Car boot benzo sale pharmacist faces Tribunal

A pharmacist has been found guilty of professional misconduct, after buying benzodiazepines from another pharmacist out of a car boot in a high rollers casino car park

In December 2016, the manager and pharmacist in charge of a Sydney store told the Pharmaceutical Regulatory Unit of the NSW Ministry of Health that he had been supplying medicines, without scripts, to another pharmacist, from the boot of his car at the Star Sydney Casino car park.

This pharmacist said that he had been doing so because the second pharmacist, identified at the time as Person B, “was losing a lot of money at the baccarat tables and was only working one day a week”.

In October 2019, the first pharmacist was found guilty of professional misconduct and his registration was cancelled.

Regulators turned their attention to Person B.

Person B “vehemently,” denied these allegations, the Civil and Administrative Tribunal NSW has heard – and noted that in March 2017, the PRU had concluded that there was insufficient evidence to support the allegations, made by the first pharmacist, that he had been selling the drugs to Mr B.

However, the PRU did find that Person B had breached the regulations governing the dispensing of S4D drugs.

In September 2017 conditions were imposed on the pharmacist’s registration, including that he not possess, supply, dispense, administer or manufacture benzodiazepines. These conditions remain in force.

A complaint was referred to the Tribunal, alleging that the practitioner had contravened several provisions of the Poisons and Therapeutic Goods Regulation 2008; that he had been buying S4D drugs from the other pharmacist at Star City with the intention of selling them on to members of the public; and that his behaviour constituted professional misconduct.

The pharmacist continued to deny that he had been buying the drugs from the other pharmacist’s car boot.

During his own legal proceedings, the first pharmacist had said Person B had approached him, showing him his AHPRA registration and saying that he had been losing money.

He said Person B had asked for Rivotril, saying he knew people who were interested in buying more of it.

The first pharmacist said he gave Person B about 10 bottles of the benzodiazepine on the first transaction, later escalating to up to 30 bottles; these transactions progressed to Serepax 30mg, diazepam 5mg, and on occasion, temazepam.

“The Respondent suggested to the Tribunal that the basis on which he was providing the drugs to Person B was that he thought that as a pharmacist, it was simply a transfer of drugs from one pharmacy to another,” that Tribunal noted at the time.

“However, in cross‑examination, he admitted that he knew that the drugs were being provided to Person B for illicit purposes and that they were being sold to the public by Person B.

“The Respondent also told the Tribunal that he had received very little profit on the supply of the drugs and that essentially he was only rounding up to the nearest $5.00 from a wholesale price when selling them to Person B.”

The first pharmacist said he would not deliver a prearranged amount of medicine to Person B, but that the second pharmacist would simply take “everything” without checking how much was in the Pharmacy Guild plastic bag provided.

He would ring Person B and arrange to meet in the “high rollers” car park at the casino.

Person B had also reportedly borrowed around $19,000 from the first pharmacist, who became concerned about the amount of drugs Person B wanted, and whose marriage had broken down by the time he admitted his own behaviour.

The Health Care Complaints Commission characterised the second pharmacist’s evidence to a “bare denial” of the allegations made by the seller.

It contended that his evidence about his gambling habits was “evasive,” the Tribunal noted, and that he had not provided a plausible explanation for the “very large amount of money cycling through his bank account during the subject period”.

It also noted that the first pharmacist had likely not told the truth about the amount of money he was making from the sales of the stolen medicines.

The Tribunal found that the complaint regarding buying drugs from the car boot had been made out, and that Person B’s account of events was “quite implausible”.

The Tribunal also agreed that particulars of the complaint about Person B’s supply of drugs at the pharmacy where he worked had been largely proven.

These included dispensing S4Ds without recording the provider’s details on two occasions; and failing on occasion to record the supply of pseudoephedrine.

He also concurrently dispensed temazepam, diazepam and nitrazepam to one patient. He dispensed diazepam to this patient on July 8, 21 and 28 in 2015 – following his July 2 dispensing of 50 tablets of the medicine.

He dispensed around 625 tablets of temazepam 10mg to another patient in a period of 62 days.

He also inappropriately dispensed benzodiazepines to patients, despite the fact that they were also receiving methadone from the same pharmacy.

“We are satisfied that, considered as a whole, the conduct found by us to amount to unsatisfactory professional conduct is of a sufficiently serious nature to justify the suspension or cancellation of [Person B’s] registration,” the Tribunal decided.

Having found him guilty of professional misconduct, the Tribunal listed the proceedings for directions regarding a second stage of the matter later this month.

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  1. Peter Allen

    Benzos with methadone. Bad therapeutics. But I’ve seen it and it was not regarded as professionally culpable.
    What do we think?

    • Sean

      It depends on the patient. Diazepam for prevention of alcohol withdrawal seizures? I think there’s a solid case to be made for that; many people with opioid dependence have concomitant alcohol dependence. Someone who is at risk of withdrawal seizures should probably be detoxifying in an inpatient setting especially if they’re on methadone, but some patients don’t want to go to hospital. These patients will almost certainly be drinking alcohol if they’re not on diazepam anyway, which might actually put them at a higher risk of toxicity due to the variable alcohol dose in different drinks. Benzos for anxiety/sleep/muscle spasms? The risk:benefit ratio here definitely doesn’t favour benzos for patients on methadone, in my opinion.

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