Struck off over opioid dependency

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A pharmacist has had his registration cancelled after stealing nearly 1000 oxycodone tablets and using them while at work

A NSW man who was employed as a pharmacy manager at two pharmacies has had his registration cancelled after a tribunal ruled he had not taken enough steps to treat his opioid dependency.

The pharmacist was caught misappropriating drugs by his employer after a stock check identified missing medications, which soon led to an AHPRA notification and subsequent proceedings.

Between February and August of 2016, the pharmacist was found to have misappropriated 588 tablets of oxycodone 80mg, 344 tablets of oxycodone 40mg, 100 tablets of alprazolam 1mg, and 30 tablets of methylphenidate for his personal use from the pharmacies where he worked.

During a police search in November 2016 he was also found in possession of illicit and restricted substances including cannabis (10.74 grams), 58 tablets of tamoxifen 20mg, 23 tablets of phentermine 40mg, 22 tablets of clonidine 100mg, 14 tablets of clarithromycin 250mg, 23 tablets of domperidone 10mg, 18 tablets of onadansetron 8mg and 1 packet of testosterone undecanoate 40mg.

The pharmacist was charged with possession of prohibited drugs and prescribed restricted substances, among other offences.

However the Local Court of New South Wales dismissed the charges subject to conditions including that the pharmacist attend all appointments with his GP, psychiatrist and psychologist, take all prescribed psychiatric medications, and comply with fortnightly drug testing if directed to by the Pharmacy Council of NSW.

Based on consultations with a psychiatrist and a psychologist, the pharmacist was found to have developed an opioid addiction due to severe depression and anxiety, and difficulty coping with stress.

The Health Care Complaints Commission (HCCC) brought his case before the NSW Civil and Administrative Tribunal, with orders handed down this week.

A psychiatrist who provided initial assessment in 2016 gave evidence at the hearing, saying the quantity of oxycodone that the pharmacist had taken – 800mg daily – was a “significant amount and demonstrated a considerable tolerance to opioid medication”.

He also found that the pharmacist’s efforts since 2016 to address his previous drug use and mental health issues were not adequate, and in light of his background “remained at risk of relapse”.

By his own evidence the pharmacist had “limited, sporadic” engagement with mental health practitioners – not at the level recommended by his former psychiatrist, the tribunal found.

Recommendations had included regular treatment from a drug and alcohol specialist service, regular urine drug screens, and ongoing psychological counselling with his psychologist, however these had not been pursued in the years leading up to the hearing.

The tribunal found that the pharmacist was guilty of unsatisfactory professional conduct and professional misconduct.

It also found that he suffers impairment due to his opioid dependence, with an absence of evidence that he had dealt with his past drug addiction and dependency issues, concluding that “his risk of relapse is significant and ongoing”.

“Combined with his lack of insight and unwillingness to engage in a meaningful treatment program we do not believe he is presently competent to practise as a pharmacist,” found the tribunal.

“On the evidence before us we do not have any confidence that were [the practitioner] to be faced with pressure in the future whilst working as a pharmacist, he would abstain from abusing drugs of addiction and seek appropriate treatment for his mental health.”

It ordered his registration to be cancelled, with the practitioner to pay costs to the HCCC.

The pharmacist cannot apply for a review of this cancellation for 18 months.

“This period will afford a reasonable opportunity for [the practitioner] to undertake the counselling and therapy work he says he is willing to do to address his drug dependence and impairment issue, but to which at this point time he has been reluctant to commit,” concluded the tribunal.

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