Kansas bill calls for study of veterinary 'drug shopping'

Topeka, Kan. — An unprecedented study about drug shopping and "doc-hopping" in veterinary medicine hinges on the passage of a pending Kansas bill aimed at tighter prescription oversight.

Senate Bill 491 calls for the creation of a Prescription Monitoring Program (PMP) database to track prescriptions and prevent people from obtaining duplicates through multiple doctors.

Originally covering human and animal medicine, the bill later was amended to exempt the veterinary profession. But it would create a Veterinary Controlled Substance Monitoring task force — the first of its kind in the country — to carry out a nationwide study evaluating the prevalence of drug shopping in veterinary medicine. The goal: to determine if DVMs should be required to report to a PMP.

"If you try to include veterinarians and there is no vet-hopping occurring, you didn't help the problem and you weakened your database," says Dirk Hanson, DVM and executive director of the Kansas Board of Veterinary Medical Examiners (KBVME).

"So the win-win result of this will be a task force that answers that question. Would including veterinarians help address the problem?"

Nationwide evaluation

The bill calls for a three-person task force — one member each from KBVME, Kansas Veterinary Medical Association (KVMA) and human medicine — to lead a five-year study. The intent is to use the information soon for federal legislation governing a state-by-state integrated program, says Gary Reser, KVMA executive vice president.

Using resources from the American Veterinary Medical Association and the American Association of Veterinary State Boards, the task force would evaluate how veterinary medicine is monitoring prescriptions and whether its methods are effective.

"Veterinarians in Kansas can kind of be heroes because there is not any study to be done like this in future years," Reser says.

As outlined in the bill, the task force would submit its findings to the House Public Health and Welfare Committee and PMP task force in five years, or report on progress when requested.

Profession assessment

At least two groups — the KVMA and KBVME — argue veterinarians' exemption is warranted, because so-called "veterinarian hopping" has never been reported in the state. "Veterinary patients, the animals, do not abuse drugs, and dosages of controlled substances veterinarians dispense are typically too low to affect humans," Reser says. "Further, veterinarians typically can assess a therapeutic response and know if an animal is receiving the drugs."

Ultimately, drug abuse in veterinary clinics is only the result of theft or break-ins, he says. "If someone is going to go to a DEA (Drug Enforcement Agency) cabinet and divert drugs, they aren't going to report it."

The requirement also would place a new reporting burden on practices — arguably one that would not produce enough benefit to offset costs. "We figured once this went into effect in Kansas, in the first three months there would be 7 million prescription reports sent in just from the human medicine side. We don't think they can even begin to analyze that," Reser says.

Reporting requirements, coupled with potential felony repercussions for those not in compliance, might even deter some DVMs from using controlled substances for pain management, KBVME argues.

"The wheel is not broken in terms of oversight of veterinarians' accountability of controlled substances," the KBVME testified in a hearing. The board already audits controlled-substance registers of every state veterinary clinic, with mandatory inspection at least once every two years.

The bill passed the state Senate and is before the House in the Health and Human Services Committee. If enacted, it could be enforced as soon as July 1, Reser says.