What veterinarians need to know about the opioid epidemic

By R. Scott Nolen
Published on
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The epidemic of opioid abuse gripping the nation affects not only professionals in human health but also veterinarians.

A recent survey conducted by the Center for Health, Work & Environment at the Colorado School of Public Health found area veterinarians were concerned that some of their clients may have intentionally hurt their pets in the hopes of receiving prescription painkillers.

Of the 189 Colorado veterinarians surveyed, 13 percent reported that they had seen a client who they believed had purposefully injured a pet, made the pet ill, or made the pet appear to be unwell. Nearly 45 percent of those surveyed knew of a pet owner or member of their team who was abusing opioids, while 12 percent acknowledged they were aware of a staff member diverting opioids or abusing them.

"The role veterinarians play in helping reduce opioid abuse hasn't been thoroughly examined," said Lili Tenney, a lead investigator of the survey and the deputy director of the Center for Health, Work & Environment. "Our results indicate that we should be paying more attention to how opioid abusers are seeking their drugs, including through veterinary clinics."

Pet owners have been known to abuse or fake illness in their animals to use the animals' prescription narcotics for themselves. In 2014, a Kentucky woman was arrested after she confessed to cutting her Golden Retriever with razor blades to use the dog's pain medication herself.

Recognizing a lack of information tailored specifically for veterinary medicine, the Food and Drug Administration over the summer issued a new resource for veterinarians who stock and administer opioids.

"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," said FDA Commissioner Scott Gottlieb, MD, in an Aug. 20 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.

"While opioids are just one part of the veterinarian's medical arsenal for treating pain in animals, it's important to understand the role veterinarians, who stock and administer these drugs, play in combatting the abuse and misuse of pain medications."

The new FDA resource offers six steps veterinarians can take to curb abuse. In addition to complying with all state and federal regulations concerning prescribing opioids, veterinarians are encouraged to use nonopioid alternatives when possible and to consider nonopioid protocols developed by the International Association of Veterinary Pain Management, the American Animal Hospital Association, and the American Association of Feline Practitioners.

Veterinarians should know what to do if a pet overdoses on fentanyl or other opioids, according to the FDA resource. Narcotics detection dogs are particularly at risk as they may inhale the powdered form of fentanyl and fentanyl-related drugs, which are potent in small amounts. Veterinarians can contact the University of Illinois College of Veterinary Medicine's emergency hotline for suspected cases of canine opioid overdoses.

Veterinarians should 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 these situations.

The FDA resource states that clients may be abusing opioids in the following situations: suspect injuries in a new patient or clients asking for specific medications by name, asking for refills for lost or stolen medications, or being insistent in their request.

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; and not showing up for work.

Opioid-related resources

Opioid information

  • Substance Abuse and Mental Health Services Administration, www.samhsa.gov/atod/opioids
  • Centers for Disease Control and Prevention, jav.ma/OpiOD

Food and Drug Administration

  • A Brief Overview of Risk Evaluation and Mitigation Strategies, jav.ma/RskEva
  • Risk Minimization Action Plans (RiskMAP) for Approved Products, https://jav.ma/RisqMin
  • Disposal of Unused Medications: What You Should Know, https://jav.ma/dispose
  • Lock It Up: Medicine Safety in Your Home, https://jav.ma/LockUp

Drug Enforcement Administration

  • “Don't Be Scammed by a Drug Abuser,” jav.ma/Scam
  • “Pharmacy, Robbery & Burglary: Tips to Protect Your Customers, Your Business, and Yourself,” jav.ma/PharSafe

AVMA

  • “Facts About Federal Opioid Training Requirements,” jav.ma/OpiReq
  • Opioid Resources for Veterinarians, jav.ma/OpiRes

University of Illinois College of Veterinary Medicine

  • Training Video on Reversing Opioid Overdose in Dogs, https://jav.ma/UofIdogs

Related JAVMA content:

Pfizer suspends opioid sales to veterinarians (Oct. 15, 2018)