‘Criminal’ prescriptions

2011-10-22 00:00

IT borders on criminal for a doctor to ignore the guidelines on the package insert and give patients repeat prescriptions for the highly addictive sleeping tablet zolpidem for an unbroken period of six months.

They may be “helping” people with sleeping problems to become so psychologically and physically addicted that these patients will start lying and deceiving to obtain the substance.

This is the opinion of a concerned Pretoria pharmacist who spoke to Beeld this week. She showed a reporter several doctors’ prescriptions for six months of zolpidem.

The package inserts clearly warn that the substance is addictive and should be used for only short periods at a time.

“Yet, it seldom happens that we see short-term prescriptions for this medicine. It is the exception rather than the rule,” the pharmacist said.

She also produced ten prescriptions that patients had forged or altered.

“The patients threaten to report me to the Pharmacy Council if I refuse to dispense the tablets. I later have to be rude to them for their own good.”

One customer had visited 10 different doctors since 2009 in order to obtain zolpidem.

Customers use different names, steam stickers off scripts, or add extra items to the prescriptions by hand.

One customer claimed her office had been blown up. Another one’s handbag was supposedly stolen three times in four months.

An elderly lady forged two prescriptions in the name of a Pretoria orthopaedic surgeon in order to prescribe 11 medicines for herself, three of which are addictive.

Zolpidem’s effect wears off within two hours. Patients are supposed to take five to 10 mg at bedtime following a personal crisis, for example.

However, they take more and more in order to stay asleep. Eventually they have to take the tablets two-hourly to counter withdrawal symptoms.

Andy Gray, a senior lecturer at the University of KwaZulu-Natal’s Nelson Mandela Medical School, says that according to the Medicines Act, schedule 5 substances like these may not be prescribed for longer than six months, unless a second medical practitioner has been consulted.

“One could argue that prescribing something without due consideration of the guidelines on the package insert is negligent. Yet, it is a problem that receives too little attention in practice.”

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