As a veterinarian, you’re dedicated to preventing and relieving animal suffering, and would never intentionally harm a pet. Knowing how much pets are loved by their owners, it may be hard to believe that a pet owner would deliberately hurt their pet. Yet that’s exactly what’s happening.
- In Kentucky, a woman cut her Golden Retriever with razor blades three times over three months so she could take her dog’s prescription pain medication (tramadol), and later admitted to police that she’d done it before.
- An Ohio man addicted to the opioid hydrocodone reportedly taught his dog to cough on command and visited several veterinarians a month for prescriptions before being stopped.
As disturbing as such stories are, they do not appear to be isolated cases.
In a recent survey of 189 Colorado veterinarians by the Center for Health, Work & Environment at the Colorado School of Public Health, 13% of veterinarians reported they’d seen a client whom they believe had intentionally injured a pet, made a pet ill, or made a pet appear to be ill in the hope of receiving prescription painkillers.
Such findings are indicative of the highly addictive nature of prescription opioids, why the epidemic of prescription opioid abuse is on the rise, and the lengths to which some will go to get opioids, despite the costs and lethal risks.
- According to the Centers for Disease Control and Prevention (CDC), painkillers killed twice as many people as cocaine, and five times as many as heroin, in 2007.
- According to the Rand Corporation, U.S. deaths from synthetic opioids (especially fentanyl) increased tenfold from 2013 to 2018.
- According to Harvard Health, nearly 2 million Americans are dependent on, or abusing, prescription painkillers.
To help curb the crisis, government healthcare agencies across North America have placed greater scrutiny on medical and dental opioid prescriptions. And to identify prescription drug misuse, they’ve implemented prescription drug monitoring programs to provide health authorities with timely information about prescribing and patient behaviors.
The problem is, the same drug-reporting regulations applied to prescription opioids for human use have not been widely implemented in the animal health industry. Even though veterinarians are registered to stock, administer, dispense, and prescribe opioids, only 20 U.S. states mandate that veterinarians report their prescribing to their state’s prescription drug monitoring program. As a result, research and case examples suggest (if not clearly show) that some opioid users have turned their attention to veterinary prescriptions in order to stay off the radar.
Disproportionate Opioid Prescribing in Veterinary Medicine
In a groundbreaking 11-year cross-sectional inventory study published by JAMA Network, researchers examined opioid prescribing by 134 veterinarians for small animals in a multi-specialty academic veterinary hospital at the University of Pennsylvania School of Veterinary Medicine. They found a concerning trend in the prescribing of these four opioids:
- Codeine sulfate (tablets)
- Hydrocodone bitartrate (tablets)
- Tramadol hydrochloride (tablets)
- Fentanyl citrate (patch form)
Overall, the prescriptions for these drugs increased by 41.2%. However, in this time period the appointments with the hospital only increased by 12.8%, which led researchers to conclude that “although medical and dental health care professionals have been the major source of these opioids,” the situation with veterinary prescriptions and drug monitoring programs “may create a pathway that allows humans to covertly access opioids for diversion or misuse from their pets or other animals” from general veterinary practices and hospitals across the U.S.
What Veterinarians Can Do
Use Non-Opioid Alternatives
To help stop the opioid crisis (and protect pets in the process), both the American Veterinary Medical Association (AVMA) and the FDA encourage veterinarians to use non-opioid alternatives when possible and to consider non-opioid protocols developed by the International Veterinary Academy of Pain Management, the American Animal Hospital Association, and the American Association of Feline Practitioners.
Have a Safety Plan
The AVMA also recommends that veterinarians have a safety plan in the event they encounter a situation involving opioid diversion or clients seeking opioids under the guise of treating their pets. Local police departments can advise veterinarians about what to do in such situations.
Know the Warning Signs
Some FDA warning signs that a client may be abusing opioids:
- Suspicious injuries in a new or existing patient
- Asking for specific opioids by name
- Asking for refills for “lost” or “stolen” medications
- Pet owner insistence in their request
Educate Clients About Leftover Medications
Clients walking out your door with prescription painkillers for their pet may not be opioid abusers, but that doesn’t mean someone in their home isn’t (or won’t become one). Leftover pain medications sitting around in medicine cabinets can mean an increased chance of opioids being misused, sold or diverted by a family member, or of children becoming unintentionally exposed. As noted by Dr. Jeanmarie Perrone in an interview with CBS News, “We know leftover opioids have been a big driver of the opioid crisis, wherever they are being left over from.”
To help clients prevent their pet’s medications from falling into the wrong hands (and mouths), the Drug Enforcement Administration sponsors and supports National Prescription Drug Take Back Day, which has a website where clients can find collection sites to safely dispose of their unused prescription drugs.
The Canadian government has a similar site where clients can locate take-back programs.
If a client can’t find a local take-back site, some pharmacies have mail-back programs and disposal kiosks for unused medications or take back unused medications directly.
Safe Flushing of Unused Medications
With the increased availability and use of both human and veterinary medications, improper disposal of medications has impacted the environment. To help lower the impact when take-back options aren’t available for clients, the FDA offers a list of medications that can safely be flushed down the toilet.
For medications that are not on the list, the FDA recommends the following four steps before putting leftover medications in the trash:
- Remove all personal information on the prescription labels of empty medicine bottles and/or packaging.
- Mix medications (liquid or pills) with an unappealing substance like dirt, cat litter, or used coffee grounds. (Do not crush tablets or capsules.)
- Place the mixture inside a container, such as a sealed plastic bag.
- Throw the container away with household trash.
Client education is pivotal to the safe management, use, and disposal of all pet medications. To further assist with this, LifeLearn’s online client education resource ClientEd provides the client education handout “Safe Handling of Medications at Home,” which includes important information on:
- Medication safety and inventory organization
- Safe handling practices and correct medication storage
If you’re not using ClientEd, consider giving it a try.
client communications, Veterinary Marketing