription opioids are largely behind a 114 percent increase in the number of emergency department (ED) visits for pharmaceutical misuse or abuse.[6] High doses of opioids have also been associated with increased risks of falls and fractures[7] in the elderly.\nTo help address the public health consequences of opioid overprescribing, medical groups have begun updating guidelines for how to properly treat both acute and non-cancerous chronic pain with opioids[8]. On December 14 2015, the CDC published for public comment new opioid prescribing guidelines for treating chronic, non-cancerous pain lasting more than three months.[9] These guidelines will have a significant impact on both pain physicians and primary care specialties, which account for nearly half of all dispensed opioid prescriptions[10].\nConcerns about the overprescribing of opioids for treating both acute and chronic, non-cancerous, pain were raised by expert witnesses during a field hearing of the Senate Finance Subcommittee on Health Care, which convened in Pittsburgh, PA on October 14, 2015. In particular, one witness, who serves as the system director of pain medicine for a large health system in Southwestern Pennsylvania, testified that some pain management clinics had now replaced so-called \"pill mills\" as large prescribers of suspect quantities of narcotics. In addition, our offices have heard similar concerns from both public health experts and employees at clinical testing laboratories. Several testing labs told staff that between 30 and 40 percent of pain clinic patients had test results inconsistent with their prescribed course of treatment. Samples showed the presence of higher-than-prescribed quantities of opioids (indicating possible addiction), too few opioids (possible diversion), and positive test results for other illicit drugs (possible substance use disorder). This information raises significant questions about the quality of care chronic pain patients are receiving.\nTo better understand the current delivery of care and the regulatory framework governing pain management clinics, we ask your agency to undertake a review of the following:\n1.\tPlease evaluate outcomes and quality measures used by pain management clinics. Examine rates of opioid prescribing at pain management clinics in comparison to other clinical settings, and give specific focus in your report to possible diversion, addiction, and adverse events, such as overdoses, fractures/falls, and emergency department visits, for pain management clinic patients.  2.\tEvaluate current state, and where applicable, federal statutory and regulatory guidelines that exist for pain management clinics, and how effective they are at curbing inappropriate prescribing.   3.\tExamine any questionable billing practices, especially in relationship to in-office laboratory drug tests.  4.\tPlease review the rate of use of clinical prescribing and treatment guidelines by pain management clinicians. Note in your report any differences in morphine-equivalent dosage amongst clinical guidelines and the possible impact these have on outcomes.\nThank you in advance for your assistance in this matter. We look forward to reviewing your report as Congress continues to work on addressing this important issue.\n  # # #", 1, "2026-03-30T12:14:52Z", "2026-03-30T12:14:52Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["http://toomey.senate.gov?p=news&id=1660"], "units": {}, "query_ms": 0.781624112278223, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}