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Healthy Paws: How the Opioid Epidemic is Affecting Veterinary Medicine

Editor’s Note: Healthy Paws is a column sponsored and written by the owners of Clarendon Animal Care, a full-service, general practice veterinary clinic and winner of a 2017 Arlington Chamber of Commerce Best Business Award. The clinic is located 3000 10th Street N., Suite B. and can be reached at 703-997-9776.

The opioid epidemic has been in the news quite a bit recently and for good reason.

While opioid and other prescription drug abuse is of significant concern on the human side, its effects are spilling over into veterinary medicine.

If you have a pet on an opioid pain medication, or drug of concern, you may have been contacted by your veterinarian recently about changes to how Virginia is handling those prescriptions from veterinarians.

As of July 1, 2018, veterinarians in the state of Virginia will be required to participate fully in the Prescription Monitoring Program (PMP), which is a 24/7 database containing information on “dispensed covered substances,” which primarily pertains to controlled drugs and “drugs of concern,” which are defined as “drug or substance where there has been or there is the actual or relative potential for abuse.”

With these new guidelines, veterinarians may elect between not dispensing any controlled drugs or drugs of concern from their office, prescribing only for a single 7-day course, or registering as a dispenser of controlled drugs and drugs of concern.

Additional Virginia regulations on veterinarians with respect to the prescribing of chronic covered substances includes a mandatory re-check in within 2 weeks of starting a covered substance and mandatory physical exams at least every 6 months.

If you have a pet on chronic, controlled pain medications, please contact your veterinarian to come up with a plan to keep everyone in compliance with the new regulations, and to reduce the risk of lapse in pain control.

  1. What is the Prescription Monitoring Program (PMP)?

Virginia’s Prescription Monitoring Program (PMP) is a 24/7 database containing information on dispensed covered substances (see definitions below for information on covered substances). The primary purpose of the PMP is to promote safe prescribing and dispensing practices for covered substances by providing timely and essential information to healthcare providers.

Law enforcement and health profession licensing boards use the PMP to support investigations related to doctor shopping, diversion, and inappropriate prescribing and dispensing.

  1. What are the PMP reporting requirements for an individual veterinarian?

To review the legislation, SB226, with the amendments highlighted click here. This legislation requires that all veterinarians report the dispensing of covered substances for a course of treatment to last more than seven days. Please note that the amendments become effective on July 1, 2018.

The Code of Virginia states the following:

54.1-2519. Definitions.

“Covered substance” means all controlled substances included in Schedules II, III, and IV and all drugs of concern that are required to be reported to the Prescription Monitoring Program, pursuant to this chapter.

Note: The definition for “Covered substance” was amended in HB1556 and is effective on July 1, 2018. The amended definition will state the following: “Covered substance” means all controlled substances included in Schedules II, III, and IV; controlled substances included in Schedule V for which a prescription is required; naloxone; and all drugs of concern that are required to be reported to the Prescription Monitoring Program, pursuant to this chapter.

54.1-3456.1. Drugs of concern.

A. The Board may promulgate regulations designating specific drugs and substances, including any controlled substance or other drug or substance where there has been or there is the actual or relative potential for abuse, as drugs of concern.

Drugs or substances designated as drugs of concern shall be reported to the Department of Health Professions and shall be subject to reporting requirements for the Prescription Monitoring Program established pursuant to Chapter 25.2 (§ 54.1-2519 et seq.).

B. Drugs and substances designated as drugs of concern shall include any material, compound, mixture, or preparation that contains any quantity of the substance tramadol or gabapentin, including its salts.

Drugs and substances designated as drugs of concern shall not include any non-narcotic drug that may be lawfully sold over the counter or behind the counter without a prescription.

Note: Gabapentin, a Schedule VI controlled substance, is currently the only drug of concern that must be reported to the PMP. In addition, the dispensing of naloxone must also be reported.

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