Potential for Prescription Drug Abuse by Veterinary Clients & Staff

In the Literature

Lehnus KS, Fordyce PS, McMillan MW. Electronic survey investigating UK veterinarians’ perceptions of the potential for veterinary prescription medication misuse or abuse. Vet Anaesth Analg. 2024;51(1):16-25. doi:10.1016/j.vaa.2023.09.004

The Research …

Drug abuse and misuse are long-standing issues in veterinary medicine, possibly due to a convergence of vulnerability and access, including stressors created by working long hours, high client expectations, financial constraints, and performing euthanasia regularly. Previous studies have described increased risk for drug abuse in emergency clinicians and staff.^1,2

In the current study, 7,126 clinicians in the United Kingdom were surveyed regarding potential for abuse and misuse of veterinary prescription medication. The response rate was 5% (n = 361). A majority (88.2%) of respondents agreed some prescription drugs were at risk for abuse; 29.9% had suspected a client of self-administering drugs prescribed for the patient; 20.1% had suspected veterinary staff of taking veterinary-prescribed drugs; 2.2% knew of attempted suicide or misuse of drugs by staff; 1.7% knew of staff stealing medication; and 1.4% knew a staff member who had committed suicide. Opioids, benzodiazepines, and gabapentin were reported most likely to be abused by clients, and opioids, benzodiazepines, and ketamine were reported most likely to be abused by staff.

Factors that raised suspicion for abuse in clients included high frequency or volume of repeat prescription requests, lack of expected clinical response of a patient to a normal drug dose, requests for specific drugs, and suspicious client behavior (eg, unwillingness to have a pet examined, coercive language). Factors that raised suspicion for abuse in staff included frequently spilled or wasted drugs by the same staff member, discrepancies in controlled drug records, prescription of large quantities of a drug to a staff member’s pet, and ordering drugs not typically stocked by the practice.

… The Takeaways

Key pearls to put into practice:

• Strict pharmacy controls (eg, dispensing systems, video monitoring of drug safes, limiting access to prescription drugs to just a few staff members) can help preclude abuse in veterinary staff.  

• Monitoring prescription records, flagging repeat requests for drugs subject to abuse, and reporting suspected fraudulent use to authorities can help prevent or stop drug abuse in clients. Clients may injure their pets to obtain pain medications.  

• Pre-employment drug testing can deter those prone to problematic drug use from applying for employment and help create a workplace free of drug abuse.³ Random drug testing is not recommended because of the high level of distrust that may develop among employees, as individual rights may be perceived as threatened.