With more Americans dying from opioid overdoses than car crashes, the US Centers for Disease Control has initiated the Prevention for States program to help states combat the ongoing prescription drug overdose epidemic. As a result, many states have policies that enhance prescription drug monitoring programs (PDMPs) or regulate pain clinics. 

For example, states such as Florida began regulating pain clinics and prohibiting health care providers from dispensing prescription opioid pain relievers from the offices in 2010. They’re working. Two years later, Florida reported a 50% decrease in oxycodone overdose deaths. 

Still, the opioid overdose epidemic continues. In 2017, the number of overdose deaths involving prescription and illegal opioids was six times higher than in 1999. Given the restrictions on prescribing opioids, patients must find other ways to obtain them. A recent study sheds light on a possible pathway: The veterinarian’s office. 

In this first-ever study of veterinary opioid prescriptions, researchers at the University of Pennsylvania’s Perelman School of Medicine and the School of Veterinary Medicine reviewed all opioid pills and patches dispensed or prescribed from January 2007 through December 2017 for cats, dogs, and other small animals at the University of Pennsylvania’s School of Veterinary Medicine. 

At the acute care multidisciplinary veterinary hospital, any licensed veterinarian, including interns, residents, or faculty, can use the hospital Drug Enforcement Administration number to order and prescribe opioids. 

During the study period, veterinarians prescribed 105,183,698 tablets of tramadol, 89,547 tablets of hydrocodone, 38,939 tablets of codeine, and 3153 fentanyl patches to dogs, cats, and exotic animals. The researchers found that the quantity of these prescriptions, measured in morphine milligram equivalents (MME), increased by 41% annually during the study time period. Similarly, visits to this veterinary tertiary care facility rose by only about 13%. 

The study findings represent the opioid use practices in only one hospital in one state for several years. Still, if extrapolated to the general population, the researchers suggest that an increase in opioid prescriptions for people over the past decade may parallel an increase in opioid prescriptions for pets and that veterinary prescriptions may be a way for patients to obtain and misuse opioids, particularly if they can no longer obtain them from their health care provider.  

According to the US Food and Drug Administration and the American Veterinary Medical Association, many states are enacting new laws or bolstering existing ones to restrict access to opioids for veterinary use. Still, only 20 states mandate that veterinarians report when they dispense opioids and controlled substances to patients. 

The following are the main insights from the study:

• Veterinarian opioid use practices aren’t as heavily regulated as medical prescriptions for humans. As a result, patients seeking opioids for themselves may have easier access through their veterinarian.

• Even if prescribed opioid medication for pets is appropriately used, it can increase the chance that household members can misuse any leftover pills or that young children can be unintentionally exposed to opioids. 

• Encourage patients to properly dispose of unused pet opioid prescriptions, just like they would for opioid medication prescribed for themselves or their family members. 

• More regulatory oversight and prescriber educational efforts are needed for veterinary practice, similar to the efforts made in medicine.