FDA and Responsible Opioid Prescribing for Pain Management in Animals
The Food and Drug Administration (FDA) continues to address the opioid epidemic on all fronts with regards to prescribing opioids in humans. But, last month, the FDA introduced a new resource containing information and recommendations specifically for veterinarians who stock and administer opioids.
The FDA recommends veterinarians take the following steps if they stock and administer opioids
Follow All State Regulations on Prescribing Opioids
State regulations can vary regarding the safe, secure storage of controlled substances and under what conditions veterinarians can prescribe, dispense or distribute them to patients. Additionally, states continue to pass new laws that restrict access to opioids or require veterinarians to report when they dispense opioids to patients.
Finally, some states, including Colorado, require a veterinarian to review a pet owner’s past medication history before dispensing opioids or writing a prescription for opioids
Follow All Federal Regulations on Prescribing Opioids
The FDA approves controlled drugs and monitors reported adverse events, while the Drug Enforcement Administration (DEA) creates and enforces the regulations surrounding controlled substances. When controlled substances are diverted, a veterinarian must promptly report the theft to the DEA and local authorities.
Currently, only two opioids – buprenorphine for cats and butorphanol for cats, dogs and horses – are marketed for use in animals. Since there are limited opioids approved for use, veterinarians often use opioid products that are approved for use in humans.
Use Alternatives to Opioids
Pain management in veterinary medicine is challenging and the FDA encourages veterinarians to consider non-opioid protocols.
Educate Pet Owners on Safe Storage and Disposal of Opioids
When prescribing opioids to their veterinary patients, veterinarians should always advise pet owners to properly secure any opioids and store them out of sight and away from any family members or friends to ensure there is no accidental or intentional misuse.
Know What to Do If a Pet Overdoses on Fentanyl or Other Opioids
Pets, like humans, can overdose on opioids. Narcotic detection dogs are particularly susceptible and, due to the extreme potency of the fentanyl products, only a small amount is needed to cause an overdose. Veterinarians should know what to do in the event of an overdose.
Have a Safety Plan and Know Signs of Opioid Abuse
Veterinarians should always be on the look out for opioid diversion – from pet owners seeking opioids to treat their pets to employees that are diverting. Veterinarians need to be diligent in identifying pet owners that ask for specific medications by name or continue to loose medications or constantly ask for opioid refills. They should also be familiar with warning signs of opioid abuse in employees, which could include: mood swings, anxiety, depression, mental confusion, frequent mistakes at work.
The FDA continues to address the opioid crisis and the misuse of pain medication in both human and veterinary medicine. Veterinarians are uniquely positioned to assist in addressing the opioid crisis by continuing to work closely with the FDA, the DEA, pharmacists, their clients and other state and federal agencies.