North Carolina Gov. Roy Cooper has signed into law the Opioid and Substance Use Action Plan, which will require veterinarians to report gabapentin use, although the medication is not a scheduled drug.
The law goes into effect for pharmacies on March 1, 2024, and for veterinarians on March 1, 2025.
Veterinarians must report gabapentin only if they dispense more than a 48-hour supply and not if the drug is a component of a compounded prescription or dispensed in 100 gm dosages or less, according to Claire H. Holley, executive director of the North Carolina VMA.
Gabapentin is commonly abused in combination with illicit opioids, and studies have demonstrated that the pairing substantially increases the user’s risk of opioid-related death. More than 36,000 North Carolinians died from a drug overdose from 2000 to 2022.
“We suspect that [the law] was enacted in an attempt to curtail misuse, diversion, and doctor shopping, much like the premise for the STOP Act,” Holley told AVMA News.
The 2017 Strengthen Opioid Misuse Prevention (STOP) Act requires veterinarians to report controlled substance prescriptions to the state’s Controlled Substance Reporting System.
The U.S. Food and Drug Administration has not approved gabapentin for animal use. Still, many veterinarians use the medication off-label to treat conditions such as nerve pain, canine and feline anxiety, seizures in dogs, and feline hyperesthesia syndrome.
Cary, North Carolina, practitioner Dr. Jennifer Jones Shults told AVMA News that many veterinarians have stopped dispensing more than a 48-hour supply of controlled medications because of the technical, time-consuming reporting process.
“Many practitioners prescribe and dispense gabapentin multiple times a day,” Dr. Shults said. “I do think you’ll see a shift with more outside prescriptions rather than in-house dispensing, as has happened with controlled substances.”