Tuesday January 21, 2020

Opioid Prescriptions for Pets Surge, Mirroring Human Crisis

Only 20 states require veterinarians to report opioid prescribing as medical doctors do to a registry designed to limit misuse, the study authors note.

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Hydrocodone pills are pictured at a pharmacy in Montpelier, Vt. VOA

Many more Americans may be getting opioids for their pets, and veterinarians appear to be prescribing increasingly potent versions of these drugs to animals, a small study suggests.

The researchers examined data on opioid tablets and patches dispensed or prescribed by 134 veterinarians at an academic small-animal hospital in Philadelphia from 2007 to 2017. Over the decade, the amount of opioids used for creatures like rabbits, birds and reptiles surged 41 percent even though visits to the hospital increased by only 13 percent.

“We have no way of knowing if any of these prescriptions were obtained by pet owners for themselves, and most were likely not,” said senior study author Dr. Jeanmarie Perrone, a toxicologist with the emergency medicine department at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

“However, the risk to humans is that leftover opioid prescriptions to animals end up in the same medicine cabinets as leftover opioids for people, leading to opportunities for misuse by teenagers or unintentional exposures in children that can be lethal,” Perrone said by email.

The study included 366,468 pet visits to the animal hospital. During these visits, veterinarians prescribed a total of 105.2 million tablets of tramadol, more than 97,000 tablets of hydrocodone, almost 39,000 tablets of codeine and 3,153 fentanyl patches.

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Dogs got the most drugs, accounting for 73 percent of these prescriptions, followed by cats at 22.5 percent and exotic animals at 4.5 percent. Pixabay

Most were for dogs

Dogs got the most drugs, accounting for 73 percent of these prescriptions, followed by cats at 22.5 percent and exotic animals at 4.5 percent.

A major factor contributing to the growing opioid crisis in the U.S. is the increasing availability of these drugs, which addicts often get from friends or relatives when they aren’t able to obtain a prescription, researchers note in JAMA Network Open.

Although medical and dental health providers are the biggest source of these opioids, the current study suggests that veterinary prescriptions may also be part of the problem, they write.

Veterinarians and animal hospitals can be registered with the U.S. Drug Enforcement Administration, and in many states vets can prescribe, stock and dispense opioids without the same reporting requirements that are in place at many retail outlets.

Only 20 states require veterinarians to report opioid prescribing as medical doctors do to a registry designed to limit misuse, the study authors note.

Pennsylvania is one of many states without reporting requirements, and results from the study may reflect what happens in other states that lack registries to help curb abuse, Perrone said.

It’s not clear if the increase in prescriptions in Pennsylvania might be due to an increased push to better manage pain for animals and pets, said Dr. Lee Newman, a researcher at the Colorado School of Public Health in Aurora, or if it is due to the growing number of people with substance abuse problems trying to get medications from veterinarians, or both.

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Only 20 states require veterinarians to report opioid prescribing as medical doctors do to a registry designed to limit misuse, the study authors note. Pixabay

Switch surmised

“It’s speculation on my part, but it could be that when a human patient stops getting opioid prescriptions from their doctor that they next turn to the veterinarian to try to get drugs,” Newman, who wasn’t involved in the study, said by email.

While the study suggests that opioid prescribing from veterinarians represents only a small fraction of the overall opioid prescribing in the country, it also suggests that veterinary practices may be an overlooked part of the problem, said Kirk Evoy, an assistant professor in both the College of Pharmacy at the University of Texas at Austin, and at the School of Medicine at the University of Texas Health Science Center at San Antonio.

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“This study brings to light that this is yet another potential source of access to opioids that many clinicians and policymakers may not be thinking about in their efforts to curtail the country’s opioid abuse epidemic,” Evoy, who wasn’t
involved in the study, said by email.

“Furthermore, while human opioid prescribing has begun to level off in recent years in response to the opioid epidemic, this data seems to indicate that, at least in the specific hospital being studied, prescribing of opioids for animals has continued to climb,” Evoy said. (VOA)

Next Story

Cases Of High-Strength Painkiller Poisonings Among Children Increase

The focus has largely been on adults so a study set out to investigate the impact on children, specifically trends in admissions to PICU

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Children
Now Researchers are calling for a strategy that combines laws to restrict access to opioids with improved mental health support for children and adolescents. Pixabay

The proportion of high-strength painkiller poisonings among children which result in emergency hospital admissions has increased, researchers have revealed.

The study involving more than 200,000 US paediatric cases of pain-relief misuse, abuse or self-harm highlights how the opioid crisis is affecting young people.

The results, published in the journal Clinical Toxicology, show that although the number of incidents reported overall has dropped since 2005, the threat to life is rising.

“This study suggests the opioid epidemic continues to have a serious impact on pediatric patients, and the healthcare resources required to care for them,” said study researcher Megan Land from Emory University in the US.

“Paediatricians caring for children with opioid ingestions must continue to strive for effective policy changes to mitigate this crisis,” Land added.

According to the researchers, the proportion of paediatric intensive care unit (PICU) admissions rose by more than a third during the study period from 5,203 (6.6 per cent), out of 80,141 reports of poisonings between 2005 and 2009, to 4,586 (9.6 per cent) out of 48,435 between 2015 to 2018.

The focus has largely been on adults so this study set out to investigate the impact on children, specifically trends in admissions to PICU.

Children
The proportion of high-strength painkiller poisonings among children which result in emergency hospital admissions has increased, researchers have revealed. Pixabay

The researchers consulted the National Poison Data System database for accidental or deliberate incidents of opioid exposure involving babies and children up to age 19.

They found 207,543 cases were reported to 55 US poison control centres from 2005 to 2018.

Factors analysed included opioid type, cause of drug poisoning and the rate of cases admitted to psychiatric units.

The study also calculated the proportion of patients who ended up in PICUs and the percentage of these requiring medical treatment.

The research suggests that the majority of child drug poisonings did not require an intensive care admission, and either resulted in minor effects such as drowsiness — or none at all.

But the proportion needing specialist treatment did increase over the study period.

This trend of children ending up in intensive care is being fuelled by suspected suicide cases among under-19s who have overdosed on legal or prescription opioid drugs, the study said.

Methadone, prescription pain-reliever fentanyl and heroin are most associated with the need for intensive care doctors to give medical treatment, according to the findings.

The picture was similar with psychiatric unit admissions — the percentage of these more than doubled from 2,806 (3.57 per cent), out of 80,141 between 2005 to 2009, to 3,909 (8.18 per cent) out of 48,435 between 2015 to 2018.

This was also the case for the proportion of intensive care admissions needing cardiopulmonary resuscitation (CPR) which went from 68 (1.31 per cent) out of 5,203 to 146 (3.18 per cent) out of 4,586 over the same time period.

Children
A study involving more than 200,000 US paediatric cases of pain-relief misuse, abuse or self-harm highlights how the opioid crisis is affecting young people and Children. Pixabay

The researchers are calling for a strategy that combines laws to restrict access to opioids with improved mental health support for children and adolescents.

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Doctors who treat children and young people should continue lobbying for policy changes, they added. (IANS)