asked the Minister for Health if he is concerned at the availability of temgesic to drug users as certain medical practitioners are facilitating the pushing of temgesic; and if he will make a statement on the matter.
Ceisteanna—Questions. Oral Answers. - Drug Abuse.
9.
I am concerned that temgesic may be being prescribed irresponsibly by some doctors and I have directed that inquiries should be pursued urgently into information which has recently been received on the matter in my Department.
Is the Minister aware that the availability of this drug to people who are pushing it in areas where heroin was formerly pushed is now a widespread problem? It is being used as a substitute among former heroin users and seems to be readily available. Could the Minister state precisely what measures he is taking to deal with this serious problem?
These prescriptions are being examined to see if there is a pattern of irresponsible prescribing by one or several doctors. In addition, information is being gathered to see if temgesic is being supplied by wholesalers in unusually large quantities to pharmacies around Dublin. This is being done with a view to building up a profile of the situation citywide. On the basis of the outcome of this action the Department will decide whether the doctors in question should be dealt with under the investigative procedures provided for in the Misuse of Drugs Acts of 1977 and 1984. The 1984 Act considerably streamlined the investigating procedure for dealing with cases of irresponsible prescribing of controlled drugs by practitioners. In regard to what Deputy Gregory has said, I can assure him that we are concerned about this matter and that a serious investigation is being carried out at present by my Department.
If it is established, as I believe it will be, that particular doctors are responsible, can the Minister of State tell us what precise action he will take under the terms of the Act he has referred to?
The position is that procedures are laid down in relation to doctors found guilty of such misconduct. Inquiries would have to take place. I could outline for the Deputy the actions which would have to be taken if what he says is proved to be true.
Can the Minister of State tell us what they are?
Under the Misuse of Drugs Acts, 1977 and 1984, the investigative procedures for dealing with cases of irresponsible prescribing of controlled drugs by practitioners are considerably streamlined. The 1984 Act provides that the Minister may establish a committee of inquiry where he considers there are grounds for giving a special direction prohibiting a practitioner from prescribing controlled drugs. Pending the report of the committee of inquiry the Minister may issue a temporary prohibition where he considers it necessary to do so. The committee of inquiry investigate the allegations, consider any representations made by the practitioner and report on the matter to the Minister. It is then a matter for the Minister to decide whether to issue a special direction.
The effect of the special direction is that a doctor would be prohibited from prescribing any or all controlled drugs. In the cases where the Minister decides to issue a special direction the practitioner will still have the right to appeal to the High Court, which is provided for in section 11 of the 1977 Act. The new investigative procedures have been availed of on a number of occasions to deal with cases of irresponsible prescribing and are proving satisfactory.
The Medical Practitioners Act, 1978 provides for the holding of inquiries by the fitness to practice committee of the Medical Council into the professional conduct of registered medical practitioners. Arising from such inquiries the Medical Council may decide to erase the names of the medical practitioners from the register of medical practitioners. Alternatively the council may decide to have recourse to the following lesser range of penalties: the attaching of conditions to retention on the register and the power to advise, admonish or censure.
The drug temgesic is used legitimately in medicine for the treatment of moderate to severe pain. It came onto the market subsequent to the enactment of the Misuse of Drugs Act, 1977 and was therefore not controlled within this framework until recently. It was decided to control temgesic because of its potential for abuse. The first steps towards controlling temgesic took effect from 1 July 1987 on the coming into force of the Medical Preparations (Control of Sales) Regulations, 1987 which designated temgesic as a prescription-only drug. The Government order, entitled The Misuse of Drugs Act, 1977 (Controlled Drugs) (Declaration Order), 1987, designated temgesic as a controlled drug under the 1977 Act. This enabled the application of the strictest misuse of drugs type control of temgesic.
Following the making of the Government Order the Minister for Health made the Misuse of Drugs (Amendment) Regulations, 1987 which subjected temgesic to the full regime of controls applicable to those drugs specified in Schedule 2 to the Misuse of Drugs Regulations, 1979. This regime embraces the licensing scheme for the production, import, export and supply of temgesic; comprehensive record keeping requirements, including the keeping of registers by pharmacists; requirements regarding the form in which prescriptions for temgesic are to be written and safe custody requirements and the recommendation of the Medical Council on the prescribing of controlled drugs together with the chief medical officer's covering letter as issued by the Department.
It should also be noted that the Medical Council and the Pharmaceutical Society of Ireland have a liaison group who monitor the problem of irresponsible prescribing and keep in close contact with the Garda Síochána and my Department. In spite of all this the information received seems to indicate that temgesic is being abused and, as I have indicated, we have put a process in train to investigate and deal with this particular matter.
Is the Minister of State aware that because this drug is so widely abused it is now known as "GGs" among addicts in many areas of the city? That indicates the extensive abuse of this particular drug. Can the Minister of State say when he will be in a position to make a decision as to whether to take action against individual doctors?
I am not aware of the title mentioned by the Deputy. This matter was brought to our attention by the United Anti-Drugs Committee of Inchicore and Bluebell in March 1988. Therefore, we have taken very speedy action in regard to this matter. As chairman of the drugs advisory group, I regard this as a very serious problem. We are carrying out an investigation and samples of the drug have been submitted to the Department for investigation. I can assure the Deputy that we will use the full rigour of the law in cases of abuse in prescribing this drug.