IN FOCUS: How the ease of getting prescription drugs from Telegram, multiple doctors can fuel addiction

PHYSICIANS A “COMMON SOURCE”

Licensed sellers and suppliers can also be a source of misused drugs.

In 2022, the Singapore Medical Council processed 39 complaints regarding excessive and/or inappropriate prescription of drugs. Of these, 15 were complaints received that year itself.

In comparison, the council received a total of 29 such complaints from 2017 to 2021. 

The statutory board under the Ministry of Health governs and regulates the professional conduct and ethics of registered medical practitioners.

According to an October 2022 paper in the Singapore Medical Journal, a survey of 1,000 individuals aged 21 and above in Singapore found that misuse of prescription medicine was common, “with prevalence comparable to the use of recreational drugs or novel psychoactive substances”.

The survey, conducted back in 2015, also found that a “common source” of misused drugs was physicians.

And this hasn’t seemed to change in recent times, according to addiction counsellors who spoke to CNA.

Mr Andy Leach, director of addictions services at Visions by Promises, has seen clients who visited “eight to 10″ doctors for the same medication.

The practice is called “doctor shopping”.

“None of these doctors have any way of communicating with each other as to what’s been prescribed. That’s incredibly dangerous because basically, people can overdose,” he said.

Echoing the sentiment, Mr Suresh Anantha, principal counsellor at the National Addictions Management Service with the Institute of Mental Health, said: “Patients abusing prescription drugs might present to their physicians as seeking help for health issues and illnesses. They might even visit various physicians to obtain multiple dosages of the prescription drugs.”

This contributes to the challenge of detecting patients who misuse prescription drugs, he noted.

With practising doctors, the Singapore Medical Council has guidelines governing various medication prescriptions.

For example, benzodiazepines – a class of depressant drugs that can be highly addictive – are supposed to be prescribed for either intermittent use or short-term relief between two to four weeks.

Doctors are also required to limit chronic benzodiazepine prescriptions where possible. When repeatedly prescribed, doctors must clearly document their justification along with a comprehensive assessment of the patient, their diagnosis and their psychosocial history.

CNA has contacted the Health Ministry about their stance on “doctor shopping” and whether there are measures against such behaviour across the public and private sectors.