A GP CENTRE in Dublin is refusing to prescribe powerful painkillers like Oxycontin or “highly addictive” benzodiazepines, such as Valium or Xanax.
Rathfarnham Medical Centre on Glendoher Road told patients it made the decision as these medications are “highly addictive substances” and “can be used as drugs of abuse and sold on the street”.
“We do not want to contribute to this in any way. They can also cause some physical problems such as liver damage,” a note on the GP’s website states.
Benzodiazepines are often prescribed to treat anxiety, sleep disorders and seizures.
There have been growing concerns in recent weeks about the sale of opioids and other potent medication on the street following a spike in overdoses in Dublin and Cork.
Rathfarnham Medical Centre recently confirmed to patients that it will no longer prescribe the following medications:
The doctors at the centre noted that some of their patients are already taking these medications via “longstanding prescriptions, and they are being reduced by their GP over a period of time”.
“We will not be prescribing these drugs to new patients who will be attending the practice.”
The statement also notes that the Government “wants GPs to clamp down on prescribing these drugs also and a national strategy has been launched to make people aware of the dangers of these drugs, particularly benzodiazepines”.
During an interview with The Journal, Health Minister Stephen Donnelly said he was not sure if GPs had recently received a circular from the department about the prescription of certain addictive medications.
However, he said he was concerned about the illicit sale of opioids and benzos in Ireland. Donnelly noted that the situation here has not reached the “epidemic” levels seen in the US and Canada but that Ireland needs to take the issue “very seriously”.
The minister said he has been told by frontline workers that drug dealers now often sell tablets in blister packs that were originally given to someone via prescription.
“I was talking with some community workers in north inner city Dublin not that long ago about drug dealing and the community services they provide.
They said to me that it’s changed completely – the guys selling the drugs on the street, it’s blister packs, that’s what they’re selling.
Donnelly added that he would be “very supportive of any additional training and awareness for our clinicians, for our pharmacists, to help with this”.
The use of prescription medication on the streets has been an issue for years. Tony Duffin, CEO of the Ana Liffey Drug Project, previously told The Journal that some drug users are consuming full blister packs which could mean taking 10 or more tablets in one go.
At the time of publication, Rathfarnham Medical Centre had not replied to two requests for comment. It is not clear if other GP centres are also refusing to prescribe certain medication due to concerns over the illegal drug trade.
Guidance for doctors
A spokesperson for the Department of Health told The Journal the department is “aware of the increased prescribing of certain controlled drugs in recent years”.
The spokesperson noted that the Medical Council has issued guidance for doctors in Ireland regarding the prescribing of drugs.
The Medical Council’s guide advises that doctors must be aware of the dangers of drug dependency when prescribing benzodiazepines, opiates such as oxycontin, and other drugs with “addictive potential”.
A spokesperson for the Medical Council said the organisation “does not comment on matters regarding individual GP practices or specific situations”. They added that the Council “does not issue clinical guidance” but “does provide principles-based guidance”.
The spokesperson said the Council is “currently working in partnership with a number of relevant stakeholders in the examination of the impact of overprescribing of certain drugs”.
Theft and forgery
The Medical Council and the Pharmaceutical Society of Ireland (PSI) previously launched joint guidance on the Safe Prescribing and Dispensing of Controlled Drugs aimed at registered medical practitioners and pharmacists.
This guidance notes that a prescriber’s obligations include ensuring they are “satisfied as to the identity of the person for whose treatment the prescription is to be issued” and ensuring “the safekeeping of prescription pads to reduce the risk of theft and forgery”.
The Council also noted that doctors “must also take additional care when considering prescribing benzodiazepines for patients in ‘at risk’ groups or those with additional care requirements” such as people who are homeless, pregnant or have dependency issues.
Under the guidelines, pharmacists’ obligations include that they must only “dispense medication on the basis of a legally valid prescription” and “be satisfied that the signature of the prescriber is genuine”.
They must also “be vigilant for forgeries or unusual prescribing patterns”.
ICGP guidance
The Irish College of General Practitioners (ICGP) declined to comment on any individual practice but noted that it provides general guidelines for GPs on the matter.
This guidance states: “Before prescribing a benzodiazepine, prescribers should check whether the person might have a tendency to misuse drugs or alcohol, or a history of same and referral to a specialist addiction service should be considered in this instance.
“Drug-related behaviours may be a feature in some patients who are prescribed benzodiazepines. These may include diversion of valid prescriptions, illicit sale or use in manners alternate to the prescribed dosage, route and frequency.”
The ICGP also provides training for its members on the issue. The Irish Medical Organisation and the PSI declined to comment.
With reporting by Christina Finn
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