SEC. 3. STRENGTHENING OF JOINT WORKING GROUP ON 
PAIN MANAGEMENT OF THE DEPARTMENT 
OF VETERANS AFFAIRS AND THE DEPART-
MENT OF DEFENSE. 
(a) IN GENERAL.—Not later than 90 days after the 
date of enactment of this Act, the Secretary of Veterans 
Affairs and the Secretary of Defense shall ensure that the 
Pain Management Working Group of the Health Execu-
tive Committee of the Department of Veterans Affairs– 
Department of Defense Joint Executive Committee (Pain 
Management Working Group) established under section 
320 of title 38, United States Code, includes a focus on 
the following: 
(1) The opioid prescribing practices of health 
care providers of each Department. 
(2) The ability of each Department to manage 
acute and chronic pain among individuals receiving 
health care from the Department, including training 
health care providers with respect to pain manage-
ment. 
(3) The use by each Department of complemen-
tary and integrative health and complementary alter-
native medicines in treating such individuals. 
(4) The concurrent use by health care providers 
of each Department of opioids and prescription
drugs to treat mental health disorders, including 
benzodiazepines. 
(5) The practice by health care providers of 
each Department of prescribing opioids to treat 
mental health disorders. 
(6) The coordination in coverage of and con-
sistent access to medications prescribed for patients 
transitioning from receiving health care from the 
Department of Defense to receiving health care from 
the Department of Veterans Affairs. 
(7) The ability of each Department to identify 
and treat substance use disorders among individuals 
receiving health care from that Department. 
(b) COORDINATION AND CONSULTATION.—The Sec-
retary of Veterans Affairs and the Secretary of Defense 
shall ensure that the working group described in sub-
section (a)— 
(1) coordinates the activities of the working 
group with other relevant working groups estab-
lished under section 320 of title 38, United States 
Code; 
(2) consults with other relevant Federal agen-
cies with respect to the activities of the working 
group; and
(3) consults with the Department of Veterans 
Affairs and the Department of Defense with respect 
to, reviews, and comments on the VA/DOD Clinical 
Practice Guideline for Management of Opioid Ther-
apy for Chronic Pain, or any successor guideline, be-
fore any update to the guideline is released. 
(c) CLINICAL PRACTICE GUIDELINES.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the Sec-
retary of Veterans Affairs and the Secretary of De-
fense shall issue an update to the VA/DOD Clinical 
Practice Guideline for Management of Opioid Ther-
apy for Chronic Pain. 
(2) MATTERS
INCLUDED.—In conducting the 
update under subsection (a), the Pain Management 
Working Group, in coordination with the Clinical 
Practice Guideline VA/DOD Management of Opioid 
Therapy for Chronic Pain Working Group, shall ex-
amine whether the Clinical Practical Guideline 
should include the following: 
(A) Enhanced guidance with respect to— 
(i) the coadministration of an opioid 
and 
other 
drugs, 
including 
benzodiazepines, that may result in life- 
limiting drug interactions;
(ii) the treatment of patients with 
current acute psychiatric instability or sub-
stance use disorder or patients at risk of 
suicide; and 
(iii) the use of opioid therapy to treat 
mental health disorders other than opioid 
use disorder. 
(B) Enhanced guidance with respect to the 
treatment 
of 
patients 
with 
behaviors 
or 
comorbidities, such as post-traumatic stress dis-
order or other psychiatric disorders, or a his-
tory of substance abuse or addiction, that re-
quires a consultation or comanagement of 
opioid therapy with one or more specialists in 
pain management, mental health, or addictions. 
(C) Enhanced guidance with respect to 
health care providers— 
(i) conducting an effective assessment 
for patients beginning or continuing opioid 
therapy, including understanding and set-
ting realistic goals with respect to achiev-
ing and maintaining an expected level of 
pain relief, improved function, or a clini-
cally appropriate combination of both; and
(ii) 
effectively 
assessing 
whether 
opioid therapy is achieving or maintaining 
the established treatment goals of the pa-
tient or whether the patient and health 
care provider should discuss adjusting, 
augmenting, or discontinuing the opioid 
therapy. 
(D) Guidelines to govern the methodologies 
used by health care providers of the Depart-
ment of Veterans Affairs and the Department 
of Defense to taper opioid therapy when adjust-
ing or discontinuing the use of opioid therapy. 
(E) Guidelines with respect to appropriate 
case management for patients receiving opioid 
therapy who transition between inpatient and 
outpatient health care settings, which may in-
clude the use of care transition plans. 
(F) Guidelines with respect to appropriate 
case management for patients receiving opioid 
therapy who transition from receiving care dur-
ing active duty to post-military health care net-
works. 
(G) Guidelines with respect to providing 
options, before initiating opioid therapy, for 
pain management therapies without the use of
opioids and options to augment opioid therapy 
with other clinical and complementary and inte-
grative health services to minimize opioid de-
pendence. 
(H) Guidelines with respect to the provi-
sion of evidence-based non-opioid treatments 
within the Department of Veterans Affairs and 
the Department of Defense, including medical 
devices and other therapies approved or cleared 
by the Food and Drug Administration for the 
treatment of chronic pain as an alternative to 
or to augment opioid therapy. 
SEC. 4. REVIEW, INVESTIGATION, AND REPORT ON USE OF 
OPIOIDS IN TREATMENT BY DEPARTMENT OF 
VETERANS AFFAIRS. 
(a) COMPTROLLER GENERAL REPORT.— 
(1) IN GENERAL.—Not later than 2 years after 
the date of the enactment of this Act, the Comp-
troller General of the United States shall submit to 
the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the 
House of Representatives a report on the Opioid 
Safety Initiative of the Department of Veterans Af-
fairs and the opioid prescribing practices of health 
care providers of the Department.