New opioid rules largely silent on veterinarian concerns

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The state has released new rules for doctors, veterinarians and pharmacies in support of a state law designed to curb drug abuse by setting limits on opioid prescriptions.

Veterinarians had hoped the rules would address a host of concerns about their role in the policing of opioid prescriptions.

They don’t.

“There aren’t very many changes that I could see,” said veterinarian Amanda Bisol, legislative chairwoman for the Maine Veterinary Medical Association and owner of Animal Medical Clinic in Skowhegan.

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At issue is Chapter 488, a law that strictly limits opioid prescriptions for chronic and acute pain, except for people with cancer, in hospice, receiving palliative care or using the medication for addiction treatment. It also requires that doctors, including vets, check the state’s prescription monitoring database before prescribing and refuse to write a prescription if the patient is over the new state-imposed limit.

The law was passed last year as emergency legislation and went into effect Jan. 1.

“We included veterinarians with the support and urging of physicians and other prescribers — because we know that opiate addicts are diverting drugs from their pets,” DHHS spokeswoman Samantha Edwards said. 

However, vets say it’s rare for people to take their pets’ pain medication, possibly because most pet prescriptions are written for a fraction of the amount a human would need to get high.

Vets across Maine have voiced their frustration with the law, saying the goal is laudable but the new requirements don’t help in their line of work and are a hassle at best and potentially dangerous at worst.

Vets have said it feels ethically wrong for them to check a human’s prescription information in order to prescribe medication for an animal, and they feel unprepared to interpret a human’s medication history since their training is in animal medicine.

Vets have also complained that they don’t know whose prescription records they should be searching for when multiple people care for the pet. They need more time to check the database since mobile vets and others don’t always have immediate internet access. And they don’t like that database doesn’t allow vets to enter their prescriptions, so someone could get medications from multiple vets without it being noted anywhere.

The Maine Department of Health and Human Services has been crafting new rules around the law and released those Friday.

The new rules stay silent on most of the vets’ concerns. They do address two points: Whose prescription background should be checked and how much time vets have to check the online database when writing a prescription.

The rules say vets should check the prescription background of “the individual seeking care for the animal” or the owner of the animal “if deemed appropriate.”

The rules also give vets 24 hours to check the prescription monitoring program online after writing a prescription.

“That’s important,” Bisol said of the 24-hour window. “That’s helpful.”

However, the rules also note that all vets in Maine need to register as data requesters in the state’s prescription monitoring program, even though the law had indicated that only those who prescribe opioids need to register. That could prove frustrating to vets who don’t prescribe opioids.

Veterinarian Gail Mason, who co-owns the Bath-Brunswick Veterinary Associates and Portland Veterinary Specialists, said she feels vets’ concerns were ignored.

“I still will not look up someone’s medical records. I’m just not going to do it,” she said. “My clients, they would let us do it because they trust us. That doesn’t make it right.”

Bisol said she plans to talk with DHHS officials more about veterinarians, the law and how to change the rules.

“My goal is to meet with them, sit down with them and go over some of the concerns and brainstorm,” she said. “I’m hoping they will be able to help us out with next steps and what will work best for the state of Maine.”

ltice@sunjournal.com

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