A new study published in BMC Veterinary Research, June 22, 2020, sheds some light on the practice of vet shopping – using deceit to acquire pet medication for personal use - through the eyes of veterinarians practicing in rural Appalachia. Results indicated that 13 of the 14 veterinarians interviewed had heard of the phenomenon and eight of the veterinarians had personally encountered vet shopping in their practices.
 
New laws have made it more difficult for people seeking opioid medication, which has forced drug seekers to turn to veterinary clinics as a new avenue to obtain prescription opioids. Vet shopping occurs when a client solicits a controlled substance prescription for their pet with no intent of giving their animal the medication but instead to use the medication for themselves. The practice of vet shopping has been highlighted in several recent media reports, but the impact it has on the opioid epidemic is still uncertain.
 
This first of its kind research project was a collaboration between the Lincoln Memorial University-DeBusk College of Osteopathic Medicine (LMU-DCOM), LMU-College of Veterinary Medicine’s (LMU-CVM) Center for Animal and Human Health in Appalachia (CAHA), the University of Arkansas’ College of Education and Health Professions (UARK-COEHP), Jackson State University’s School of Public Health (JSU), and the University of Mississippi Medical Center (UMMC).
 
Falguni C. Patel, a fourth-year osteopathic medical student at LMU-DCOM was the primary author on the study with a team of researchers including Dr. Jeffrey A. Raines, LMU-CVM alumnus; Richard W. Kim, fourth-year osteopathic medical student at LMU-DCOM; Dr. Karen Gruszynski, assistant professor of epidemiology and CAHA epidemiologist at LMU-CVM; Dr. Robert E. Davis, assistant professor of public health and director of the Substance Use and Mental Health Laboratory at UARK-COEHP; Dr. Manoj Sharma, professor of behavioral health promotion and education at JSU; Dr. Gilbert Patterson, manager and principal researcher at CAHA; Dr. Jason W. Johnson, vice president and dean of LMU-CVM; and Dr. Vinayak K. Nahar, assistant professor of dermatology and preventive medicine at the UMMC.
 
“The data gathered from this study will provide a better understanding regarding the attitudes and practices used by veterinarians related to vet shopping and will provide insight for future research and intervention strategies,” said Nahar, a principal investigator on this research project.
 
Fourteen veterinarians from 14 different practices located within the Appalachian footprint of Kentucky, Tennessee and Virginia participated in this qualitative study. Among the veterinarians interviewed, eight practiced in Tennessee, four in Kentucky, and two in Virginia.
 
The study revealed a need for more education for veterinarians and their staff regarding best practices for prevention of vet shopping. From those interviewed, one of the veterinarians was unaware of the phenomenon of vet shopping, and only four had received training on prevention or management of vet shopping. Continuing education programs were recommended as a possible solution to educating veterinarians on the opioid crisis as it pertains to their practices.
 
Veterinarians interviewed expressed the desire to have a way to communicate with other veterinary colleagues, medical professionals and pharmacists in an efficient manner. Similarly, the need for an information database that could be used to track and control animal prescriptions -like the Kentucky All Schedule Prescription Electronic Reporting (KASPER) - was mentioned. Laws are currently in place across the nation to curb human physician shopping, however only 20 states and the District of Columbia have addressed the vet shopping issue by requiring veterinarians to report dispensing of controlled substances into Prescription Drug Monitoring Programs (PDMPs).
 
“One of the biggest takeaways was the importance of a valid veterinary-client-patient-relationship,” said Gruszynski. “It is important for veterinarians to take time to get to know both their patients and clients. Relationships are built over time, and while it is hard to gauge a first-time client’s intentions, there are red flags to watch for.”
 
Dr. Jason Johnson, vice president and dean of the LMU-CVM, stresses the importance of teaching communication skills to veterinary students from the start so that when they go into the workforce, they know what to watch for and how to build those client relationships.
 
“At LMU-CVM we are committed to educating confident, competent, career-ready veterinarians,” said Johnson. “Excellent communication with clients is one of the most valuable skills a veterinarian can have. We teach our veterinary students the basics of building that relationship in our communication center where they interact with standardized patients who play the role of a pet owner.”
 
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