Doctor fined for prescribing himself opiates

A doctor who snuck out of his house while his family was sleeping to fraudulently prescribe himself opiates has been fined $8000.

The Health Practitioners Disciplinary Tribunal released its decision today after a hearing in Tauranga on April 12 and 13 into the conduct of the doctor, named in the decision as "Dr N".

Dr N was charged with misconduct for fraudulent entries in controlled drugs registers, fraudulent entries in patient case notes, forgery of colleagues' signatures, and self-prescription of drugs of dependence and/or abuse for his own use and without proper medical oversight.

From 2006 to 2014, Dr N admitted to making 266 fraudulent entries in the controlled drugs register for morphine, pethidine and fentanyl, an opioid analgesic which is up to 100 times stronger than morphine. He also made 49 fraudulent entries in patient notes.

Dr N would sneak out to his practice after his family had gone to sleep and either enter a fake name or a name of a real patient on the register.

In September 2014 concerns were raised about the amount of pethidine Dr N had signed out and, after discussions with a fellow partner at his practice, he admitted taking the pethidine for his own use.

His partnership was terminated at the practice and he began rehabilitation and treatment.

The tribunal decision said Dr N's actions showed a "significant element of deceit".

He deceived his family by sneaking out to access the drugs, he deceived his patients by changing their records and putting them at risk by potentially affecting any future treatments, and he deceived his colleagues by forging their signatures.

The tribunal acknowledged that Dr N had remained abstinent since September 2014 and had taken steps to address his addiction.

Dr N had expressed "deep shame and remorse for his actions" and had described being a rural practitioner as "very stressful". He referred to his "many losses as a result of [his] addiction" including termination of his partnership and his inability to work for four and a half months, with five weeks as an inpatient on withdrawals processes.

A statement from a the director of the National Addiction Centre at the University of Otago said: "Dr N's poor behaviour ... was generated through an initial attempt at self-medicating stress and sleeplessness, which then developed into a full-blown opioid addiction over time."

"Ms A", the practice manager at the family medical practice where Dr N now works, said Dr N had been frank with her about his history and that trying to replace Dr N would be "devastating" to her practice.

The tribunal report said it was to Dr N's credit that he had faced the realities of his addiction and his knowledge of what he needed to do to address it. This did not gainsay the fact he had made fraudulent entries in the controlled drugs register and patient notes.

The report said this type of offending would usually result in suspension, but the tribunal had weighed that against the other issues to be taken into account including Dr N's need for rehabilitation and the need for his skills in the area he was currently working.

Dr N was censured by the tribunal and fined $8000. He had conditions placed on his practice for three years including a prohibition on prescribing, administering or accessing any controlled drugs and not being allowed to work in a sole practice as he would have more ready access to controlled drugs. He will also have to pay for his own ongoing clinical supervision and must undergo regular drug testing.

He was also required to pay $18,000 in costs.

Dr N sought ongoing suppression of his name and identifying details, which the tribunal declined. However, his identity remains hidden for four weeks to enable him to "organise his affairs".