A legislative committee has approved a bill that would exempt veterinarians from having to check the prescription drug monitoring program on the pets and their owners. Veterinarians support the exemption, but those who say they should check the PDMP argue that drug users could target animal hospitals as a source of drugs.
For more on this, NHPR's Peter Biello spoke with Jane Barlow Roy. She’s a veterinarian at Weare Animal Hospital and the past president of the New Hampshire Veterinary Medical Association.
Why are you opposed to having veterinarians check in with the Prescription Drug Monitoring Program?
I think the reason why veterinarians are opposed to checking in with the PDMP is at its source it’s a program designed for humans, and he basis is information that we upload that we take for granted for humans that is unchanging and permanent identification isn’t such with dogs and cats. So for veterinarians our main focus is treating the patient, which is an animal, and what we’re being asked to do is potentially look into a privacy issue with humans. And most veterinarians that I talk to don’t want to get into any sort of legalities with privacy.
But whether they want to or not, is there not some obligation to regulate the distribution of these drugs? People are involved in this and the dogs or cats aren’t making decisions to see you. The people are. So why not in some way monitor these drugs?
I think there’s a misconception that veterinarians are prescribing a tremendous amount of opioid medication to begin with. Most veterinarians that are practicing in the state do not prescribe things like OxyContin, Vicodin, Percocet. Those are just not medications that we prescribe to dogs and cats.
You prescribe no opioids to animals?
Tramadol, which is a class IV, is really the only opioid we prescribe in any sort of amount. And even Tramadol has been shown over the last couple of years not to be that effective as a pain medication. Granted, there aren’t very many studies that are out there. There aren’t very many studies on pain medications to begin with, so a lot of it we are trying to extrapolate from human medications, but we’re finding that dogs metabolize things quite differently than people, so we can’t make those jumps. So most veterinarians are not prescribing these heavy-hitting opioid medications that are really affecting the state.
So do you disagree with the assertion that by not forcing veterinarians to participate in the PDMP, they might become targets for those seeking drugs like the one you just described?
Some of the drug seeking behaviors we already get the gist of with our common sense. If a client comes in that we’ve never met before, it’s a new dog, new owner, and they come into our office saying they have a dog that is sick and they need to be prescribed x-y-z opioid, most common sense veterinarians in the state will notice a red flag in that.
Again, because we don’t prescribe those heavy-hitting opioids, if someone comes in saying, “My dog did very well on my OxyContin, I want to take it home for my dog,” most of us will say, “There are other medications that are FDA approved, proven to help your dog with their pain other than an opioid.”
Describe to me the harm that would result to veterinarians if you were forced to check the Prescription drug monitoring program.
I think the biggest thing that I’m hearing from my colleagues is the idea that we could be opening ourselves up to potential lawsuits.
What lawsuits would they be worried about?
Privacy issues. When you look you the PDMP, if we were required to query the owner and see a list of their medications and use that information to decide whether or not we’re going to send home an opioid medication with a pet, if we are telling an owner that we’re doing this, they could perceive this as a violation of their privacy. Just a straight up violation of privacy, but it could also be a violation of their medical privacy and they could take that and say, “You’re a veterinarian. Your patient is the dog, not myself.” And there could be potential liability lawsuits towards us. So I think that’s what I’m hearing form my colleagues.
But there are ways to cover yourself, so to speak, by asking any potential owner of a patient to sign a waiver and say, “This is how it is, and by the way, this is the way it is in all of New Hampshire.” So if you wanted to get treatment and you didn’t want to have this done, perhaps another state would be right for you.
Correct. However, most people that are living in border states right now – Vermont, Massachusetts, Maine – have these same types of laws in the works, all varying in different levels of how they are accessing the PDMP.
I don’t know all of the different laws that they have in place, but people that are potentially seeing that, they’re not going to leave their vet and go somewhere else if they won’t sign a waiver. And I think what will end up happening if we do encounter that is the veterinarian is just not going to prescribe that particular opioid.
The bill just passed committee, and the bill was slightly modified since it was discussed at the state house last week. Can you tell us about what you hope the bill will look like in its final form?
In its final form, I feel that what veterinarians wanted to get out of the bill is to not have to query the owner, as our patient is the dog. And so if we need to query the pet, I want a formal way to keep track of that pet from a permanent identification standpoint. Not using the pet’s name or birth date or anything like that, but other forms of permanent identification. I know microchip was thrown around as a permanent form of identification which many pets already have.
Microchips, for those who don’t own pets, that’s embedded under the skin of the pet so it would be a permanent identification for the pet. So even if the pet’s name were changed or the birth date was wrong and then corrected, that pet would have a permanent medical record associated with that chip.
Correct. And I know that I’ve heard from different avenues that that microchip can be easily removed at home with a razor blade or such.
Which would be a noticeable injury to an animal.
Which would be a noticeable injury to a pet. I have never attempted to remove a microchip. I know in the skinniest of pets I can feel them, but most of the time they’re deeply embedded between the shoulder blades at least a centimeter or more under the skin. So if somebody tries to remove that microchip at home, it’s going to be noticeable.
One of the things that we do feel of the opioids that the veterinary community uses, we would not be opposed to uploading that data into the database. And so that part of it was removed from the current bill that’s going through right now. But again, we would be willing to continue to modify the bill so that all parties involved are satisfied with the final outcome.