Tuesday, January 17, 2017

The Drug Epidemic

Everyone seems to be talking about it, even this recent election, it was an important topic in states like New Hampshire.  When most people think about drugs, they think about marijuana, or heroin.  What is really becoming a problem though is prescription pain killers.

Some veterinary clinics have actually been held up at gunpoint, so that people can steal controlled substances, including ketamine, from clinics.  Clinics and hospitals follow policies set out by the DEA, or drug enforcement administration.  Every drug that comes into a clinic is accounted for and every drug that goes out is also accounted for.  Some clinics have chosen not even to carry the drugs that are more likely to be abused, seeking instead to write prescriptions so that clients can purchase them from a drug store and take them out of the paperwork (and risk) of having such drugs in stock.  It's unfortunate, because sometimes these drugs can be very helpful for pain injections and not having them in a clinic can make it difficult to treat extremely painful patients, such as those hit by a car or spinal traumas.  If the clinics don't have adequate pain medication, the patient will be referred to a place where they do.  There is a certain amount of security risk, and risk to the staff with having controlled substances.  Like any profession, there can be people who abuse controlled substances and that is why people get background checks and even random drug testing when they work with them.

The more difficult aspect of veterinary medicine and controlled substances is the policing of people who might be abusers.  Every time I get a prescription request or a refill request for a controlled substance or substance that can be addictive, I have to meticulously go through the file and do calculations and math to make sure that we aren't giving extra refills.  I have actually had people say they need Xanax (an anti-anxiety medication) for their dogs for thunderstorm anxiety and have calculated out that from the time it was dispensed last to the time they need a refill there would have been a thunderstorm on a daily basis.  There are other pain medications we have to be careful of too.  Sometimes it's just a simple matter of doing math and sometimes it just requires you to have an extra "sense" and see how people respond when you suggest alternatives for their pet rather than controlled substances.  I have to say that these conversations are about as difficult as talking to an overweight person about their overweight pet (AWKWARD).  Sometimes pharmacists and veterinarians work together to do the math and there are now new laws that require new prescriptions for any controlled substance, rather than just being able to call it in.  I've worked at places where they have worked in conjunction with police for people who are nefarious and actually steal prescription pads or falsify information in order to get a hold of drugs.  It's really rather sad and it's a side of being a veterinarian I did not think I signed up for when I graduated.  Hopefully, as a culture we can get a handle on the drug problem and help those who have been hurt by this addiction and who hurt others, including their pets who don't always get the pain meds they deserve.

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