The Food and Drug Administration's famous tweet from August: "You are not a horse."

CORRRECTED

When some neighbors of William Joseph Roberts needed medicine, they turned to their local feed store over a doctor or pharmacy.

Roberts, a writer in rural northern Georgia, said it was not uncommon for people in his community to use veterinary medicines to self-medicate.

“Antibiotics, some pain killers, anti-inflammatories… Mainly it was 1) convenience, and 2) price,” Roberts said. “A few folks I know got them through someone, not sure if it was a dealer or someone who worked at a vet clinic, but they got what they needed based on what scripts they had been given in the past. It was easier to just get (animal medications) than to get a new (human) script.”

Roberts said it was a common thing in north Georgia and in West Virginia where he grew up.

A mistrust of doctors and surgeries that left them in pain added to their decisions to use veterinary medicines instead of human ones, he said.

The use of veterinary medications on humans is in the news because the anti-parasitic drug ivermectin has been falsely touted as a treatment or cure for Covid-19. There are no published studies supporting ivermectin’s use in treating Covid-19, and the Food and Drug Administration warns people not to self-medicate with it, especially in dosages formulated for animals. In a tweet, the FDA stated: “You are not a horse. You are not a cow. Seriously, yall. Stop it.”

“They won’t listen to us when we say, ‘Do not take animal medicines, they are not safe or effective in any way…’ But yet if they choose to do that and they go to the hospital, they expect the physician and the pharmacists to treat them.

Elaine Blythe, veterinary pharmacist

Experts say those who use veterinary medicines put themselves at risk.

The list of medications used in humans that are also used in animals is long. From amoxicillin to meloxicam to doxycycline to propofol, the names may be the same, but the uses and composition may be different.

Members of the Appalachian Americans group on Facebook were split on whether it was a common practice in rural America or not.

While many said they’d never heard of the practice, others said it was common. Users mentioned using fish antibiotic, horse tranquilizers and horse liniment for joint pain.

Elaine Blythe, a veterinary pharmacist and member of the American Pharmacists Association, living in central New Mexico, said that up until recently human use of animal medications was limited to recreational drug abuse.

“Twenty years ago ketamine was actually a fairly common drug of abuse,” Bryant said. “If you’re going to use ketamine, you want the good stuff, right? You want a veterinary formulation. Ketamine for a long time was prescription, and it got elevated to controlled substance status because of human abuse.”

To say rural residents were commonly self-medicating with animal medications would be stretching it, she said. While rumors circulated of people using medicines purchased from places like Tractor Supply or livestock supply stores, she said, they weren’t frequent.

Tractor Supply said in an emailed statement that it only sells medications for animals.

“The veterinary medicines we offer are only suitable for animals and are clearly labeled as such,” the company said. “Our policy is to have them available for our customers to use to treat their animals only.”

One common rumor was people taking Fish-Mox, an antibiotic meant for ornamental fish.

The FDA warns against using fish antibiotics. The antibiotics are not approved for use in humans or animals, the agency said, and without approval, there’s no guarantee the product even contains the medicine it claims to contain.

“The FDA is concerned about the health of consumers who may self-medicate by taking products, like ivermectin, intended for animals,” a spokesperson for the FDA said in an email interview. “People should never take animal drugs, as the FDA has only evaluated their safety and effectiveness in the particular animal species for which they are approved. These animal drugs can cause serious harm in people.”

Drugs for large animals are often highly concentrated, the agency said, because of the animals’ weight, which would make the dose highly toxic in humans. While some veterinary drugs have the same name as human drugs, the two are not the same, the agency said.

“The FDA reviews drugs not just for safety and effectiveness of the active ingredients, but also for the inactive ingredients,” the agency said. “Many inactive ingredients found in products for animals aren’t evaluated for use in people, or they are included in much greater quantity than those used in people. In some cases, we don’t know how those inactive ingredients will affect how products are absorbed in the human body.”

One of the biggest problems with taking animal medications, Bryant said, is that researchers don’t know what it might do.

“We do not know anything about their adverse effects or their profile, as we typically call it, or perhaps even a contraindication because (they) have never been studied for safety and efficacy in human patients,” she said. “When people do make that choice, when they later present to a health care entity, even in an emergency department, physicians are saying, ‘I don’t know how to treat this patient who took a vet medication, we don’t have any data on that.’”

The current trend of taking animal medicines to treat human diseases baffles her, she said.

“I never thought we’d be here, where people won’t listen to the scientists, the epidemiology virologist, the pharmacist, the physicians, the veterinarians, and the organizations that represent those trained and educated people,” Bryant said. “They won’t listen to us when we say, ‘Do not take animal medicines, they are not safe or effective in any way…’ But yet if they choose to do that and they go to the hospital, they expect the physician and the pharmacists to treat them.”

CORRECTION: An earlier version of this story incorrectly reported that Bag Balm contains estrogen and that the product had caused an infant to exhibit signs of puberty. The maker of the product, Vermont’s Original LLC, lists ingredients as petrolatum, lanolin, paraffin wax, water, and 8-Hydroxyquinoline Sulfate (0.3%). The product is marketed for both human and animal use on Vermont’s Original website. We are sorry for our error.