A GP has been suspended for continually overprescribing addictive drugs, despite concerned colleagues repeatedly telling him to stop
A Victorian general practitioner has been reprimanded and temporarily suspended following serious allegations relating to high levels of opioid and benzodiazepine prescribing.
The conduct related to three patients, and spanned an extensive period of time between 2005 and 2012.
In early February, the Victorian Civil and Administrative Tribunal (VCAT) heard that the GP, who has been practising since 1980, had prescribed drugs of dependence to Patient MW between June 2007 and May 2012, despite knowing that MW was a drug-dependent person.
Medical records at the clinic in which the GP practised stated that MW had a history of drug abuse, doctor shopping and illicit drug use.
MW’s mother had also written to the GP in both 2008 and 2010 sharing concerns that MW was being prescribed too much Xanax and painkillers, and asking that MW’s medication be dispensed responsibly several times a week by a pharmacy.
She also advised the GP that MW regularly overdosed on Xanax, and sometimes sold or exchanged the medication prescribed to him on the street in order to buy alcohol or other drugs.
The GP was also contacted several times by local health services saying his prescribing was interfering with MW’s psychiatric care, and a fellow GP made a note in 2007 that MW was not to be prescribed benzodiazepines by any GPs practising at the clinic.
Despite his colleagues’ warnings and letters of concern from his patient’s mother, the GP continued to prescribe benzodiazepine medication to MW up until 2012.
From 2007 to 2011, the GP also prescribed a second patient (Patient MR) morphine slow release capsules as well as oral morphine mixture in “doses and quantities … which were excessive”.
Specialists contacted the GP sharing their concerns that MR’s opioid medications were “inappropriately high” and that she had a history of drug abuse.
Despite being advised by another practitioner treating MR to cease or reduce prescribing certain drugs of dependence to the patient, the GP continued to prescribe them in a manner contrary to that advice.
Furthermore, the GP prescribed “excessive” doses and quantities of codeine, morphine, oxycodone, oxazepam and diazepam to a third patient (Patient MC), the tribunal heard.
On 28 September 2012, the GP pleaded guilty before, and was convicted by, the Magistrates’ Court of Victoria of 96 charges, of having breached the Drugs Poisons and Controlled Substances Act 1981 (Vic) and its regulations.
After reviewing all the evidence, the tribunal concluded that the GP had engaged in “unprofessional conduct of a serious nature” in that his prescribing of drugs of dependence to the three patients was “clinically inappropriate and excessive”.
“The conduct in which [the GP] engaged was in significant breach of the applicable regulatory context occurring on multiple occasions over an extended period, despite advice to the contrary from other practitioners including relevant specialists and in one instance a concerned parent,” the tribunal discussed.
“We agree that a medical practitioner who prescribes and handles drugs of dependence recklessly and contrary to law engages in professional misconduct.”
However as the GP had undertaken a “significant amount of education … of his own volition”, and received a number of positive testimonials from peers regarding his ongoing commitment to his patients, the tribunal decided that he had come to understand that his practices were dangerous and was therefore unlikely to repeat his conduct.
The Medical Board of Australia, which brought the GP before the VCAT, conceded that the GP would be fit to resume practice after a period of suspension, assuming further education was undertaken.
The tribunal reprimanded the GP and suspended his registration for three months, effective from midnight on 31 March 2018.
Upon return to practice, the GP is prohibited from prescribing, possessing, supplying, administering, handling, dispensing or accessing any substance listed in Schedule 8 of the Standard for the Uniform Scheduling of Medicines and Poisons (SUSMP), although this condition may be reviewed after eight months.
The tribunal shared its confidence that the GP would not fall into old patterns upon his return to practice.
“We are mindful of the fact that [the GP] has remained in practice during the period of five and a half years since these matters came to light during which time he has reflected upon his conduct,” says the tribunal.
“He has not breached the conditions on his registration and has made changes within his work practice, which gives us confidence that he will not allow himself to fall into such a situation again.”