Does the use of opioids in pets create a higher risk of maltreatment in humans?

Penn's study reveals a 41% increase in opioids for small animals over the last 10 years; the results indicate another potential risk for opioid human access

According to a study by researchers at the University of Pennsylvania, the increase in prescription opioids for people over the past decade could be parallel to an increase in the number of prescriptions for Opioids for pets. Perelman School of Medicine and the School of Veterinary Medicine. The results of this first study on veterinary opioid prescriptions suggest that there is also an increased demand for veterinary opioids, motivated by complicated procedures practiced in veterinary medicine, as well as a take-up increased awareness of the importance of pain management. Since opioid prescription in veterinary medicine is not as regulated as medical prescriptions intended for humans, it is possible that abused veterinary prescriptions could contribute to the continuation of the epidemic outbreak. 39; opioids. The results are published today in JAMA Network open now.

As part of this study, researchers examined all the opioid pills and patches delivered or prescribed to dogs, cats, and other small animals at the University of Pennsylvania's Faculty of Veterinary Medicine (Penn Vet) from January 2007 to The results show that these prescriptions, measured in milligram equivalents of morphine (MME), increased by 41% during the period, while the annual number of visits increased by only about 13%. As a veterinary tertiary care facility, Penn Vet's unique workload requires special attention and treatment of pain in veterinary species, which may explain the increased use of opioids in the study.

"While we see the epidemic of opioids squeezing, we identify other avenues of human consumption and abuse," said the lead author of the study. . Jeanmarie Perrone, MD, professor of emergency medicine and director of medical toxicology at Penn Medicine. "Even if the vet wishes it well, the increase in the number of veterinary opioids prescribed may mean an increased risk of misuse of pills eventually by household members, selling or misappropriating , or endangering young children by involuntary exposure. The results of this study suggest that by evaluating the prescription rate of veterinary opioids, we can develop strategies to reduce the risks to human and animal health associated with increasing use. "

In the United States, the current opioid crisis is causing tens of thousands of overdose deaths each year, or about 50,000 in 2017, according to the report. Centers for Disease Control and prevention. The crisis began in the late 1990s and was fueled largely by a sharp increase in prescriptions for opioid analgesics. Tighter regulations, including prescription drug monitoring programs, have reduced the number of opioid prescriptions from their record level in 2011. Although the number of Opioid overdose deaths prescribed now outweigh that of heroin and fentanyl obtained illegally, these deaths still account for nearly 20,000 deaths annually. Since the prescription of opioids in veterinary medicine is not so regulated, it is feared that opioids prescribed for pets are misused by humans.

The researchers reviewed pharmacy records from Penn Vet's Ryan Hospital during the 10-year study period and analyzed trends in the four opioids prescribed or dispensed to animal patients – tramadol, hydrocodone and codeine and fentanyl patches. The animals in the study included dogs (73.0%), cats (22.5%) and others, including rabbits, snakes and birds (4.5%).

"We found that the increase in the amount of opioids prescribed by our hospital was not solely due to the increase in patient volume. It is likely that our goal of ensuring our patients a pain-free postoperative, especially in patients requiring complex and invasive procedures, has resulted in an increase in our prescribing practices during this period, "said Dr. Principal author. Dana Clarke, VMD, Assistant Professor of Interventional Radiology at the Faculty of Veterinary Medicine at the University of Pennsylvania "At the national level, we do not know the potential or the extent of misappropriation of animal prescriptions at the University of Pennsylvania. man, and what impact it could have on the human opioid crisis. "

Anecdotes about the use of opioids prescribed by veterinarians have already prompted some states to add restrictions to the veterinary prescription. In Pennsylvania, state legislators are working with the Pennsylvania Veterinary Medical Association (PVMA) to determine the most effective course of action for opioid dispensing by practicing veterinarians in the state. Two states, Maine and Colorado, now require that veterinarians be able to write an opioid prescription before going on to review the opioid prescribing history of pet owners. Alaska, Connecticut and Virginia now limit the amount of opioids that a veterinarian can prescribe to a single patient / animal. Twenty states now require veterinarians to declare their opioid prescriptions in a central database, as do doctors. At Penn Vet, ongoing efforts to reduce opioid prescription include local anesthetic preference for postoperative pain, pain scores to guide opioid administration and patient monitoring. requiring long-term use of opioids, such as dogs with chronic cough requiring hydrocodone. .

The authors believe that it is important to further investigate the potential problem of diverted veterinary opioids in order to determine the magnitude, and that this situation should be remedied in this way. extending opioid management measures that already affect physicians to veterinarians in all states.

Co-authors of the study include Kenneth Drobatz, DMV, of Penn Vet, Chloe Korzekwa, of Trinity College in Dublin, and Lewis S. Nelson, MD, of Rutgers New Jersey Medical School.

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Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research and excellence in patient care. Penn Medicine is made up of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the country's first medical school) and the Health System of the University of Pennsylvania, which together make up a $ 7.8 billion business.

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