Painkillers For Pets + People = Dangerous Mix

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A few years back, something really strange happened to Eli. Maybe something stung him. Or maybe he hurt his back somehow. Since I didn’t see what happened to cause him so much pain, I guess I’ll never know. But it wasn’t good.

So I took him to the veterinarian — and she couldn’t figure out what happened, either. All she could say for sure was that his back was extremely tender and he was in a lot of discomfort. So she gave him something for the pain and sent him home.

Eli, the In Brief Legal Writing Services mascot.
In Brief Legal Writing Services mascot Eli catching up on the latest news. Photo by Alexandra Bogdanovic

I don’t know what it was. But it drove him crazy. Literally. He hid under the bed for days, only coming out to use his litter box. Of course I stopped giving him the medicine as soon as I figured out it was causing the odd behavior. Even so, it took poor old Eli a few day to recover.

When I told the vet what happened, she confirmed that cats and dogs sometimes have adverse reaction to strong painkillers.

So imagine my shock — and horror — when I came across a recent article about the potential misuse of these drugs by people.

Establishing a link between the prescription of pet painkillers and the American opioid crisis

The article, which appeared on cbsnews.com back in January details the findings of a new study published in JAMA NETWORK OPEN earlier this year.

Based on research conducted during an 11-year period, the study addresses the following question: “What kind of opioids and how many are prescribed by veterinarians?”

To answer it, researchers documented the number of opioid tablets and/or patches dispensed or prescribed by veterinarians at a “multispecialty academic veterinary teaching hospital” in Philadelphia  between January 1, 2007 and December 31, 2017 (all dates inclusive).  They found that 134 veterinarians practicing there during the time in question prescribed:

  • 1 05,1 836 Tramadol tablets
  • 97 547 Hydrocodone tablets
  • 38 939 Codeine tablets
  • 3153 Fentanyl patches

The research also determined that the veterinarians prescribed most of these medications  for dogs (73 percent); followed by cats (22.5 percent); and other species including rabbits, birds, and reptiles (4.5%)

Finally, the research revealed that while the number of animal hospital visits increased by 12.8 percent over the 11-year period, the number of opioid-based medications increased by 41.2 percent.

With a lack of available data for the entire 11-year period, researchers could not make an accurate comparison between the number of new prescriptions and refills. However, a separate assessment of 2017 prescriptions revealed that approximately 10 percent were refills.

Nap time! Hurricane Harvey kittens take a break at the 30th annual Puttin’ on the Dog festival. Photo by Alexandra Bogdanovic

So what?

In their assessment of these findings, the researchers acknowledge that veterinarians have historically received less education about opioid misuse than medical doctors and dentists. The researchers also acknowledge that increased awareness among physicians and dentists has prompted people who misuse opioids to get opioid-based painkillers elsewhere.

Specifically, the assessment cites the FDA Commissioner’s concerns that, “the recent increased scrutiny of medical and dental opioid prescribing may have redirected some individuals to obtain opioids from veterinarians.”

As a result, the researchers conclude that veterinarians should be subjected to the same rules and regulations as their peers in medicine and dentistry. They also say that veterinarians should receive similar educational outreach.

As things now stand

Rules and regulations

According to the American Veterinary Medical Association there are regulations that mandate reporting when veterinarians dispense controlled substances — including opioids — to patients on the books in 15 states and the District Columbia. These are:

  • Alaska
  • Arkansas
  • California
  • Connecticut
  • Illinois
  • Indiana
  • Michigan
  • New Hampshire
  • New York
  • North Dakota
  • Oklahoma
  • South Carolina
  • Vermont
  • Washington state
  • West Virginia

However, it is important to note that 34 states exempt veterinarians from Prescription Drug Monitoring Programs.

Educational outreach

The U.S. Food and Drug Administration (FDA) has also provided a comprehensive list of tips for veterinarians that stock and prescribe opioid-based medications for animals.

Among other things, it includes advice about how to spot clients and staff that may be “diverting” and misusing these medications.

Some warning signs that a client is potentially abusing opioids may include:

  • Suspect injuries in a new patient
  • Asking for specific medications by name
  • Asking for refills for lost or stolen medications
  • Pet owner is insistent in their request

Some warning signs that veterinary staff may be abusing opioids include:

  • Mood swings, anxiety, or depression
  • Mental confusion and an inability to concentrate
  • Making frequent mistakes at work
  • Not showing up for work

The bottom line

“Combating opioid addiction and addressing misuse of pain medication continues to be one of FDA’s highest priorities,” the agency says. “Veterinarians as medical professionals have an opportunity to partner with FDA and others to take on this deadly epidemic, and the agency encourages them to continue to work with their clients and both local and national organizations to join in the fight.”

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