Thanks to a new law that went into effect at the start of the year, whenever Dr. Amanda Bisol, owner of The Animal Medical Clinic in Skowhegan, writes an opiate-type painkiller prescription for one of her patients, she has to first run a background check on its owner.
Public Law Chapter 488: An Act to Prevent Opiate Abuse by Strengthening the Controlled Substance Prescription Monitoring Program was signed by Gov. Paul LePage in 2016 and went into effect Jan. 1.
In addition to establishing limits on the amount and dosage of specific painkilling drugs can be prescribed by medical professionals, the law also required all prescribers check the state’s prescription monitoring program before writing any prescription for opiate or benzodiazepine drugs.
Medical professionals who care for the state’s animals are not exempt.
“It has meant a lot of extra work for vets,” Bisol said. “For a lot of vets this is completely new, and there is some confusion as they are trying to learn what the system is all about.”
Bisol, the legislative chair on the Maine Veterinary Medical Association Board, worked closely with the various legislative, law enforcement and medical profession stakeholders in helping craft the new rules.
“As animal doctors, we had some concerns how this would affect us,” she said.
“Human health care providers have been involved with using the prescription monitoring program for some time before Rule 488 came into play,” said Dr. Michele Walsh, state veterinarian with the Maine Department of Agriculture, Conservation and Forestry. “But since there is the potential for these drugs [prescribed by veterinarians] to be diverted for human use, now we are affected.”
According to Walsh, anytime a veterinarian in Maine prescribes opiate-class painkillers or anxiety-relieving medications in the benzodiazepine family, they must first record the pet owner’s name and date of birth and then run a check on the Maine Department of Health and Human Services’ prescription monitoring program as part of the department’s substance abuse and mental health services.
The program is a secure, online database accessible by all medication and drug prescribers and dispensers allowing them to review a patient’s controlled substance drug history.
“The vet checks [the prescription monitoring program] to determine if the owner, or person presenting the pet, is in possession of their own [human] prescription that could put them over what they are legally allowed to possess,” Walsh said. “If nothing looks out of whack, they can dispense the medication for the pet or write a prescription to have it filled at a pharmacy.”
Since the start of the year Bisol said her animal hospital has had to run about 20 prescription background checks and, by and large, her clients are understanding.
In her six years as a veterinarian, Bisol said she has had only one case in which she was concerned a human was diverting opiates prescribed for a pet for their own use.
“Other vets I’ve spoken to in the state said they have seen a case here and there,” she said. “But in general I think it’s pretty rare.”
Under rule 488 veterinarians must now earn three continuing education credits covering the writing of opiate prescriptions, but according to Bisol, no courses have yet been designed and veterinarians are currently in limbo regarding those requirements.
When it comes to veterinary use, the drugs in question are prescribed only in extreme cases of pain — such as serious wound trauma or post surgical care, or to treat extreme behaviour anxiety.
According to Bisol and Walsh, when setting parameters over opiate prescriptions in Maine, the new rule did take into account that dosages to treat pain in animals are far greater than needed in humans.
“We really feel that it is important for this type of legislation to be geared to protecting and promoting public health while maintaining reasonable things,” Walsh said. “We feel the rules do represent a happy medium.”
Bisol said veterinarians are facing a learning curve when it comes to the new rules, and she has been working with Walsh on outreach and spreading the word.
Walsh said those working in the veterinary field are well aware of the immense mental and physical tolls opiate abuse is taking in the state where, according the Maine Center for Disease Control, there has been a 265 percent increase in deaths from prescription opioid overdose in men, and a 400 percent increase in deaths in women since 1999.
“If diversion from veterinary practices is a problem, of course we want to work with our colleagues in human health and close that gap,” Walsh said.
