Invasion of the Insomniacs

Not long ago, we told you about the difficulty of obtaining the prescription sleep aid Ambien (zolpidem) in the VA medical system. We had been told by the VA HQ spokespeople the prescription policy was under review. We had been told that for many, many months. In January, we were told the new policy was published and were provided a copy — it was true! Whereas chronic insomniacs could receive only a single prescription for the drug for seven days (14 if your physician was creative and said you needed two 5 mg tabs a night), now according to the VA’s own Pharmacy Benefits Management Service, physicians may prescribe 20 pills (the envisioned dosage for a month) with two refills. That’s an increase from 14 to 60 pills — without repeated calls to the head of your meth program. 

Too good to be true? Sort of. It seems the new directive has not reached the health care providers who need it. 

One doctor had been presented the written directive on two occasions but maintained she could not comply. Why? The VA’s prescription refill system, at least the Washington, D.C., VA’s system, STILL would not allow an Ambien prescription for more than seven days. We were told to take the matter up with the pharmacy. While pharmacy employees were aware of the restrictions on Ambien, they told us we’d have to talk to the pharmacy chief. Our intent was to correct the problem or obtain clarification. We spoke with the stunned deputy who seemed unaware of the pharmacy benefits management information we presented. The “WHO are you?” and “Are you a VA employee?” queries indicated his surprise. We were waiting for the question about the hidden camera, but it never came. 

It has been several days, and we are awaiting an answer. We cannot be the only ones with VA prescription challenges. Challenge your local VA, if necessary. VA medical care is quite good, but it is unfortunate that frustrations from what appears to be miscommunication can cause veterans to bail into other systems. 

We did consider chaining ourselves to the doors of the facility and maybe chanting or singing, but we don’t think anyone would have noticed.Visit and click on the Guidance for Treatment of Insomnia in Veterans in the Primary Care Setting posting for Nov. 29, 2007, to learn more.


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