Like nearly every state, Maine is dealing with an opiate and heroin epidemic. In 2015, Maine experienced 272 overdose related fatalities. In January 2017 one of Maine’s media outlets, WMTW, did an outstanding feature entitled Goodnight moon, goodnight mum,’ ‘Chronicle’ investigates Maine’s heroin epidemic. Anchor David Charns did a phenomenal job detailing the pain and heartache of addiction through a series of interviews and videos including one with Oxford County Sheriff’s Office Sgt. Matthew Baker Sergeant  who, moments after arriving home from work in February 2015, discovered his 23-year-old daughter Ronni near death in the upstairs bathroom. Despite CPR from her father and several doses of Narcan by paramedics, she died, leaving behind an 11 month old daughter Claire. Ronni’s daughter, now 2, lives with her grandparents and is the source behind the name of the WMTW article:

When Claire asks for her mother, she and her grandfather look up, past that second-floor bathroom, to the sky. “I’ve always told her that that full moon is mum,” Baker said. “We go outside, and she says, ‘Goodnight moon and goodnight mum.'”

In an effort to combat the Maine opiate epidemic, the Maine Legislature enacted Public Law 488 which became effective January 1, 2017. PL488 affects nearly all facets of healthcare except in this law, veterinarians are included. I didn’t have all the exact data on PL488 so reached out to my State Senator, Thomas Saviello. I must tell you, he is the only government official to respond during the two weeks I called and emailed various agencies, elected officials  including the State House. Sad indictment against them but a huge kudos for Senator Saviello. 

What I do know about PL488 and it’s impact on veterinarians is such. If an owner takes their pet to be seen and the veterinarian feels it necessary to prescribe a narcotic or benzodiazepine for your pet, they must first do a check on the owner with DHHS to determine if the owner is on a controlled substance. As I previously mentioned I still need to clarify the parameters but the fact that a veterinarian or perhaps his staff has the power to access a person’s prescriptions is a huge HIPAA violation. But I digress. Let’s use a hypothetical situation. Owner has an anxiety disorder for which he takes Valium on a daily
basis. He also has a severe back issue (long-term) so is on hydrocodone for pain control. His cat is hit by a car and taken to the vet where she undergoes successful emergency surgery but because her injuries are severe, the vet prescribes a pain medication; hydrocodone. Would the fact that the owner is on hydrocodone prohibit the vet from prescribing it for the cat’s postoperative pain? If so, would he be allowed to prescribe a different pain medication such as tramadol which also falls in the opiate category? Is
he is prohibited from prescribing any narcotic because the owner is on two (2)?  Or is it only if the owner is on the same drug? If his prescriptive powers are limited
because the owner is on a controlled substance, what criteria is used to determine if the animal can or cannot get a prescription?

Whilst I understand the opiate epidemic our country is tackling, how can a veterinarian or
anyone for that matter be absolutely certain that a person who is taking several controlled drugs is abusing or trafficking? Plus the thought that an innocent animal might have to suffer needlessly because his owner is on a controlled substance is not only abhorrent but
inhumane.  I want to know if it’s possible for the check to be done during non-business hours when DHHS is closed. Does the veterinarian’s office have to speak directly to a DHHS employee or is the information accessible online? And if it is accessible online, how can we, the human patient, be assured it’s secure? If the drug check on the owner can’t be done when DHHS is closed, then what happens to the animal who is in pain?  Any pet owner knows that many accidents happen at night, weekends or holidays when government agencies like DHHS are closed; what then?  Going back to HIPAA, who has authority within the veterinary practice to request the DHHS information? Can a receptionist do it? A vet tech? Or only the veterinarian? Finally, I do not understand how PL488, a state law, can override HIPAA, a federal law enacted in 1996 by Congress and signed into effect by then President Bill Clinton. Under HIPAA an individual’s medical and other health information including prescriptions, is private and protected. The Privacy Law sets limits on who can look at and receive our health information such as covered entities and their business associates. As a nurse and former Union representative I am extremely familiar with HIPAA. In light of PL488 however I reviewed it once again and no where did I find where veterinarians, veterinary technicians, or veterinary employees of any type are entitled to our records in any form. Additionally, PL488 is in essence requiring veterinarians to understand human medication dosages compared to animals which often differ greatly.hipaa_violations_by_type_-_pie_chart

I chose a veterinary team for my German Shepherd based on their reputations and expertise in animal physiology, not human. I value all members of her team despite being in different practices because of their knowledge. Having said that, I expect they keep current with the newest modalities of treatment for my dog. They work long hours yet now the State of Maine expects them to undertake additional training in order to understand and monitor the Prescription Monitoring Program (PMP)?  A program historically used only for humans?

This is ludicrous. There has to be a middle ground, a way the government, human healthcare providers and law enforcement can work together in an effort to reduce the rampant drug abuse without violating a persons rights or including veterinarians where there is potential for an animal to suffer because “something” raises a red flag when in reality it could be legitimate.

Once I have all the specifics, I’ll revisit this in a future post.

funny-dog-pictures-your-dog-has-a-tummyache

13 thoughts on “Veterinary Visits In Maine Just Got Complicated…

  1. Hi D! Thank you for highlighting thus sad sad situation….my soul really grieves for these lost in search of themselves and peace in a world that’s just chaos from birth to final resting. Praying for these forgotten ones tonight.

  2. Laws like this hurt more then help. An addict will find a loophole because that’s how they survive. Or an innocent owner has their privacy violated. God forbid their name pops up either because they are legitimately on several medications or human/computer error. Then who suffers? A helpless animal. There are no winners in laws like this.

  3. This is going too far. I agree America is seeing an unprecedented amount of drug abuse and deaths. But to expect a vet, trained and skilled in medical treatment of animals, to check on the owner’s meds and determine the milligrams etc is very wrong for man reasons. Vets are doctors who as you pointed out, constantly learn the latest techniques to help improve the care of our pets. Now the state wants them to get involved in human medication along with the rules & regs? As for HIPAA, my wife can’t even get one of my X-ray results from my doctor unless I authorize her in writing so what gives anyone working in animal health that right? No disrespect to vet staff but they simply don’t have that right. As a pet owner and American who takes my rights seriously, learning this really bothered me so I did some Googling before commenting. I couldn’t understand Maine’s PL488 but don’t understand bills and such. What shocked me was to learn how many states also require vets to check the owner’s drug use and for the life of me don’t know why owners allow it.
    https://www.avma.org/News/JAVMANews/Pages/170201a.aspx
    I also wonder if these laws will keep drug abusers from taking their pet for vet care? Is that fair to an innocent animal? Drug addiction is just that – an addiction like any other disease. Many of us have been touched by it in some way. I lost a family member 8 years ago. He wasn’t evil. He never stole from anyone to buy drugs and he never sold them. Not every addict is a trafficker or slimeball who could care less about their pet. They might be trapped by the power of drugs but it doesn’t necessarily mean they don’t care for their pet. Yet with laws like this, their animal would be denied pain relief if needed. It’s inhumane plus a losing situation. On the flip side, a record check on the owner could appear they’re misusing when in reality they’re not but because that red flag popped up their pet sufferers. You’re right in that there has to be a better way.

  4. This is government going too far! Absolutely disgusting that so many states are creating these laws. What is the sense of Hippa if some tech or office clerk from an animal doctors office can see a humans medical info?? Worse, how many helpless animals will suffer because their owner is an addict or a mistake is made???

  5. Seems Orwellian actually. Disturbing g as potential for both HIPAA violations against owner and suffering by animal. I don’t understand why those of us who are honest have to bare the burden of addiction when a judge simply gives them a slap on the wrist.

    1. It’s just another way of the government skirting their responsibility by dumping it on the shoulders of other professions and the people they serve. There probably are some people who use their pet to get drugs but I doubt it comes close to the number of convicted drug abusers the court lets go.

  6. On the other hand, you have drug seekers intentionally hurting their pets in order to get tramadol or buprenorphine from a veterinarian. Because they know veterinarians don’t have access to PDMP’s. This is happening more and more as people become more desperate for opioids. Something has to change.

    1. I agree that there are probably pet owners who have diverted their pets drugs or possibly hurt them to obtain drugs but expecting anyone who is connected with the pet to consent to a PMP search (that goes back 5 years) that doesn’t even tell WHY they are on the controlled meds is faulty. Theoretically this bill is also mandating that veterinarians practice outside their scope. The bill has provided human doctors the right to waivers in cases of end of life care yet not extended that to vets. In order for any bill to work as intended there must be continuity and fairness. PL488 says that no human without a waiver shall have access to more than 100 MMEs/24 hours. If said person is prescribed a 7 day supply which they pick up in one bottle during one pharmacy visit, they are in possession of much more than the daily allotment. I also have a problem with the fact that if I ask my friend to pick up my cat following surgery, she has to consent to a PMP search. What if she is on the high end of the daily allotment because of a chronic illness? My animal would be denied. No one wins and a pet is given a medication that will not be as effective. Addicts and traffickers are going to get drugs despite any obstacle thrown in their way. It’s the nature of the beast, the power of the grip of addiction. Having said that, why must those who don’t have ulterior motives be subjected to more and more scrutiny? I get carded to buy compressed air to clean electronics, carded to buy glue. Now they want to look at my drug history? They need to take a long hard look at the sentences being handed down to drug traffickers because in the past few weeks I’ve seen two get suspended sentences and one has a previous conviction. Thank you for commenting as I truly enjoy reading how other people view a topic. I apologize for not answering sooner. Between snow and veterinarian visits I’ve been on the road a lot.

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