Drug reporting changes to impact NC veterinarian offices

In North Carolina, the veterinary community is bracing for a transformative change as the state gears up to enact a law requiring vets to report the use of Gabapentin,  a medication often employed for pain management in animals. This legislative shift, which will come into effect on March 1st, 2024, after a bill was signed into law by Governor Cooper, is designed to enhance transparency and accountability in the usage of this medication. This move by the state has sparked discussions within the veterinary profession, particularly in light of the ongoing debate over the scientific support for Gabapentin's use in animals.
Gabapentin has long been a staple in veterinary medicine, utilized for managing both acute and chronic pain in animals. However, the scientific evidence supporting its use in this manner remains a topic of debate. '
 
Dr. Richard Joseph is a board certified veterinary neurologist and the founder of Veterinary TeleSpecialty by VOCN explains use of gabapentin in animals.
In human medicine, Gabapentin plays a crucial role in managing neuropathic pain, which results from nervous system damage or dysfunction. This medication operates by altering the way NERVES in the brain transmit messages. The underlying theory is that by reducing the transmission of these messages, pain can be alleviated. However, it is important to note that Gabapentin has not demonstrated effectiveness in treating deep pain, known as nociceptive pain, which arises from the stimulation of pain receptors due to tissue injury.
The debate over Gabapentin's effectiveness in veterinary medicine is further fueled by scientific studies and case reports. A 2017 study on cats undergoing ovariohysterectomy found that Gabapentin, when used as an adjunctive analgesic, did not provide better pain control than buprenorphine alone or the combination of buprenorphine and meloxicam.
Conversely, a 2018 study suggested that Gabapentin had a positive impact on the activities of osteoarthritic cats, based on owner perceptions. HOWEVER, A 2012 study in dogs following hemi-laminectomy  found that a 10 MILLIGRAM per kilogram dose of Gabapentin administered orally twice daily did not significantly reduce pain behavior when compared to opioid therapy.
Also, a 2015 study indicated that peri-operative Gabapentin reduced postoperative morphine requirements in dogs following mastectomy. It's worth noting that this study cited limitations, including non-homogenous groups and variations in mastectomy extent.
In human medicine, the co-administration of Gabapentin with opioids has been shown to increase the absorption of opioids by the body, leading to the classification of Gabapentin as a controlled medication in some states. Several states, including Kentucky, Virginia, West Virginia, Michigan, and Tennessee, have already reclassified Gabapentin as a controlled substance, while others require the tracking of Gabapentin prescriptions.
In light of these ongoing debates and regulatory changes, veterinarians in North Carolina are tasked with adapting to the new reporting requirements for Gabapentin usage.  As the March 1st deadline approaches, the North Carolina veterinary community will continue to grapple with the evolving landscape of Gabapentin usage in their practice.
 
 
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