Doctors are being turned into drug suppliers for many sections of society.

Doctors and drug experts admit Western Australia’s illicit drug market has become flooded with opiate-based prescription painkillers, sold everywhere from schools to nightclubs.

Users and dealers are exploiting general practitioners into prescribing legal pain killers like Oxycontin and benzodiazapines such as Valium, reserved for those who suffer from chronic pain, to either satisfy their cravings or make a quick buck.

One former addict, who did not want to be named, was 17 years old when he began “doctor-shopping” – making the rounds of Perth doctors trying to get his hands on the drugs.

Generic pic of vitamin pills.Prescription medications are helping fuel the new wave of designer drugs.

“I’d usually go in there and I’d either say that ‘I’m coming off the heroin and I just needed something to sleep’, or make an excuse,” he said.

“Sometimes I’d say I had a plane trip and I couldn’t fly so I needed to sleep on the plane. You find there’s a lot of doctors around Perth that are very easy-going and it’s sort of more about finding the group of those doctors and then doing the rounds with them.”

He said he was first prescribed Valium after a family tragedy and when he became addicted he quickly lined up a few “sympathetic” doctors who would continuously renew his prescription.

By the time his habit was well entrenched, he had progressed to breaking down Oxycontin and MSContin pills to inject when he couldn’t get his hands on heroin.

“Because you’ve got so many doctors you might have only one appointment a fortnight, so you get your pills, and then by the time you’ve run out of them you’ve got another doctor’s appointment,” he said.

“After you’ve been there four or five times they know what you’re doing. For instance I had one doctor, I’d just walk in, he’d say ‘just the normal’ I’d say ‘yep’ and I’d walk out. I’d be in there for one minute for him to print my script out.”

The highly-addictive drugs have been the subject of warnings from doctors and drug researchers alike.

Doctors sound the alarm

Australian Medical Association (WA) vice president Steve Wilson, who has a medical practice in Bassendean, said the problem was increasing in a growing population, as more people dealt with the chronic pain of arthritis, injury and trauma.

“They are getting (the drugs) usually on a Health Care Card for $5 for 60 tablets and they’re selling those tablets for between $20 and $100 each at nightclubs or at schools and places like that. There is a huge illicit market for that sort of thing,” Dr Wilson said.

“I’ve seen them as young as their teens and I’ve seen them in their 60s and sometimes even older.”

Allan Quigley, the director of clinical services for Next Step Drug and Alcohol Services, backed the claim, saying the rehabilitation centre helped a large number of people addicted to prescription opiates.

Only alcohol surpassed opiate addiction in terms of the number of patients treated.

“There’s been a very significant increase in opiate prescribing in general practice and the drug and alcohol services are seeing people with problems with drugs like the long-acting oral morphine preparations’,” Dr Quigley said.

“There are also a large number of people who have presented to GPs with health problems and persuaded them that prescribing these drugs is reasonable, but they might have had much longer-standing problems with amphetamine or opiate use.”

Spotting an addict

Detecting an opiate addict could be especially tricky for GPs, Dr Wilson said, because they spun elaborate stories and shared information such as which doctors were “soft touches”.

“They often flock around a practice once they hear amongst themselves, and they tell each other that ‘there’s a new registrar down at that practice’, for example,” he said.

“They’ve often got well-constructed stories, often letters from previous specialists, maybe interstate or within the state and then they say, ‘I need some more of this medication’ and it’s very easy to be sucked in by them.”

But the former addict said he and his friends would usually steer clear of registrars because they tended to adhere to rules more strictly than their more experienced colleagues.

“Having said that, I have come across some (registrars) that have no idea and you end up walking away with a lot more than you probably would have expected,” he said.

Although GPs can notify the WA Health Department’s pharmaceutical services branch if they believe a patient has become addicted to their medication, Dr Wilson said the outcome wasn’t always satisfactory.

“I have been advised by an anonymous telephone call that a patient of mine who is receiving such drugs is actually selling them and making an income from them but that person would not come forward,” Dr Wilson said.

“When I reported this to the Health Department they said it was a police matter and when I spoke to the police at the relevant area, in this case Mirrabooka, they said ‘not interested doc, we’ve got bigger fish to fry than someone selling prescription drugs to kids’.

“So the police aren’t interested (and) the Health Department neither has the punitive capacity to pursue that patient in many regards or can’t be bothered. But I’m the one that gets the snippy letter saying ‘please explain why this patient’s getting more than their usual quantity that they should and advise us why we shouldn’t revoke your schedule A prescribing licence’.”

A WA Health Department spokeswoman said patients reported as addicts or suspected dealers by their doctors were noted on a database and any further prescriptions had to be authorised by the department.

She said those suspected of dealing prescription medication should be reported to the police.

Doctors prescribing ‘excessively’

In its latest annual report, Medicare’s fraud watchdog – the Professional Services Review – listed the inappropriate prescribing of narcotic and benzodiazepine drugs as one of the main issues it dealt with in 2009/10.

PSR director Tony Webber referred 17 medical practitioners across Australia to their state’s medical boards, most commonly for the excessive prescribing of such drugs.

One doctor, known as “Dr D”, was flagged by Medicare after handing out 1598 prescriptions for benzodiazepines and opiates, well above the number most other doctors had prescribed in a year.

The review found the doctor gave drugs without adequately inquiring about the patient’s symptoms or attempting to manage drug dependence. A third of the medical records related to those prescriptions included no detailed history or notes about patient examinations.

“During the review, Dr D stated that the prescribing practice was probably reprehensible; however, the doctor would also have difficulty changing this practice due to a large cohort of drug-addicted patients and the lack of treatment facilities in the region,” the report stated.

The doctor was disqualified from prescribing medicine for three years and forced to pay $17,958 back to Medicare.

The WA Health Department recommended GPs have patients sign an opiate agreement, which states that lost, misplaced or stolen medicines will not be replaced, and early prescriptions will not be provided.

A danger for doctors

Assault or the threat of being subject to violence also convinces some doctors to get out their prescription pad, Dr Wilson said.

“Especially for female GPs, where they feel threatened by patients and the easiest thing to do is acquiesce,” he said.

“I’ve been assaulted, I’ve never reported it but I was pushed by a patient, I was threatened… I’ve been called all things on the planet in front of a waiting room full of patients, because you’re basically denying them the ability to put their hands in the lolly jar any time they want to.”

Dr Wilson said doctors should give patches instead of pills where possible because they were difficult to abuse and on-sell.

“It can lead quite rapidly to addiction, particularly the quick-acting form,” he said.

“The quicker the onset of the drug and the quicker the offset the more likely they are to lead to addiction issues.”

Sourced & published by Henry Sapiecha

Tags: , , , , , , , , ,

Leave a Reply