Please Read and Consider

[Easnadh]

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Especially for those of you that plan on being large animal vets, or want to provide mobile services, this is an important issue! Please consider signing.

http://avmacan.avma.org/avma/issues/alert/?alertid=62592206

 

[Jamr0ckin]

I've signed and shared it on my Facebook. 🙂

 

[cowgirla]

OK, I'm confused...
According to Wiki, the Controlled substance act has been around since the 70s. Has every road call veterinarian since then been working illegally? If so, how? And why does the DEA care all of a sudden? At one of the clinics I worked for, all of the trucks were registered to the clinic, not to an individual, and had their own lockbox, drug log books, etc. I figured that was just what the law wanted, but apparently not? We had to deal with the DEA a couple of times for other issues and every time they did an inspection of all the log books and never said a word.

 

[BlackDog17]

I'm confused about this too. I've seen vets do euthanasia on farms before. In fact our regular small animal vet did a house call to euthanize my dog years ago because she was no longer able to walk, and from what I hear he does this as necessary for his regular clients. And I seem to remember the vet I worked for signing out controlled meds when she would go on emergency house calls. Either vets have a habit of breaking this law or something is not quite right here.

 

[Rainheart]

I have heard my vets mention this, so I know it has potential to be a huge issue. Of course, we do still travel to do house calls and euthanasias in home... so we do have to have those drugs with us.

 

[485501]

A vet I shadowed last summer talked a bit about this. What he said was that traditionally, a doctor's/veterinarian's "black bag" (or truck, or lockbox, or whatever) has been considered an extension of their clinic. So, as long as the vet was carrying the drugs in a container that is clearly meant to be part of their practice, the DEA didn't care. But then, sometime in the last couple of years, the DEA decided that it wasn't ok for their inspectors to use that traditional exemption anymore, and they're trying to start enforcing the law more to the letter. That vet said he knew someone who had gotten cited for taking drugs along to a housecall, although I don't think there was any consequence other than a light fine. But still, it's a worrying precedent.

It's actually not that unusual for laws to not be enforced to the letter, and then suddenly start being enforced, particularly old laws.

 

[Lissarae06]

Considering how many areas of this country that don't have access to a veterinarian for one reason or another, enforcing these laws is only going to make the problem worse. They really need to pass the exemption for vets.

 

[pirateyoho]

Wow, I had no idea about this. 😱 Thanks for sharing; signed it & passed it on.

 

[WelshCob]

Interesting but here is a little flicker of like my representative is a mobile large animal veterinarian. I have faith that he'll stand tall and explain the need to his fellow representatives.

 

[Meatballerina]

signed and shared on facebook!

 

[rugbychick16]

A vet I shadowed last summer talked a bit about this. What he said was that traditionally, a doctor's/veterinarian's "black bag" (or truck, or lockbox, or whatever) has been considered an extension of their clinic. So, as long as the vet was carrying the drugs in a container that is clearly meant to be part of their practice, the DEA didn't care. But then, sometime in the last couple of years, the DEA decided that it wasn't ok for their inspectors to use that traditional exemption anymore, and they're trying to start enforcing the law more to the letter. That vet said he knew someone who had gotten cited for taking drugs along to a housecall, although I don't think there was any consequence other than a light fine. But still, it's a worrying precedent.

It's actually not that unusual for laws to not be enforced to the letter, and then suddenly start being enforced, particularly old laws.

Yes-the vet truck was until recently considered part of the clinic where the DEA license was registered too. Now its not, and controlled drugs are not supposed to leave the clinic in our posession....

I'm a mixed animal vet. I routinely go on farm calls and emergencies and carry ketamine, butorphanol, diazepam, and euthanasia solution in a little locked box in my truck at all times. This is now technically illegal.

Even better, if I crossed state lines in my truck (which we rarely do as we're 60 miles from the border, but it is still a possibility) and the DEA wanted to get picky about it, that is a felony offense of trafficking drugs across state lines.

 

[MarxistPreVet]

Signed and forwarded to sympathetic family members.

 

[LetItSnow]

Considering how many areas of this country that don't have access to a veterinarian for one reason or another, enforcing these laws is only going to make the problem worse. They really need to pass the exemption for vets.

Yup. And not just LA or Equine vets. How many SA practitioners offer at-home euthanasia? Heck, I know one vet whose entire practice is hospice care; 100% of her work is on-the-road with controlled substances.

Just out of curiosity - how would this impact the fully mobile practices (you know, the rigged-out mobile-home style vehicles with an operatory in back, etc.)? Are the low-cost mobile spay/neuter clinics also illegally operating?

 

[Lissarae06]

Yup. And not just LA or Equine vets. How many SA practitioners offer at-home euthanasia? Heck, I know one vet whose entire practice is hospice care; 100% of her work is on-the-road with controlled substances.

Just out of curiosity - how would this impact the fully mobile practices (you know, the rigged-out mobile-home style vehicles with an operatory in back, etc.)? Are the low-cost mobile spay/neuter clinics also illegally operating?

👍

 

[bbeventer]

Yes-the vet truck was until recently considered part of the clinic where the DEA license was registered too. Now its not, and controlled drugs are not supposed to leave the clinic in our posession....

I'm a mixed animal vet. I routinely go on farm calls and emergencies and carry ketamine, butorphanol, diazepam, and euthanasia solution in a little locked box in my truck at all times. This is now technically illegal.

Even better, if I crossed state lines in my truck (which we rarely do as we're 60 miles from the border, but it is still a possibility) and the DEA wanted to get picky about it, that is a felony offense of trafficking drugs across state lines.

This just blows my mind. I know a vet who routinely sees patients in 3 different states for farm calls (because their practice is right on the border).

I emailed my representative and I guess he's already a co-sponsor of the bill... so yeah!

 

[Easnadh]

Bump!

If you haven't looked at this and sent a notice to your local representative, please do! Mobile veterinarians need to be able to use their drugs in the field!!

 

[Chocl8luva]

I'm assuming there's some exception to this for human medicine (ambulances, hospitals, etc.)?

 

[Fly Racing]

I'm assuming there's some exception to this for human medicine (ambulances, hospitals, etc.)?

I could be mistaken, but I don't believe ambulances carry any controlled substances. Hospitals will have appropriate DEA licenses with (probably many) doctors at that address, so is fine just as it is at a vet hospital. The issue is only when the drugs leave or are administered at a different address.

If the government decides to penalize vets for doing farm call/house call euthanasias, we are in big trouble. That would make an uncountable number of animals suffer needlessly. I'm shocked to hear action has been taken against several California equine and farm animal vets who work primarily ambulatory. It's ridiculous.

 

[Minnerbelle]

How does at home hospice care work for terminal human patients? Are they not allowed to be given opioids for pain relief?

 

[Dwindlin]

Providers can fill out a DEA form (I believe form 222) that allows them to carry drugs (including schedule II's) for "terminal distribution." We were just discussing this the other day for making personal/tactical kits for various situations.

 

[Lissarae06]

I could be mistaken, but I don't believe ambulances carry any controlled substances. Hospitals will have appropriate DEA licenses with (probably many) doctors at that address, so is fine just as it is at a vet hospital. The issue is only when the drugs leave or are administered at a different address.

If the government decides to penalize vets for doing farm call/house call euthanasias, we are in big trouble. That would make an uncountable number of animals suffer needlessly. I'm shocked to hear action has been taken against several California equine and farm animal vets who work primarily ambulatory. It's ridiculous.

My husband is an EMT. They are allowed to carry controlled substances on the ambulance. They are locked up, of course, but they do carry them.

 

[Dwindlin]

I could be mistaken, but I don't believe ambulances carry any controlled substances. Hospitals will have appropriate DEA licenses with (probably many) doctors at that address, so is fine just as it is at a vet hospital. The issue is only when the drugs leave or are administered at a different address.

Wow, sad I missed this. 10 year Firefighter/Medic. With my current department we carry Morphine, Fentanyl, Valium, and Versed. Also carry Etomidate and Ketamine, plus Roc and Succs. Then we carry a whole host of other "unscheduled" drugs (ACLS drugs, D10, dopamine, dobutamine, Narcan, Benadryl, Duonebs, etc, etc).

Each department will have it's own State Board of Pharmacy License that dictates what that department is allowed to carry on its apparatus. And that is dictated by the physician medical director for your department.

 

[equineconstant]

I just got an email response from my congressman. It was full of "as you know"s and "I'll keep your opinion in mind"s, but at least I know he got it.

 

[LetItSnow]

Wow, sad I missed this. 10 year Firefighter/Medic. With my current department we carry Morphine, Fentanyl, Valium, and Versed. Also carry Etomidate and Ketamine, plus Roc and Succs. Then we carry a whole host of other "unscheduled" drugs (ACLS drugs, D10, dopamine, dobutamine, Narcan, Benadryl, Duonebs, etc, etc).

Each department will have it's own State Board of Pharmacy License that dictates what that department is allowed to carry on its apparatus. And that is dictated by the physician medical director for your department.

Dwindlin: Do you guys not carry vecuronium, rocuronium, or the like for intubation? (Over here in the vet world we're not quite as familiar with them - it's not as common to use the non-depolarizing relaxants. They're occasionally used, but not ubiquitously like in the human world.)

 

[LetItSnow]

Dwindlin: Do you guys not carry vecuronium, rocuronium, or the like for intubation? (Over here in the vet world we're not quite as familiar with them - it's not as common to use the non-depolarizing relaxants. They're occasionally used, but not ubiquitously like in the human world.)

Oops. I assume Roc is rocuronium and Succs is succinylcholine. Sorry, didn't catch them in the shortened slang when I read it the first time.

So.... carry on. Dummy can't read.

 

[catlady816]

How does at home hospice care work for terminal human patients? Are they not allowed to be given opioids for pain relief?

Having cared for someone on in-home hospice, I can tell you (in my county at least) hospice patients get a "hospice box" to keep in their fridge that's filled with controlled substances to ease pain and other issues (morphine, diazepam, etc.) in case of emergencies and are given as a prescription. Any additional controlled substances that might be used on a daily basis are scripted out by Dr's and kept in the patients home. I never met a hospice nurse who carried any. I'm sure this is different in other areas though.