An incident in Nova Scotia seems to bring up a new problem in the fight against drug abuse, in particular addictive substances used to treat pain that we all know is a major health concern not only in Nova Scotia, but coast to coast across Canada. Thousands of people are struggling with their addiction issues when it comes to prescribed opioid medications, and there is plenty of blame to go around as to who is responsible for the problem. Some blame the pharmaceutical companies, others blame the addicts themselves, but this particular story is about a doctor in Nova Scotia who has been reprimanded for prescribing a ridiculous number of prescriptions to his patients over the course of a number of years. It isn’t about his other patients, so much as one drug addict under his care who received 2,360 eight-milligram Dilaudid tablets from his doctor (Dr. Phillip Davis) despite his long and extensive history of drug and alcohol abuse and dependence, while also enrolled in a methadone treatment program. It was a phone call from a Nova Scotia pharmacy that really landed Dr. Davis in hot water. The call was made to Nova Scotia’s prescription monitoring program after the pharmacy felt it was not comfortable filling the prescription written by Dr. Davis.
When a medical consultant from the program contacted Davis, he admitted that he knew his patient had been discharged from the methadone program for non-compliance and was aware the patient had a history of injecting hydromorphone. The consultant told Davis the patient required treatment for addiction and recommended the prescription he wrote be cancelled, the decision said. “Dr. Davis felt it would be more beneficial for (the patient) to continue to receive his medication through his prescription than to acquire the drugs on the street,” the decision said.
While this doctor has landed himself in a lot of trouble for prescribing a dangerous amount of narcotics to someone who was clearly not going to use the pills for their designated purpose, it begs the question as to what doctors are supposed to do in a situation like that. On the one hand it is a violation of the regulations that govern prescribing practices for doctors, but on the other hand the doctor may very well have been acting in the patient’s best interest by providing him medications that he knew to be safe in comparison to what his patient might buy from someone on the street.
Perhaps, in the future, doctors who choose to write prescriptions to known addicts will reduce the frequency and quantity of the prescription and further advise their patients to receive the help they need to quit using drugs and ultimately lead a healthier life. However, doctors like Davis still see many patients in their exam rooms on a frequent basis demanding drugs for pain (whether they are in pain or not) and all they have to go on is the symptoms provided to them by the patients under their care, regardless of whether or not they are known drug addicts. It is a tricky situation to be sure, and the right course of action in dealing with drug seeking patients (who are known addicts) may yet remain unknown as every situation is different and complex in it’s own way.