Purpose Since 2014, the Veterans Health Administration (VA) has reduced high-risk opioid prescribing, and opioid-benzodiazepine co-prescribing, at every VA healthcare system in the United States. However, Veterans who use VA healthcare services may receive opioids or benzodiazepines from non-VA healthcare providers. We examined the prevalence of concurrent non-VA opioid and benzodiazepine prescriptions among a sample of Veterans receiving long-term opioid therapy (LTOT) from the VA between 2014 and July, 2019.

Methods VA healthcare data were probabilistically linked to Oregon prescription drug monitoring program (PDMP) data for a total of 30,820 post-9/11 VA users in Oregon. Veterans who received outpatient services and LTOT (defined as ≥90 days of prescribed opioids in any 104-day period) from the VA were included in analyses for each respective year. We examined patterns in Veterans’ receipt of concurrent (defined as ≥1 days of overlap) non-VA opioid and benzodiazepine prescriptions by year.

Results The proportion of VA users receiving opioid prescriptions from the VA decreased between 2014 and 2019. Among Veterans receiving LTOT, the proportions receiving concurrent non-VA opioids also decreased between 2014 and 2019 (24.1% in 2014; 26.1% in 2015; 19.3% in 2016; 19.0% in 2017; 15.6% in 2018; 6.3% in 2019). Smaller proportions of Veterans received concurrent non-VA benzodiazepines (3.8% in 2014; 4.9% in 2015; 2.8% in 2016; 3.4% in 2017; 3.8% in 2018; 1.2% in 2019).

Conclusion Among Veterans receiving VA LTOT, the proportions receiving concurrent non-VA opioids have been reduced during the 6-year analytical period. However, a substantial number of Veterans still receive concurrent VA and non-VA opioid and benzodiazepine prescriptions.

Significance Although improvements in safe opioid prescribing have been realized within the VA, there is still a need to account for non-VA prescriptions when considering Veterans’ overall opioid safety.