Opioid abusers could be 'doctor shopping' with pets, vet warns
The association representing Nova Scotia's veterinarians wants to find a way to keep pet owners from using opioids prescribed for their animals.
Veterinarians can dispense whatever drugs they feel are appropriate for treating animals, and the registrar of the Nova Scotia Veterinary Medical Association calls the current lack of controls a "loose brick" in the medical system.
"There's no limitation or restriction on the drugs that a veterinarian can write a script for," said Dr. Frank Richardson.
The available drugs for pets include fentanyl and hydromorphone.
Risk of doctor shopping
Richardson said opioid prescriptions issued at veterinarian clinics are not recorded in the province's prescription monitoring system, which means there is a risk of "doctor shopping."
"The same client could go into another veterinarian with the same complaint and potentially get the same medication from that veterinarian and so on down the line," said Richardson.
"There's an opportunity for some of these drugs to be diverted to the street, which is never a good thing, and certainly something that we're all conscious of, and we want to minimize the risk of those things happening."
Richardson said he raised the issue two years ago with the Nova Scotia College of Physicians and Surgeons. But the college told CBC News it "doesn't regulate veterinarians, nor their prescribing."
Medavie Blue Cross — the company that runs Nova Scotia's prescription monitoring program — declined an interview, saying only that the topic "remains of interest" in an email.
Chief medical officer makes inquiries
Nova Scotia's chief medical officer of health, Dr. Robert Strang, broached the subject again in December by contacting the veterinary association.
CBC News obtained a copy of an email sent by Strang that outlined how he wanted to have a discussion with the association about "opioid use in veterinary medicine and how this might link to work underway in the Nova Scotia health and justice systems regarding misuse and overdose."
Strang also declined an interview for this story.
"Hopefully in the near future, something will happen," Richardson said about tighter controls on opioids. "Certainly the Nova Scotia Veterinary Association is 100 per cent behind it and we will do whatever it takes from our part to see that happen."
'Animals feel pain'
The veterinary association is not discouraging opioid prescriptions for pets. Those who work in clinics say drugs are necessary for sick animals.
Dr. Stephanie Hamilton, an anesthesiologist at the Atlantic Veterinary College in Charlottetown, said it's important to remember "animals feel pain just like people do."
"For example, a cat with cancer or a dog with arthritis — they would feel pain just like we would. And sometimes those conditions are painful enough that we would need opioids to treat that pain," she said.
Concerns about tighter controls
Hamilton said she's aware some owners neglect their pets by keeping opioid prescriptions for themselves, but she has concerns about tighter controls.
"I don't want animals to receive a substandard pain relief," she said.
"But I certainly understand the crisis that is happening, and so I think we all just probably need to work together to figure how to make sure that pain in animals is treated as appropriately as it should be."
Other veterinarians say they take precautions by monitoring when pet owners are coming in to get prescriptions refilled, so they can ensure the drugs aren't running out early.
"We can't actually prescribe anything unless we examine the animal, and we would have to see something going on with the animal that would require that kind of drug," said Dr. Eric Carnegy of the Carnegy Animal Hospital in Halifax.
He and the five other veterinarians at his clinic each write three to four opioid prescriptions a day, on average.
"We try to use as minimum amount of drug as we can to achieve the pain relief for that particular animal," Carnegy said. "We're not coming out with the big cannons right from the beginning."
He doesn't believe the problem of drugs diverted from pet use is widespread, but he supports tighter controls.
"I think there's enough evidence now that there's enough abuse out there that it's up to us to screen as well."
