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Safe Prescription of Opioids in Veterinary Care is no longer available for free; however, the course is available for a small fee.

Research Says Oral Opioids Don't Work in Dogs

As a growing number of states—including Illinois—mandate training for opioid prescribers, experts from the University of Illinois College of Veterinary Medicine have released "Safe Prescription of Opioids in Veterinary Care," a free online course that covers appropriate use of outpatient opioid prescriptions, drug disposal techniques, and alternative pain management strategies.

"To combat the human opioid epidemic, many states are in the process of mandating training programs for opioid prescribers to help reduce unnecessary prescriptions," said Dr. Maureen McMichael, a specialist in small animal emergency and critical care and one of the creators of the course. "This video module is designed to address these issues on the veterinary side of the equation."

Drs. Stephanie Keating and Ashley Mitek, both boarded in veterinary anesthesia and analgesia, led the development of the continuing educational module. Further input and review of the module was provided by Dr. William Weir, an emergency medicine physician, and the late Dr. Gary Stamp, founder of the Veterinary Emergency & Critical Care Society.

The module cautions about unwarranted prescription of oral opioids and provides advice on effective pain management for veterinary patients.

[Editor's note: Two additional online modules on veterinary opioid prescription have also been created and can be found on the i-Learning Center website.]

Rethinking Prescription of Oral Opioids in Dogs

When a dog is hospitalized and in acute pain, intravenous opioid administration is one of the best pain management options available, according to Dr. Keating. But intravenous drugs are not an option for an animal at home.

"We have lots of good evidence that dogs respond favorably to injectable opioids, but the same is not true for the opioid tramadol when given orally," said Dr. Keating. (See more on development of the module.)

The way dogs absorb and metabolize oral tramadol may hinder the drug's pain-reducing effects, she said. And yet, veterinarians routinely prescribe this drug in oral form for dogs when they leave the hospital after surgery or other traumatic events.

"Oral opioids are still commonly prescribed to canine patients, despite research illustrating their lack of effectiveness," added Dr. Mitek. "While our scientific understanding of how dogs respond to oral opioids has evolved over the years, prescriber behavior hasn't changed, due in part to challenges in disseminating updated information to practitioners. We hope this online course will empower and educate veterinarians to treat pain effectively in dogs."

Changing Current Practices May Help Opioid Crisis

In addition to more effectively treating pain in canine patients, a shift away from sending dogs home from the hospital with tramadol in pill form may also help address the human opioid crisis by reducing the circulation of prescription drugs that could be abused by people.

Five video lectures developed for the course are publicly available at go.illinois.edu/FreeOpioidCe. Veterinarians and veterinary technicians visiting that link can sign up for one hour of free veterinary continuing education, which combines the lectures with case studies and assessments, through the college's i-Learning Center.

1. Are veterinarians in Illinois required to take continuing education on safe opioid prescribing?
   Yes! If you hold a controlled substance license in the Illinois, you are now required to take 3 hours of continuing education on Safe Opioid Prescribing by January 2021.
   This legislation was passed in 2018. To read more about SB 2777 you can visit: http://ilga.gov/legislation/publicacts/fulltext.asp?Name=100-1106
2. But I thought Illinois veterinarians were now exempt from the Prescription Monitoring Program (PMP)? I'm so confused!
   Correct! Veterinarians in Illinois are now exempt from the PMP. However, the legislation requiring controlled substance providers to take 3 hours of CE on Safe Opioid Prescribing still stands. (Many other states have adopted similar CE requirements for veterinarians in an effort to help combat the nation's opioid epidemic.)
3. Does the online Safe Opioid Prescribing course offered by the University of Illinois College of Veterinary Medicine fulfill the new requirement for veterinarians, as described in SB 2777?
   Yes! This online course was specifically developed to meet the requirements for this legislation. The Illinois Department of Professional Regulation has confirmed that the College of Veterinary Medicine may offer this continuing education online to fulfill the requirements in SB 2777.
4. In Illinois, is there a maximum number of CE hours I can obtain online?
   No! You may obtain all of your CE online from an approved vendor. For additional information please visit: https://go.illinois.edu/jcaradmincode1500
5. I live in a state other than Illinois. Does this Safe Opioid Prescribing Course fulfill CE requirements for veterinarians in other states?
   We recommend that you review your state's CE requirements for veterinarians to ensure this course fulfills licensing requirements. In most cases, this online course will comply with your state's requirements. However, at this time, we can only guarantee that it fulfills licensing requirements for Illinois veterinarians.
6. What will I learn from this continuing education module?
   This module was developed by veterinarians with board certification in anesthesia and emergency/critical care, with input from a physician with expertise in opioid abuse, to provide veterinary practitioners with clinically relevant information on the appropriate use of opioids in veterinary patients.
7. I am a pharmacist. May I enroll in this course?
   Yes! This course is free and available to anyone (including non-veterinarians) around the world. However, at this time, we are only legally allowed to issue continuing education credit to veterinarians and veterinary technicians.
   If you are a pharmacist, physician, or other non-veterinary medical staff, and wish to take our course for CE credit, please email: ope@vetmed.illinois.edu
8. I'm a veterinary technician. May I take this course for CE credit?
   Yes!

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Source: https://vetmed.illinois.edu/2019/10/14/free-online-c-e-veterinary-opioids-2/

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