The Role of Veterinary Prescribing in the National Opioid Epidemic

By: AffirmHealth

Reading Time: 6 minutes

Date: 04/30/2019

The opioid epidemic has been an ever-present, evolving issue across the United States over the past two decades. Efforts to address the misuse of opioids have ranged from prescriber education and state-led drug take back programs to novel pain treatments and new opioid prescribing regulations

Nevertheless, individuals who are dependent on opioids have found new, and sometimes more harmful, means of accessing opioids. A recent study suggests that veterinary prescriptions are just another source through which people can access and misuse opioids. 

Veterinary prescription of opioids is not regulated as heavily or prescribed with as much caution as medical prescriptions are for humans. Due to recent findings, researchers fear that poor veterinary prescribing practices and ease of access could contribute to the misuse and overdose epidemic. 

Recent Findings on Veterinary Opioid Prescribing 

The University of Pennsylvania's Perelman School of Medicine and the School of Veterinary Medicine conducted a study on all opioids dispensed by the veterinary school for animal patients between January 2007 and December 2017. 

In the study [1], records of four different opioids - codeine tablets, fentanyl patches, hydrocodone, and tramadol - were analyzed for trends in how and who they were dispensed to. Over the ten year period, 73% of the animal patients were dogs, 22% were cats, and 5% were other small animals such as rabbits or birds. The 366, 468 patient visits resulted in prescriptions for 1, 051, 836 tramadol tablets, 97,547 hydrocodone tablets, 38,939 codeine tablets, and 3,153 fentanyl patches.

The study found that prescriptions rose 41% annually while patient visits only rose by 13%, leading researchers to question the misuse risks of opioid prescriptions not controlled by heavier regulations. 

"As we are seeing the opioid epidemic press on, we are identifying other avenues of possible human consumption and misuse," said Jeanmarie Perrone, MD and the study's senior author. "Even where the increase in prescribed veterinary opioids is well intended by the veterinarian, it can mean an increased chance of leftover pills being misused later by household members, sold or diverted, or endangering young children through unintentional exposure." [2]

What Solutions Are Being Proposed

The results of the University of Pennsylvania’s study suggest that veterinary prescriptions could contribute to the human opioid epidemic. Therefore, more research and preventative actions are needed. From surveillance and tracking to educating the veterinary medicine community and making them aware of this issue - there are many preventative steps that can help address this issue. 

"The results of this study suggest that by assessing the rate of veterinary opioid prescriptions, we can develop strategies to reduce both human and animal health risks associated with increasing use," Perrone said.

Based upon a recent survey [3], veterinarians are reporting low awareness of the issue at hand and their role in preventing diversion of prescription opioids. Of the veterinarians surveyed, 62% thought they played a role in preventing opioid abuse while 40% were unsure if opioid abuse was an issue in their communities at all. The results of the survey demonstrate that veterinarians reported lack of knowledge and education in opioid prevention and misuse during their medical school training and/or since entering this field. 

With the high rates of opioid misuse and overdose fatalities in the U.S., some experts believe it is necessary that veterinarians are monitored like other medical practitioners prescribing opioids. This includes following both federal and state regulations when prescribing and administering opioids to prevent over-prescribing. 

Education is also important for the veterinary community. Veterinarians should have a safety overview with pet owners of the best practices for storing, administering, and disposing of leftover opioids. By focusing on education, veterinary practices can help prevent pet owners from improperly disposing of opioids or inherently allowing for them to fall into the wrong person's hands. 

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Veterinary Prescribing with the use of PDMPs

Another regulatory process that is recommended to be implemented into veterinary medicine is the use of PDMPs to monitor the prescribing and monitoring of opioids.

There are concerns, though, in the veterinary community regarding the addition of regulations and mandatory practices for veterinarians prescribing opioids. The American Veterinary Medical Association has released a statement [4] regarding veterinary prescribing policies and guidelines in response to the opioid crisis. Their primary concerns include veterinarians’ lack of training to evaluate human prescription histories and the financial burden of compliance with mandatory electronic prescribing.

Some states have already passed legislation to prevent further misuse of opioids in the veterinary field. For example, Maine now requires pet owners’ to have background checks on their opioid prescription histories before a veterinarian can write an opioid prescription for their pet. Alaska, Connecticut, and Virginia now limit the amount of opioids a veterinarian is able to prescribe to any one animal. Twenty other states require veterinarians to report their opioid prescriptions to a database, as other physicians do. 

All of these steps are ways in which the veterinary community can work together to promote safer opioid prescribing. 

At AffirmHealth, we believe that responsible prescribing practices can protect both patients and practices alike. To learn more about driving responsible, compliant opioid prescribing in your organization, visit our How Shield Works page or get started now.

 

[1]https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2720587

[2]http://www.aaha.org/blog/NewStat/post/2019/01/11/463869/Study-Rise-in-veterinary-opioid-prescriptions-could-contribute-to-human-opioid-epidemic.aspx

[3]https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2018.304603?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&

[4]https://www.avma.org/KB/Policies/Pages/The-Veterinary-Professions-Role-in-Addressing-the-Opioid-Epidemic.aspx

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