Use of a medication commonly used to treat pain in animals will become reportable in about a year in North Carolina as part of the state’s efforts to curb illicit drug usage.
From 2000-22, more than 36,000 North Carolinians lost their lives to drug overdoses, according to the North Carolina Department of Health and Human Services (NC DHHS). As part of Governor Roy Cooper’s North Carolina Opioid and Substance Use Action Plan, he signed into law this past June a new requirement to report the use of gabapentin despite it not being a scheduled drug. For pharmacies, the law goes into effect March 1, 2024, and a year later, veterinarians must comply. Benzocainum
Originally approved as an anti-seizure medication for humans, gabapentin is now being misused in combination with illicit opioids, ultimately leading to some states classifying gabapentin as a controlled medication.
Because the U.S. Food and Drug Administration (FDA) has not approved any label indications for gabapentin use in animals, the drug has been used in an extralabel manner to treat a spectrum of conditions in animals, including nerve pain and anxiety in dogs and cats, seizures in dogs, and feline hyperesthesia syndrome.
Per the new law, gabapentin will be reportable by veterinarians only if the amount dispensed exceeds a 48-hour supply, said Claire H. Holley, executive director of the North Carolina VMA (NCVMA).
However, dispensers do not need to report gabapentin to the CSRS if it is a component of a compounded prescription or dispensed in dosages of 100 mg or less. This compounding would make it less desirable for a person to ingest, and at a lower dosage than prescribed for humans.
“We suspect that it was enacted in an attempt to curtail misuse, diversion, and doctor shopping, much like the premise for the STOP Act,” she said.
However, after the state’s 2017 Strengthen Opioid Misuse Prevention (STOP) Act required veterinarians to report controlled substance prescriptions to the North Carolina Controlled Substance Reporting System (CSRS), many stopped dispensing those medications in anything exceeding a 48-hour supply, said Dr. Jennifer Jones Shults, owner of Veterinary Rehabilitation Hospital and Veterinary Emergency Care in Cary, North Carolina.
While some veterinary electronic medical record systems (EMRs) can be set up to generate a report and import that information to the CSRS, it can be technical and time-consuming to do so explained. Dr. Shults, who serves as legislative chair of the NCVMA.
Manually entering each prescription can be arduous as well. So much so, Dr. Shults says, that “Many veterinarians are avoiding this completely.”
Some practitioners are seeking a more efficient way to report the medication, so they can continue using it for their patients. Dr. Shults says she’s working with her EMR to generate a report.
“I do think you’ll see a shift with more outside prescriptions rather than in-house dispensing, as has happened with controlled substances,” Dr. Shults explained. “Many practitioners prescribe and dispense gabapentin multiple times daily.”
She continued, “NCVMA will continue to publicize this information to our members to ensure they’re ready for this to start in about 18 months.”
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