Vet-shopping and potential controlled substance misuse in pet owners

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Since the early 2000’s, states began to mandate the use of prescription drug monitoring programs (PDMPs) to prevent “pharmacy shopping” and abuse of controlled substances.¹ Pharmacy shopping is a term used for a person who will go to multiple pharmacies to buy controlled substances with cash. Now, pharmacists and prescribers use PDMPs to track who, where, and when a person has received a controlled substance. More recently, there have been reports of veterinarian shopping for the misuse of controlled substances. With vet-shopping, investigators believe that pet-owners are obtaining controlled substance prescriptions for their pets, then using the prescription for themselves.

Researchers from the University of Michigan published a study² that identified trends in vet-shopping in the United States. This study’s goal was to fill the gap in current research on vet-shopping. Currently, there are no recent, national studies in trends of vet-shopping. From 2014-2019, researchers gathered dispensing data for opioid and benzodiazepine prescriptions to see the number of patients that visited multiple veterinarians for the same medication.

Overall, researchers discovered that the number of patients with controlled substance prescriptions from 4 or more veterinarians increased 3-fold. Although prescriptions for opioid analgesia medications decreased, prescriptions for opioid cough or cold medications increased 9-fold.² Researchers attribute the change to the growing awareness of opioid analgesia abuse and less awareness about cough and cold medication abuse.

Most commonly, dogs and cats cough as a sign of infection.^3,4 In both species, opioid medications, such as codeine or hydrocodone, are commonly used as off label treatment.⁵ One of the limitations of this study was that the database does not indicate the species receiving the medication. However, the PDMP did record the age of the patient and 75% of the participants of the study were between 0-17 years old. The researchers assumed that pharmacists would not dispense controlled substance prescriptions written by a veterinarian to human children, indicating that a majority is linked to vet-shopping.

It is important to note that this study did not include prescriptions that were dispensed directly from veterinarians’ offices. The included medications were only prescriptions that were sent to pharmacies, then dispensed to the patient. This indicates that the number of opioid prescriptions from 4 or more veterinarians could be higher than what was reported.²

Investigators concluded that mandates requiring veterinarians to use PDMPs are necessary. Currently, veterinarians are not required to report their controlled medication prescriptions, but new mandates could help prevent misuse. Veterinarians using PDMPs will be able to see where patients have received controlled substance prescriptions and make educated decisions about prescribing to prevent misuse.

Dylan Decandia is a 2023 PharmD candidate at the University of Connecticut

References

1. History of prescription drug monitoring programs. (n.d.). Accessed June 27, 2022. https://www.pdmpassist.org/pdf/PDMP_admin/TAG_History_PDMPs_final_20180314.pdf
2. Chua KP, Perrone J, Redding LE, Brummett CM, Bahl S, Bohnert AS. Trends in the number of patients linked to potential vet-shopping behavior in the United States (2014-2019). Am J Vet Res. 2022;83(2):147-152. Published 2022 Jan 21. doi:10.2460/ajvr.21.10.0173
3. Burke, A. (2021, June 21). Dog coughing: causes and treatment options. American Kennel Club. Accessed June 30, 2022. https://www.akc.org/expert-advice/health/dog-coughing-causes-treatment
4. Coughing in cats: VCA Animal Hospital. Vca. (n.d.). Accessed June 30, 2022. https://vcahospitals.com/know-your-pet/coughing-in-cats
5. Codeine: VCA Animal Hospital. VCA. (n.d.). Accessed June 30, 2022. https://vcahospitals.com/know-your-pet/codeine