A medical license in the US gives a doctor the ability to prescribe a wide variety of powerful pharmaceuticals. Occasionally you hear about a doctor abusing this privilige, but it seems to be relatively rare. What or who keeps doctors in line other than personal ethics and a fear of incarceration. Who watches the watchers?
On a secondary note how do doctors get their hands on meds? Do the pharmaceutical reps deliver directly to the doctor or does the doctor have to go through a pharmacist himself? I’ve gotten meds directly from doctors but they were always in “trial packs” the reps would give them and I didn’t get charged for these. I don’t recall ever buying medicine direclty from a doctor, only a pharmacy via prescription called in by the doctor’s office. Are doctors allowed to sell drugs directly?
To get free samples the doctor must fill out a sample request form with DEA number and other such information. The samples received either directly from a drug rep or from a fulfillment house are always marked ‘not for sale’.
I sent out 45,000 sample request forms to reps this week.
Long week.
Well, I have access to narcotics - perscription pain killers - I don’t abuse them because it’s not in my nature to do so.
I wouldn’t expect a higher percentage of physicians to have a substance abuse problem then the percentage of average Joe citizens that do. So - short answer - Drs. monitor themselves.
Anesthesiologists have fairly broad access to many drugs, but most of the other specialities would have less so - every Drs office I’ve been to has a sign that says “No Narcotics on Premisis”, I assume to disuade theft - therefore a doc would need a perscription like everyone else. They MAY be able to write it out themselves, however.
Sad to say , doctors do engage in drug abuse, higher than pharmacy workers, for sure ,not sure about compared to rest of population. The US Government (FDA) has set up drug “schedules”- I to V. II require in Cal triplicate scrips-availble only through DEA. One scrip stays w/ doc, one w/ pharmacy & yep, one w/ the state. Other states may do it differently. Examples of II are narcotics, barbs & amphetamines. This is to control mostly drug users, but all docs know they are being monitored too.
Actually what I’m asking about (and I should have been more specific) is not who keeps the doctors from prescribing drugs for their own personal use, but more specifically who keeps them from abusing their authority by prescribing narcotics etc and acting as a legal supply conduit for people who are re-selling the drugs or are simply addicted.
An example would be the favored physicans of some movie stars or society wives who have the reputation of dispensing large amounts of pain killers for questionable needs. Is anybody watching over these doctors with respect to the prescription of narcotic medicines? Is it the state medical board? Is it the DEA? Is it anyone?
Usually there is also some sort of paperwork. On the ambulance, narcotics have to be logged every 8 hours, and all have to be accounted for, still in stock, used, or broken.
Also, at one of the ER’s in town, they’ve got a med cabinet that only opens after a fingerprint scan. The machine scans the print, then they select the patient and the drug. The machine keeps a log of who accesses what when, and for whom.
A doctor and his wife were arrested in Albuquerque yesterday in connection with the narcotics deaths of seven people over the past few years. The case started as an investigation by the State Board of Medical Examiners into the doctor’s prescription of “inordinate and ‘injudicious amounts’ of controlled substances.” So apparently, in New Mexico at least, a state board is keeping an eye on the doctors, and if there’s a criminal irregularity they call in the Attorney General’s office and, if necessary, the DEA.
Back in the 1970’s there were a lot of doctor’s that would readily prescribe meds that could be abused. They were known as DR. FEELGOODS. There were also STRESS CLINICS and WEIGHT CLINICS that were set up as prescription mills for those that just wanted to get pills. Just tell the doctor what you wanted and you got the RX. This is not near as prevelant now, but I’m sure it still goes on to a lesser degree and not as openly.
From what I can gather, the only way the doctors are held accountable is when people start to overdose and law enforcement gets involved. Now, I think people should be able to get addicted to whatever the hell they want to without government interference, but this is GQ, so I’ll refrain from ranting about that.
Some people would like to see the current system changed:
Remember that becoming a doctor is extremely lengthy and arduous process. Most doctors aren’t willing to give up ~12 years of schooling by making a bad choice.
Psst…people give up a hell of a lot more than 12 years of schooling to addictions all the time (families, cars, homes, fortunes, whatever). As a matter of fact, the big defining factor in diagnosing someone as an addict is the continuation of usage in the face of negative consequences.