To fight America’s opioid epidemic, lawmakers and regulators have clamped down hard on doctors’ prescribing practices.
But one avenue for obtaining prescription opioids appears to have been overlooked, according to a new study.
Millions of tablets
Veterinarians are prescribing large quantities of opioids to pets, raising concern that some people might be using Fido or Snuggles to feed their addiction.
Opioid prescriptions from the University of Pennsylvania’s School of Veterinary Medicine rose 41% between 2007 and 2017, even though the annual number of visits increased by just 13%, researchers found.
Penn Vet handed out 105 million tramadol tablets, 97 500 hydrocodone (Hycodan) tablets, and nearly 39 000 codeine tablets during the study period, results show.
“I think it would come as a surprise to everyone, the quantities,” said senior author Dr Jeanmarie Perrone, director of medical toxicology at the University of Pennsylvania’s Perelman School of Medicine.
Not just for pets
It’s very likely at least some of these drugs wound up being used by humans, said Emily Feinstein, executive vice president of the Center on Addiction.
“There’s a small percentage, I’m sure, of people in this data who are using their pets and an encounter with a veterinarian as a means of getting themselves opioids,” Feinstein said.
The US opioid crisis led to roughly 50 000 overdose deaths in 2017, according to the US Centers for Disease Control and Prevention.
Americans now are more likely to die from an opioid overdose than from a car or motorcycle crash, a fall, drowning or choking on food, a report issued Tuesday by the National Safety Council concluded.
Perrone initiated her study after vet school colleagues complained that they’d been getting a lot of after-hours calls from patients about filling opioid prescriptions for pets. They asked her advice about how to handle these requests.
“Before I went to talk, I asked them to pull all of their opioid prescriptions so I’d have an idea how often they actually prescribed opioids,” Perrone said. “To their shock and our shock, there were about 3 000 prescriptions a month.”
Perrone thought back to when she’d had her own dog spayed, and the vet handed her a bag of supplies to care for her recovering canine. She went looking for that bag.
“I found a bottle of tramadol I was given when my dog got spayed four years ago. It was still in the cabinet with all the dog stuff,” Perrone said.
Following general trends
After looking at Penn Vet’s prescribing practices, Perrone’s team obtained statewide prescription data kept by the US Drug Enforcement Agency for all Pennsylvania veterinarians.
Between 2014 and 2017, Pennsylvania vets doled out 688 340 hydrocodone (Hycodan) tablets, 14 100 codeine tablets, 23 110 fentanyl patches, 171 100 tablets of hydromorphone (Dilaudid) and 7 600 doses of oxycodone (Oxycontin), the federal data showed.
The findings were published in the journal JAMA Network Open.
The opioid epidemic stems from a shift in medical philosophy, in which pain’s role as a symptom to be treated became more prominent and the risks of opioid addiction were not fully appreciated, Feinstein said.
“Veterinarians live in the same society as the rest of us,” she said. “It’s not surprising to see the same trends happening in veterinary medicine as were happening in the rest of medicine. All of medicine was prescribing more opioids and thinking they were safe.”
Beyond the risk of people “vet shopping” for drugs, Feinstein said the numbers suggest pet cabinets across the country might contain opioids ripe for misuse.
Better pain management
“If there is someone with an opioid use problem in your circle, those leftover pills can become a temptation if they’re not safely locked up,” she said.
Dr John de Jong, president of the American Veterinary Medical Association, said he hasn’t seen any data to suggest that what was found in Pennsylvania is occurring elsewhere.
“First, this is a survey of veterinarians at a veterinary teaching hospital to which complex cases are referred and for which more extensive pain management is often needed,” de Jong said. “It is inappropriate to extrapolate results from a practice like that to primary care practices across the country.”
Second, pain management is a rapidly emerging field in veterinary medicine, de Jong said.
“The period of this study overlaps a period of significant growth in understanding pain and its impact on veterinary patients,” he said. “It is reasonable to expect that as knowledge grows, so will efforts to address related concerns. So, it’s very possible that this study doesn’t reflect overprescribing, but instead reflects appropriate prescribing representing better pain management in veterinary patients.”
At the same time, vets are starting to keep a closer eye on their opioid prescriptions, de Jong added.
“There appear to have been few confirmed cases of owners deliberately injuring their pets to obtain opioids,” he said. “We have heard more veterinarians share that they suspect some pet owners may be using their pet’s medications and asking for refills in advance of when those should be needed, or that they’ve lost or spilled medications, but this is anecdotal.”
These results suggest vets need to be urged as strongly as other doctors to prescribe opioids with care, said Dr Harshal Kirane, director of addiction services at Staten Island University Hospital in New York.
“Our national response to the opioid epidemic should leave no stone unturned,” Kirane said. “This work highlights that contemporary veterinary medicine uses a significant volume of opioid medications, yet lacks a systematic framework for safe opioid-prescribing practices. While the apparent scale of opioid medication management in animals is drastically smaller in comparison to humans, it still represents a powerful opportunity for practice improvement.”
In the meantime, pet owners should secure any opioids prescribed for their animals, and dispose of the drugs safely when they’re no longer needed, said Dr Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, New York.
“I feel like sometimes you don’t even think of it. It may slip your mind that the medication is there in the cabinet,” Krakower said. “Sometimes it’s not clearly marked as a human medication may be.”
People wave flags atop cars in traffic during a demonstration to voice support for the people of Palestine, at Toronto City Hall in Toronto, Ontario, Canada, on 15 May 2021.
between pro-Israel and pro-Palestine protesters in Montreal was condemned by
Canadian Prime Minister Justin Trudeau.
city police force intervened and declared the protests illegal after tensions
heightened and clashes broke out.
strikes killed 42 Palestinians in the Gaza Strip on Sunday, the worst daily
toll in almost a week of clashes.
– Canadian Prime Minister Justin Trudeau on Sunday condemned the violence and
“despicable rhetoric” that marked several weekend protests throughout
the country, after clashes between pro-Israel and pro-Palestinian protesters in
worst violence in years, sparked by unrest in Jerusalem, is raging between the
Jewish state and Islamist militants.
strikes killed 42 Palestinians in the Gaza Strip on Sunday, the worst daily
toll in almost a week of deadly clashes.
after protests in Montreal, Trudeau condemned what he said was “despicable
rhetoric and violence we saw on display in some protests this weekend”.
Everyone has the right to assemble peacefully and express themselves freely in Canada – but we cannot and will not tolerate antisemitism, Islamophobia, or hate of any kind. We strongly condemn the despicable rhetoric and violence we saw on display in some protests this weekend.
insisting on the “right to assemble peacefully and express themselves
freely in Canada”, Trudeau stressed in a tweet that there was no tolerance
for “antisemitism, Islamophobia, or hate of any kind”.
on Sunday, Montreal police used tear gas following clashes between pro-Israel
and pro-Palestinian protesters.
hundred demonstrators, draped in Israeli flags, had gathered in a central
Montreal square to express solidarity with the Jewish state.
‘Protesting is a right’
the protest started peacefully, tensions ratcheted up with the arrival of
pro-Palestinian demonstrators and clashes soon broke out.
SPVM, Montreal’s city police force, declared the protests illegal, and squads
of riot police intervened, using tear gas to separate and disperse the two
groups, according to an AFP journalist at the scene.
police spent much of the afternoon in pursuit of the pro-Palestinian
protesters, who spread out and regrouped in commercial streets in the city centre.
the clashes, Montreal Mayor Valerie Plante said on Twitter that
“protesting is a right”, but that “intolerance, violence and
anti-Semitism have no place here”.
Montreal is a city of peace.
thousand pro-Palestinian demonstrators had gathered on Saturday in central
Montreal to denounce what they said were Israeli repression and “war
crimes” in Gaza.
Israel”, some protesters chanted, while others held up a banner that read,
“Stop the genocide of Palestinian children”.
protests happened the same day in multiple Canadian cities, including Toronto,
Ottawa and Vancouver.
“A new app is offering you the chance to do just that.”
When writer Brandon Wong recently couldn’t decide what takeaway to order one evening, he asked his followers on social media app NewNew to choose for him. Those that wanted to get involved in the 24-year-old’s dinner dilemma paid $5 (£3.50) to vote in a poll, and the majority verdict was that he should go for Korean food, so that was what he bought…
NewNew is the brainchild of Los Angeles-based entrepreneur Courtne Smith. The app, which is still in its “beta” or pre-full release stage, describes itself as “a human stock market where you buy shares in the lives of real people, in order to control their decisions and watch the outcome”. For many of us that sounds a bit ominous, but the reality is actually far less alarming. It is aimed at what it calls “creators” — writers, painters, musicians, fashion designers, bloggers etc. It is designed as a way for them to connect far more closely with their fans or followers than on other social media services and, importantly, monetise that connection…
Whenever a vote is cast the creator gets the money minus NewNew’s undisclosed commission… In addition to voting, followers can also pay extra — from $20 — to ask a NewNew creator to do something of their choosing, such as naming a character in a book after them. But the creator can reject all of these “bids”, and if they do so then the follower doesn’t have to part with the money…
Co-founder and chief executive Ms Smith, a 33-year-old Canadian, has big plans for NewNew, and has some heavyweight backers. Investors include Peter Thiel, the billionaire co-founder of PayPal, and the first outside person to put money into Facebook. Others with a stake in the business include leading US tech investment fund Andreessen Horowitz, and Hollywood actor Will Smith (no relation to Courtne). Snapchat has also given technical support.
Saker was Australia’s bowling coach when Bancroft was caught trying to rough up the ball with sandpaper during the third Test against South Africa.
While refusing to be drawn on who knew what, Saker said “the finger-pointing is going to go on and on and on”.
“It’s like the underarm, it’s never going to go away,” he told Fairfax Media, referring to a 1981 incident when Trevor Chappell bowled underarm to ensure New Zealand lost a one-day match at the Melbourne Cricket Ground.
The notorious delivery is still cited in New Zealand and in cricketing circles as a prime example of unsporting conduct.
However, the ball-tampering scandal – dubbed “sandpapergate” – had a greater impact on Australian cricket, with the then-captain Steve Smith and his deputy David Warner suspended for a year from all cricket and stripped of their leadership roles.
Darren Lehmann also quit as coach and all the top brass from Cricket Australia left after a scathing review blasted their “arrogant and controlling” win-at-all-costs culture.
No one else among the team or coaching staff was held to account but Bancroft’s remarks in an interview with The Guardian newspaper hinted that the team’s bowlers at least knew about the plan.
“Obviously what I did benefits bowlers and the awareness around that, probably, is self-explanatory,” he said.
Saker added: “There was a lot of people to blame. It could have been me to blame, it could have been someone else. It could have been stopped and it wasn’t, which is unfortunate.
“Cameron’s a very nice guy. He’s just doing it to get something off his chest … He’s not going to be the last.”
In response, Cricket Australia said that if anyone had new information, they would look into it.
Saker said he was not opposed to a fresh investigation but added “I just don’t know what they’re going to find out.”
We live in a world where facts and fiction get blurred
In times of uncertainty you need journalism you can
trust. For only R75 per month, you have access to
a world of in-depth analyses, investigative journalism,
top opinions and a range of features. Journalism
strengthens democracy. Invest in the future today.
Washington – Miss Mexico was crowned Miss Universe on Sunday in Florida, after fellow contestant Miss Myanmar used her stage time to draw attention to the bloody military coup in her country.
Sunday night marked the Miss Universe competition’s return to television, after the pageant was cancelled in 2020 for the first time due to the coronavirus pandemic.
Andrea Meza, 26, finished first ahead of the Brazilian and Peruvian finalists in a flashy televised event, hosted by American actor Mario Lopez and television personality Olivia Culpo.
Former Miss Universe contestants Cheslie Kryst, Paulina Vega and Demi-Leigh Tebow (who won the title in 2017) served as competition analysts and commentators, and a panel of eight women determined the winner.
Dressed in a sparkling red evening gown, Meza tearfully walked the catwalk as Miss Universe for the first time, before rushing back for a group hug with the other competitors.
Meza beat more than 70 contestants from around the globe in the 69th installment of Miss Universe, which was held at the Hard Rock Hotel & Casino in Hollywood, Florida.
In the days leading up to the final competition, Miss Myanmar Thuzar Wint Lwin, who made the top 21, made waves when she used her time in the spotlight to bring attention to the coup in her country.
“Our people are dying and being shot by the military every day,” she said during her biographical video, which showed photos of her taking part in the anti-coup protests. “Therefore I would like to urge everyone to speak out about Myanmar.”
She also won the award for best national costume: during that competition segment on Thursday, she wore an outfit beaded in traditional Burmese patterns and held up a sign that said, “Pray for Myanmar.”
Myanmar has been in uproar since February 1, when the army ousted civilian leader Aung San Suu Kyi.
At least 796 people have been killed by security forces since then, according to a local monitoring group, while nearly 4 000 people are behind bars.
Miss Singapore Bernadette Belle Ong – who did not make the top 21 – also used the national costume portion to make a political statement.
Dressed in a glittering red bodysuit and matching thigh-high boots, she turned around to reveal her cape – in the colours of the Singaporean flag – was painted with the words “Stop Asian Hate.”
“What is this platform for if I can’t use it to send a strong message of resistance against prejudice and violence?” she wrote on Instagram alongside pictures of her outfit.
The United States in particular has seen a surge in anti-Asian violence in the past year, which activists have blamed on former president Donald Trump’s rhetoric, especially his repeated description of Covid-19 as the “China virus.”
The pageant has also drawn criticism in the past for objectifying the contestants.
In recent years, the competition has shifted image, focusing more on female empowerment and activism.