Thomas Graham, DVM, PhD, used to keep controlled substances in a locked box in his vehicle. A cattle practitioner outside of Sacramento, Calif., Graham often practices veterinary medicine at ranches and production facilities outside his clinic walls. Then last year an e-mail from the U.S. Drug Enforcement Agency (DEA) popped up in his inbox, and that was the end of the locked box.
Graham was notified that by transporting controlled substances off his clinic premises, he was in violation of the Controlled Substances Act (CSA). Many mobile veterinarians work with the understanding that the CSA is not enforced in regard to their work and that using a locked box to carry drugs is acceptable. “That’s what we were told was compliance,” Graham says.
But veterinarians across California, specifically those who list their home address as their principal place of business, as Graham does, have been receiving similar notifications. According to Grant Miller, DVM, director of regulatory affairs for the California Veterinary Medical Association, the DEA is contacting veterinarians to confirm that the address provided is where controlled substances are stored and dispensed. “If the registrant offers information about being a mobile practice or ambulatory service, then that triggers the DEA enforcement officer to notify the registrant of a violation,” Miller says.
The law requires practitioners to register every location where they store, distribute or dispense controlled substances. Before, the DEA seemed to treat veterinarians as an exception to the CSA, but now, at least in California, it is leaning toward enforcement. “It’s our charge and our mandate to enforce the Controlled Substance Act. Those in violation could receive scrutiny,” says Rusty Payne, a spokesman for the DEA—but he does concede that this is a difficult issue.
Ashley Morgan, DVM, assistant director of the American Veterinary Medical Association (AVMA) Governmental Relations Division, says the DEA is maintaining that it cannot “accommodate” mobile registrants, including veterinarians. “The DEA interprets the Controlled Substances Act in a way that requires veterinarians to register at each location where they want to administer or dispense a controlled substance,” Morgan says. “And the DEA says the regulations resulting from the law cannot be changed through rulemaking.”
The AVMA contends that the Controlled Substances Act was not written with veterinarians and their unique circumstances in mind. A letter to the DEA signed by U.S. Congressmen Kurt Schrader, DVM, Frank Lucas and Collin Peterson was sent in October 2012 to address the issue.
“At this time, the DEA is still in the process of responding to the congressional letter, which requested technical assistance in drafting legislative language to change the Controlled Substances Act to address the issue veterinarians face,” Morgan says.
DEA spokesman Payne says the agency is aware of the issue and is working to find a satisfactory solution, but reiterated that it would take legislative changes to the CSA. “We do want to solve this issue,” Payne says. “There could be a legislative fix where there was a carve-out for veterinarians.”
Those affected by the current status of enforcement are anxious for a speedy resolution. “[The] AVMA has been working closely with congressional offices and stakeholders on this issue, which seems to be noncontroversial, and believe that legislation will be introduced this Congress,” Morgan says. “We are hopeful that it will pass without delay.”
Graham, for one, also hopes the issue will be resolved soon. As a cattle practitioner, no longer carrying controlled substances is less of a concern for him than it is for others, he says. For example, mobile small animal and equine practitioners who regularly provide euthanasia services need to be able to transport the required controlled substances to the appropriate location—there are humane, emotional and quality-of-practice issues at stake. If a veterinarian is prevented from bringing euthanasia supplies along on a visit, “you’re at a point where you can’t relieve pain and suffering,” Graham says.