FDA Warns Veterinarians of Opioid Misuse By Pet Owners

September 4, 2018
American Veterinarian Editorial Staff

In light of the ongoing opioid abuse epidemic, a new FDA resource center includes recommendations for veterinarians who stock or prescribe opioids to their patients.

The opioid abuse epidemic that has plagued the human medical industry has now spilled over into veterinary medicine. Commonly believed for some time, a recent FDA report cautions that some pet owners may be misusing opioid medications originally prescribed for their pets.

"We recognize that opioids and other pain medications have a legitimate and important role in treating pain in animals—just as they do for people," FDA Commissioner Scott Gottlieb said in a statement. "But just like the opioid medications used in humans, these drugs have potentially serious risks, not just for the animal patients, but also because of their potential to lead to addiction, abuse, and overdose in humans who may divert them for their own use."

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The FDA recommends that veterinarians take the following actions if they stock and administer opioids in practice.

Follow State Regulations

States, which individually regulate the practice of veterinary medicine, are enacting new laws or strengthening existing ones in an effort to restrict access to opioids. According to the American Veterinary Medical Association, 17 states and Washington, D.C. have regulations requiring veterinarians to report, through Prescription Drug Monitoring Programs, when they dispense opioids and other controlled substances to patients: Alaska, Arkansas, California, Colorado, Connecticut, Illinois, Indiana, Maine, Michigan, New Hampshire, New York, North Dakota, Oklahoma, South Carolina, Vermont, Washington, and West Virginia.

The FDA recommends that in order to ensure compliance with current state laws, veterinarians should contact their state boards of veterinary medicine and pharmacy to obtain the current regulations.

Adhere to Federal Regulations on Prescribing Opioids

While the FDA approves controlled drugs and monitors reported adverse events, it is the Drug Enforcement Administration (DEA) that creates and enforces the regulations regarding controlled substances. If a controlled substance is ever stolen from a veterinary clinic, veterinarians are required to report the theft to DEA and their local police department.

Few opioids are approved specifically for use in animals, and only 2 are currently being marketed: buprenorphine for use in cats and butorphanol for use in cats, dogs, and horses. Because of the limited number of veterinary products approved for use, veterinarians often use products approved for use in humans to control pain in their patients.

Although veterinarians using approved human opioids extra-label in animals do not have to follow the human drug’s risk mitigation requirements, they do have to follow the regulations for extra-label use in animals. The FDA also strongly encourages veterinarians to read the label information for human opioid drugs and take any associated training.

Consider Alternatives

There’s no denying that pain management is an important aspect of veterinary medicine, but the FDA encourages veterinarians to use non-opioid protocols that may control pain adequately when possible. The agency points to the International Veterinary Academy of Pain Management as a resource for pain management information for companion animals.

Review Storage and Disposal Protocols With Clients

In some instances, pet owners may be completely unaware that having their pet’s opioid prescription in the home poses a risk of misuse by other family members or guests. When prescribing opioids, veterinarians should advise pet owners to store the opioids securely out of sight. When no longer needed, clients should be encouraged to dispose of the medication using the FDA’s recommendations for opioid disposal.

Know What to Do If a Patient Overdoses

Companion animals are just as vulnerable to overdosing as humans. In particular, working dogs—like narcotics detection dogs—are susceptible because they may inhale a powdered drug. Because fentanyl and fentanyl-related drugs are potent, it only takes a tiny amount of drug to cause an overdose.

Be Able to Recognize the Signs of Opioid Abuse

To best protect themselves, veterinarians should have a safety plan in the event that they encounter a situation involving opioid diversion or clients seeking opioids under the guise of treating their pets. Some warning signs that a client is potentially abusing opioids may include the following:

  • The presenting injury seems suspicious.
  • The client asks for specific medications by name.
  • The client asks for refills for opioid prescriptions that have allegedly been lost or stolen.
  • The client remains insistent in his or her request for opioids.

"As medical professionals, veterinarians have an opportunity to partner with the FDA and others to take on this public health crisis," Gottlieb said.