‘Egregious’ breach of legislation

prescription pad doctor

A GP has been suspended for prescribing alprazolam, codeine, oxycodone and fentanyl without the proper authority

A general practitioner from western Sydney has been reprimanded and suspended for six months over his prescribing practices related to 20 patients.

The doctor was found to have prescribed alprazolam for 19 patients, and codeine, oxycodone and fentanyl separately to three individual patients, without the appropriate authority.

He prescribed alprazolam for a period exceeding two months, where he knew or ought to have been aware that 14 of the patients had a drug dependency.

All 20 patients were on an opioid treatment program.

His prescribing of alprazolam without authority was after the medication had been rescheduled to a Schedule 8 “drug of addiction”, which occurred from 1 February 2014.

The NSW Civil and Administrative Tribunal found the GP was “ignorant of the legislative requirements” to require an authority to prescribe alprazolam until he was told about them in a phone call on the 1 February 2016 by the Pharmaceutical Regulatory Unit (PRU), and again in a letter on the 3 February 2016.

However despite being put on notice by the PRU, the doctor continued to prescribed alprazolam without authority for two more years, conduct the tribunal described as “egregious”.

“Someone of [his] training and experience treating this cohort of patients should have known that an authority was required,” said the tribunal.

“The power to prescribe drugs of addiction and restricted substances is subject to strict legislative requirements which were not adhered to in this case … for more than two years.

“Risks of prescribing drugs of addiction to patients who are drug dependent are significant. Those risks include overdose and overdose deaths,” it said.

The GP maintained it was never his intention to flout the rules, and he had “only the welfare of (his) patients at heart”.

However the tribunal said his “conduct, while well intentioned, put his patients at risk of prolonged drug dependence, overdose and suicide.”

In relation to fentanyl prescribing for one patient, the doctor said while he was aware the drug was S8 he did not think he needed an authority unless prescribing for more than two months, and explained he had organised staged dispensing for the fentanyl by the local pharmacist.

The doctor did not respond to the allegation of prescribing codeine or oxycodone without an authority.

Each breach of the legislative requirements to obtain an authority constituted professional misconduct, the tribunal found.

The GP was reprimanded, and his registration as a medical practitioner was suspended for six months.

When the period of suspension has expired, he must practise under conditions including not possessing, supplying, administering or prescribing S8 or S4D drugs, except to prescribe on a medication chart for residential aged care patients.

He was also ordered to pay costs to the Health Care Complaints Commission.

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