There's abuse of every system. So should we just quit doing anything?
I don't think pet-food companies will be paying doctors to approve support animals, so probably most of this will have to come from the patients themselves.
Chinese fentanyl typically doesn't need a script.
The pill mill part of the opioid epidemic was decades ago. Today, access to pain meds is better described as a war on pain relief. People in chronic pain with no history of abuse are denied everywhere, every day.
I know a number of people who turn to the black market because it is their only option.
Twenty years ago I knew opioid addicts utilizing pill mills. I no longer do.
Today I know people in chronic pain buying illegal opioids because that is the best of their awful choices.
I suspect strongly that the people worrying about it being abused outnumber the actual instances of it being abused. I don't think there is rampant unchecked fraud.