A NSW doctor has had her registration cancelled for repeatedly prescribing large amounts of opioids and benzodiazepines to drug-seeking patients
The GP, who cannot be named for legal reasons, has been brought by the HCCC before the NSW Civil and Administrative Tribunal for her prescribing behaviours in regards to 15 different patients.
These behaviours include overprescription of oxycodone, morphine and fentanyl, in many cases alongside benzodiazepines and at inappropriate levels, to patients who the respondent admitted were exhibiting drug-seeking behaviours.
In one case, over a two-year period the respondent prescribed a single patient (Patient B): 2,160 5mg diazepam tablets; 675 5mg oxazepam tablets; 460 5mg nitrazepam tablets; 380 5mg oxycodone tablets; 490 40mg oxycodone tablets; 1,606 80mg oxycodone tablets; and 60 10mg temazepam tablets.
Another patient (Patient C) was prescribed over the course of 14 months: 550 5mg tablets of diazepam; 84 30mg oxycodone tablets; and 224 40mg oxycodone tablets.
Thirteen other patients were found to have been prescribed drugs in a similar way.
After hearing all the evidence, the tribunal found the respondent had:
- Consistently and inappropriately prescribed drugs of addiction to a large number of patients with histories of drug dependence or who were seeking drugs of dependence;
- Failed to carry out any proper medical assessment in most cases;
- Prescribed at a dosage which is inappropriate;
- Inappropriately combined opioids with benzodiazepines;
- Failed in some instances to make referral to a specialist
- Failed to obtain an Authority as required by statute; and
- Failed to create and keep proper medical records.
An expert witness told the tribunal that in all cases the respondent should have taken “a good thorough history”, performed proper examinations, created management plans, consulted a specialist, and made enquiries from the “Doctors Shoppers Hotline” or the Methadone users register before prescribing.
In a statement to the tribunal, the respondent said she had no or little exposure in dealing with chronic pain patients and had been “too dependent” on guidance from more experienced fellow practitioners at the medical centre where she worked.
“I think this dependency and subservience resulted from a lack of knowledge about drugs of addiction and drug addicts,” she said.
Despite this, the respondent accepted responsibility for her misconduct, saying she did not know how to appropriately prescribe drugs of addiction to difficult or drug-seeking patients.
She conceded that she was guilty of professional misconduct as well as unsatisfactory professional misconduct, and expressed her “shame and embarrassment” regarding her misconduct and the complaints brought against her.
Although at the time of the hearing the respondent said she is now more confident in her professional ability to appropriately prescribe these types of drugs, the tribunal decided her actions were of “a very serious nature” that could not be overlooked.
“We acknowledge that the respondent has asserted that she has learned from her past mistakes… However, apart from these bald assertions we have no specific evidentiary material upon which to accept what the respondent now says.
“We have grave doubts concerning the ability in general of the respondent to safely practice medicine,” they added.
The tribunal ordered the respondent’s registration as a medical practitioner cancelled, with no possibility to apply for review until 18 months after the decision date in late November.
The respondent was also ordered to pay costs for the HCCC.