A bill exempting Alaska veterinarians from the state’s prescription drug monitoring program is headed to Gov. Mike Dunleavy’s desk. The measure, House Bill 56, is sponsored by Rep. Justin Ruffridge, R-Soldotna, and received nearly unanimous support in both the House and Senate.
Alaska’s prescription drug monitoring program, or PDMP, monitors the prescription of Schedule II-IV controlled substances. The program is meant to improve patient care and reduce the misuse and abuse of controlled substances. It became mandatory for health care providers, including veterinarians, to report to the program in 2017.
Those in favor of exempting veterinarians from the program say it inefficiently regulates a group that largely does not prescribe opioids. Those opposed worry the exemption could create a loophole through which people with substance use disorders could receive controlled substances without appearing in the state database.
Ruffridge told the Clarion earlier this year that, in bringing the initiative forward, he sought to bolster patient privacy, recognize that the program wasn’t designed with veterinarians and to acknowledge that less than 0.3% of all opioid prescriptions come from veterinarians.
Alaska’s PDMP, for example, allows a veterinarian to input a pet patient’s name and birthday, but doesn’t have a section to indicate the animal’s species.
The program also allows veterinarians prescribing a controlled substance to an animal to see whether or not the pet’s owner has ever been prescribed a controlled substance, as veterinarians are not subject to the Health Insurance Portability and Accountability Act, or HIPAA.
Ruffridge wrote in the bill’s sponsor statement that the practice poses a “major privacy concern.”
“(Veterinarians) are currently required by their licensing board and the State of Alaska to perform this task,” Ruffridge wrote. “When asked, many pet owners are not aware that their veterinarian would have access to any part of their medical information, and they are often concerned about veterinarian access to this private information.”
That’s on top of the fact that less than one half of one percent of all opioid prescriptions come from a veterinarian. The most commonly prescribed controlled substance by veterinarians is phenobarbital, which is commonly used to treat pets in seizures and is not a narcotic. Phenobarbital is a Class IV controlled substance, which falls under the purview of the PDMP.
Per the U.S. Department of Justice, Schedule II controlled substances are those that have a high potential for abuse, such as morphine, oxycodone and codeine. Schedule III controlled substances have less potential for abuse but may lead to dependence and Schedule IV substances have a low potential for abuse relative to Schedule II and III substances.
H.B. 56 while in the Senate Labor and Commerce Committee was amended to expand the ways veterinarians can become licensed to practice in Alaska. If the bill is signed into law, the Alaska Board of Veterinary Examiners would now have a certification process for veterinary licensing and recognize completion of a widely used veterinary equivalency program.
Ruffridge said Monday he thinks his familiarity with the program as a pharmacist and a neutral letter on the bill from the Alaska Medical Association, which has previously opposed the bill, helped move the legislation forward. The Alaska Pharmacists Association also submitted a letter in support of the bill.
“I’ve worked with the PDMP myself,” Ruffridge said. “I know what it looks like and for there to be a person on the other end of the bill who can speak to those issues I think really helps. I think the second component is realizing that the PDMP isn’t a perfect system and there’s probably some bigger changes that need to be made with it to make it function a little better.”
Broad support for the legislation in both the House and Senate, Ruffridge said, was good to see. The bill garnered 28 cosponsors in the House and 11 cosponsors in the Senate, with only one lawmaker across both chambers voting in opposition. Both Sen. Jesse Bjorkman, R-Nikiski, and Rep. Ben Carpenter, R-Nikiski, are cosponsors of the legislation.
“Getting it across the finish line with broad bipartisan support and almost unanimous support was a big deal,” Ruffridge said.
Alaska State Medical Association Executive Director Pam Ventgen wrote in a Feb. 16 letter to Ruffridge that the group has followed state debate over whether or not veterinarians should participate in the PDMP for several years. The association has previously opposed efforts to exempt veterinarians, citing the need to curb misuse of prescription drugs in Alaska.
“While we still have concerns over illegal prescription drug use it is clear that the current PDMP does not work for veterinarians and there isn’t currently a path forward to alter the PDMP to mitigate the impacts of its use by veterinarians,” Ventgen wrote. “Given the reality of the situation and Alaskan’s need for veterinary care, ASMA has adopted a new position and does not oppose HB56 and its goal to reduce PDMP burdens on veterinarians.”
Dr. Jim Delker co-owns Twin Cities Veterinary Clinic with his wife and serves as the legislative liaison for the Alaska Veterinary Medical Association. He wrote in a Jan. 28 letter in support of the bill that, in addition to being burdensome to veterinarians and a privacy concern for pet owners, the PDMP is redundant because veterinary use of opioids in clinics is already monitored by the U.S. Drug Enforcement Agency.
“Once in the clinic the DEA requires us to maintain controlled drug inventories, as well as tracking each individual dose given to each patient in the clinic setting,” Delter wrote. “These measures ensure proper inventory counts as well as serving as an audit trail for any discrepancies that may occur. Removing Veterinarians from the PDMP will have no reduction in DEA oversight.”
The bill now heads to Dunleavy’s desk, where Ruffridge said he is not expecting any resistance.
“It was really good to see, you know, the support of the entire Legislature on this,” Ruffridge said. “It’s very rare that you have that level of support for a bill that previously had some controversies. (I’m) really happy to see that we were able to get it over the finish line.”
More information about H.B. 56 can be found on the bill webpage at akleg.gov.
Reach reporter Ashlyn O’Hara at email@example.com.