For veterinarians treating livestock in the field or making house calls to pets, traveling in vehicles outfitted with much of the equipment of a brick-and-mortar hospital is a given. Yet the legality of an essential component of mobile practice has been in question since 2012 when California veterinarians with mobile practices registered to their home addresses began receiving letters from the U.S. Drug Enforcement Agency (DEA) warning that they were in violation of federal law for transporting controlled substances.
Legislation to clarify a murky facet of the Controlled Substances Act (CSA) passed a congressional hurdle this month.
The Veterinary Medicine Mobility Act would amend the law to exempt veterinarians from a provision that controlled drugs may not be transported from the address of the DEA registrant.
The House Subcommittee on Health passed HR 1528 to the full House Energy and Commerce Committee on April 3, moving the bill one step closer to approval.
The Senate passed its version of the mobility act, S 1171, on Jan. 8.
Dr. Ashley Morgan, assistant director of the Governmental Relations Division of the American Veterinary Medical Association (AVMA), hopes the legislation will put an end to the mixed messages the veterinary profession has received from the DEA.
“We have seen conflicting statements from the DEA,” said Morgan, referring to statements in the press and correspondence to congressional offices.
DEA spokeswoman Dawn Dearden told the VIN News Service by email in May 2012 that “any violation of the CSA could result in criminal and/or administrative action.” She said the agency’s position was that DEA registrants need to register for each location that they maintain supplies of, administer or directly dispense controlled substances.
But in May 2013, responding to an inquiry from Rep. Kurt Schrader, a Democrat from Oregon and a veterinarian, DEA Deputy Chief of Congressional and Public Affairs Eric J. Akers wrote: “… a veterinarian who is registered with the DEA to dispense controlled substances at a particular location in a state may travel to other unregistered locations in the same state to dispense controlled substances on an ‘as-needed and random basis,’ provided that he/she does not maintain a principal place of professional practice at any of these other locations.”
The letter to Schrader not withstanding, Morgan said, “We still have nothing in writing for veterinarians. We’re still having veterinarians told by field offices that veterinarians can’t register at home offices and transport controlled substances.”
At the same time, the AVMA isn’t aware of any disciplinary action being taken by the DEA against mobile veterinary practitioners, according to Morgan.
As currently written, the CSA prohibits those with a DEA license from transporting controlled substances including drugs used for pain control, and most drugs used for anesthesia and euthanasia. The proposed amendment exempts veterinarians from this restriction by adding the following paragraph to the law:
"... a registrant who is a veterinarian shall not be required to have a separate registration in order to transport and dispense controlled substances in the usual course of veterinary practice at a site other than the registrant's registered principal place of business or professional practice, so long as the site of transporting and dispensing is located in a State where the veterinarian is licensed to practice veterinary medicine and is not a principal place of business or professional practice."
According to Morgan, the only early opposition to the bills came from the DEA. “Months ago ... DEA sent messages to congressional offices saying it wasn’t necessary. Later in the fall, the same thing,” she said. “But since that time, (we) haven’t heard that they have been making contact with the Hill. They are the only ones that had any possible issues.”
DEA Public Affairs Officer Barbara Carreno, reached by email, told the VIN News Service she would look into the agency’s position on the pending legislation. But two days later, she had not responded further.
Of late, all parties appear to be united in wanting greater legal clarity on the topic, Morgan said: “This issue has the support of pretty much any stakeholder, animal interest group. It’s a win across the board.”
In the meanwhile, the AVMA has this advice for veterinarians: "Veterinarians should adhere to the federal and state laws while providing care to the best of their ability.” Morgan acknowledged that following this advice may put veterinarians between a legal rock and a medical hard place. She said, “AVMA recognizes that in order to meet some of the needs of being able to provide appropriate care, veterinarians may not be able to adhere to the federal law of not transporting controlled substances.”
Dr. Fred Gingrich, a dairy veterinarian in Ohio, knows this balancing act all too well. He hasn’t let the uncertainty change the way he practices medicine. “Although it makes me slightly concerned because what I’m doing is illegal, there’s no way for me to practice without breaking the law,” he said.
“I think for us, the controlled substances in cattle, it’s a humane issue,” he continued. “It’s an animal welfare issue. We use (the drugs) for analgesia, anesthesia or euthanasia. I’m not going to stop providing those services because some bureaucrat tells me I can’t, when I have everything else in order.”
Gingrich sees this part of the CSA as “an oversight on the part of the DEA,” and has provided input to Morgan and the AVMA in the hopes of having that oversight corrected. “I think this is an area where AVMA has done a fabulous job of advocating for veterinarians,” he said.
Should the Veterinary Medicine Mobility Act pass, resolution is unlikely to be instantaneous. “If or when the bill passes, there is still the implementation component,” Morgan said. “We don’t know what that’s going to look like. We don’t know what that application or registration process is going to look like. That’s not something we can define in statute.”
Morgan stressed that veterinarians should remain vocal about their practice needs and engaged in the process. “We will need to hear from veterinarians as they go through the process of registering — whether in one location or multiple states,” she said.
Gingrich will be one of those commenting. “I am absolutely willing to provide input because it’s important to me,” he said. “As a veterinarian, we’ve taken an oath to relieve animal pain and suffering. Just because (the patient is) a food animal, I’m still going to do that.”