Inquiry into the misuse/abuse of benzodiazepines and other forms of pharmaceutical drugs in Victoria : final report / Drugs and Crime Prevention Committee.

  • Victoria. Parliament. Drugs and Crime Prevention Committee
Date:
2007
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Licence: In copyright

Credit: Inquiry into the misuse/abuse of benzodiazepines and other forms of pharmaceutical drugs in Victoria : final report / Drugs and Crime Prevention Committee. Source: Wellcome Collection.

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    difficulties. In fact, with heroin | have always found the illicit drug users easy. They say, ‘This is how much heroin | use. | buy it each day’, and, strangely, it is a bit easier to deal with. The licit drug users who are haphazardly buying prescription drugs on the street are really quite tricky.'76 The Victorian Youth Substance Abuse Service (YSAS) also believes that ‘doctor shopping’ has to be viewed as other than just an economic or even drug seeking problem. In evidence to the Committee, Mr Tony Palmer from YSAS queried whether ‘doctor shopping’, at least in some cases, might not be viewed as a ‘cry for help’ from young people in crisis. He asks: [w]hether what is normally called ‘doctor shopping’ is actually doctor shopping or whether it is a form of help seeking, because we have seen this link between doctor shopping and suicide. The question is whether, at a point where the young person is getting really agitated and really anxious about life, they then start doctor shopping in the hope that somebody can offer some kind of answer to what is going on.'77 A representative of the Australian Medical Association (AMA) also stressed the need for a therapeutic approach when addressing suspected ‘doctor shopping’ by a patient: Prescription shoppers are a major source of concern in general practice. | had a telephone call from a local pharmacist just two weeks ago. He said there was a certain patient whom | have known for quite some time who was appearing to be shopping around other doctors and was getting too many opioids. He had a legitimate lumbar back problem but he came in to me and | laid it on the line to him. | said, ‘Look, you will go to one doctor. It is either me or whoever it is, nominate your doctor, but you do not go to anybody else and we will see if we can manage this pain. You seem to be increasing the need for opioids’. Then we discussed his condition, how life was going for him and the fact that he had developed depression. He was started on antidepressant medication, and counselling was arranged for him, and now he is back to his normal prescribed medication without going doctor shopping. It is very important that there is this communication between the pharmacists and the doctors, and perhaps it probably does not occur often enough.!78 The points made in the above quotes about the need to take a therapeutic approach to ‘doctor shopping’ in most cases are well taken. ‘Doctor shopping’ is not just about numbers. There are many human stories behind the Medicare Australia statistics. This is no better exemplified than through the story of Mary who has often been quoted throughout this Report. Mary supplied the Committee with a diary of her experiences as a ‘doctor shopper’ from early June to early July 2007. This testament titled ‘Diary of an Addict’ was written after her original testimony before this Committee and during a time when she had recommenced taking benzodiazepines. It is an extraordinary account of how easy it is for a person determined to access these drugs through legitimate channels, even though in some cases the prescribing of these drugs was clearly inappropriate — at best inadvertent, at worst negligent or even unethical. Methods used by ‘doctor shoppers’ It would seem that the methods used by ‘doctor shoppers’ to seek and access prescription drugs illegitimately are many and varied. This was certainly the case in one London study 176 Dr Mathew Frei, Interhospital Liaison Group, Evidence given to the Drugs and Crime Prevention Committee, Inquiry into the Misuse/Abuse of Benzodiazepines and Other Forms of Pharmaceutical Drugs in Victoria, Public Hearings, Melbourne, 19 June 2006. 177. Mr Tony Palmer, Trainer and Consultant, Youth Substance Abuse Service, Evidence given to the Drugs and Crime Prevention Committee, Inquiry into the Misuse/Abuse of Benzodiazepines and Other Forms of Pharmaceutical Drugs in Victoria, Public Hearings, Melbourne, 20 June 2006. 178 Dr Harry Hemly, Vice President, AMA (Victoria), Evidence given to the Drugs and Crime Prevention Committee, Inquiry into the Misuse/Abuse of Benzodiazepines and Other Forms of Pharmaceutical Drugs in Victoria, Public Hearings, Melbourne, 26 June 2007. Such an approach whilst commendable seems to be at odds with the suggestion of the AMA (Victoria) that a criminal offence of ‘doctor shopping’ be introduced. Although it could be inferred that the AMA may consider a doctor shopping offence less appropriate in a case where a person is ‘shopping’ to sustain their own addiction compared to a person who is seeking to access drugs to on-sell for commercial gain only. For discussion of the AMA’s proposal for a doctor shopping offence see Chapter 3.2 of this Report.