The role of veterinarians in the opioid crisisNov 26, 2019
A 2014 online survey of Colorado Veterinarians found:
- 13% of surveyed veterinarians were aware that an animal owner had intentionally made an animal ill, injured an animal, or made an animal seem ill or injured to obtain opioid medications.
- 44% were aware of opioid abuse or misuse by either a client or a veterinary practice staff member.
- 12% were aware of veterinary staff opioid abuse and diversion.
- 62% believed that they had a role in preventing opioid abuse and misuse.
- 64% said that they had not completed continuing education on best practices for prescribing opioids since entering practice.
The Food and Drug Administration offers guidance in The Opioid Epidemic: What Veterinarians Need to Know. The FDA provides the following information on how to tell if a client or employee is potentially abusing opioids.
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
- Mood swings, anxiety, or depression
- Mental confusion and an inability to concentrate
- Making frequent mistakes at work
- Not showing up for work
The role of opioids in veterinary staff suicides must also be examined. Suicide is more likely among veterinarians than among the general population — 1.6 times more likely for male veterinarians and 2.4 times more likely for female veterinarians. Veterinary technicians and technologists are also more likely to commit suicide than the general population — 5.0 times more likely for males and 2.3 times more likely for females. Vet technicians and technologists most often died from opioid poisoning (see related blog).
Although extensive efforts have been made in educational campaigns about opioid misuse directed toward physicians and dentists, similar programs have not been replicated for veterinarians. There is a need for a broader discussion about the use of prescription drug monitoring programs (PDMP) by veterinarians and what use is most appropriate for logging prescriptions of scheduled drugs into state PDMP systems. Currently, only 20 states require veterinarians to report their opioid prescribing to the state’s PDMP. Some states allow veterinarians to access a PDMP report for any person who brings an animal to a clinic. In addition, because much of the prescribing, dispensing, and administration of DEA-scheduled drugs by veterinary practices does not flow through commercial pharmacies, there is a need to reexamine efforts to ensure the highest standards of inventory stocking, tracking, and security from the time these medications reach the clinic to the time they are either dispensed or returned to the supplier. This should include enhanced workplace policies, practices, procedures, training, and monitoring to mitigate the risks of diversion and misuse by both clinic staff and clients. State PDMP systems can serve as a valuable resource that is available to veterinarians in almost every state.
More research, surveillance, and public health efforts are needed to understand the scope of the problem and design system-level interventions. Are you aware of efforts happening in your state to prevent opioid misuse in veterinarian practices? Please share in the comments below.
For more information:
Prescription Opioid Epidemic: Do Veterinarians Have a Dog in the Fight? American Journal of Public Health
FDA-The Opioid Epidemic: What Veterinarians Need to Know
NIOSH- Opioids in the Workplace
Written by Lee Newman, MD, MA; Liliana Tenney, MPH; and Julie Tisdale-Pardi, MA for the National Institute for Occupational Safety and Health (NIOSH) Blog.