Pharmacist misused oxycodone, alprazolam

A pharmacist who misappropriated OxyNorm and Kalma has been given a formal reprimand by the Victorian Civil and Administrative Tribunal

The North Melbourne pharmacist suffered a rib injury in 2012, while still in his intern year, and was twice prescribed OxyNorm to treat the pain.

He began work as a registered pharmacist in 2013, but was also under significant stress because, as the Court noted, “he and his Lebanese fiancee were embroiled in interfamilial conflict arising from their decision to marry”, the pharmacist being of Turkish origin.

“This conflict and the pressures of working as a registered pharmacist provided the context in which the respondent said he commenced unauthorised, self-administration of oxycodone and alprazolam; the latter drug administered in an attempt to manage withdrawal symptoms,” the Tribunal noted.

His employer contacted AHPRA in July 2014 to allege that the pharmacist had misappropriated OxyNorm and Kalma over a period of four to six months.

“When confronted on 7 July 2014 the respondent apparently admitted the conduct and claimed he was addicted to the medications.”

According to the investigation report, the pharmacist misappropriated “significant” amounts of the drugs, particularly oxycodone.

“The oxycodone misappropriated by the respondent, expressed as the equivalent number of OxyNorm 20mg capsules, indicated that the respondent’s average rate of misappropriation had escalated from one daily in May 2013 to 58 or 1160 mg daily in 2014,” the Tribunal noted.

“The investigation report further revealed that between 9 July 2013 and 27 December 2013, when this drug was still classified as a Prescription Only Medicine under Schedule 4 of the SUSMP, the respondent misappropriated at least 1200 Alprazolam 2mg tablets and a further amount of 1500 Alprazolam 2mg tablets in the three weeks between 14 June 2014 and 5 July 2014, when this drug became a Schedule 8 poison.”

The pharmacist had sought help in late 2013 from his doctor to treat his substance abuse problem, but was advised to go “cold turkey” and suffered significant withdrawal symptoms.

He continued to self-administer large quantities of the drugs.

The pharmacist was dismissed from his job, and he gave the Board an undertaking not to practise as a pharmacist without its approval.

Since then, he has been working in the produce section of a supermarket and has not to date applied to renew his registration.

He successfully completed the Buprenorphine program for opium dependency in 2014, following the breakdown of his marriage.

The pharmacist was charged and pleaded guilty in early 2016 to nine rolled-up charges under the Drugs, Poisons and Controlled Substances Act.

No conviction was recorded but the pharmacist was placed on a Community Corrections Order for 15 months, with conditions that required him to undergo drug addiction therapy, random drug testing and mental health assessment, as well as paying costs of $6000 (this latter was stayed for six months).

“Based on the evidence as a whole, the Tribunal further accepts that the respondent has expressed genuine remorse for his conduct and demonstrated insight into how his conduct may have affected those around him and could have affected the welfare of those attending the Pharmacy during the relevant period,” the Tribunal noted.

But “it is the Tribunal’s view that the medical evidence indicates an ongoing vulnerability to stressors which could impact on his ability to practice as a pharmacist. This is a matter which bears upon the protection of the public and the profession’s reputation.

“The supply of Schedule 8 (and previously Schedule 4) drugs without authorisation and for the purpose of self-administration without prescription; the making of false or misleading entries in pharmaceutical records, the failure to keep required records of transactions involving poisons; and to possession of drugs of dependence without authorisation over an extended period, which ceased only when the respondent was detected, represent egregious breaches of the respondent’s professional obligations as a pharmacist.

“It goes without saying that the respondent’s conduct reflects an abuse of the trust of the owner and customers of the pharmacy and of the community and has brought the profession into disrepute.”

The Board said that if the pharmacist had not already spent three years without seeking to return to practising pharmacy, it would have requested cancellation of his registration for a further period.

VCAT issued a reprimand and said that if the pharmacist reapplied to the Pharmacy Board for registration as a pharmacist, he would need to satisfy the Board that his capacity and fitness to practise were not compromised, via an independent psychiatric assessment.

Any registration granted would need to contain a condition that required him to undertake a minimum of nine months of supervised practice without direct access to Schedule 8 drugs.

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