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GPs must act carefully if patients are selling on prescription medications

MDU advises what to do if you believe that patients might be selling their prescribed drugs online

Louise Prime

Tuesday, 24 April 2018

There is an increasing trend for patients to sell on their prescription drugs online, the Medical Defence Union has warned. It has urged GPs to act with caution if they suspect a patient is selling on their medicines, and to give the patient a chance to explain – and it has issued advice on when it might be appropriate for GPs to contact the police about their suspicions, even without the patient’s consent.

The MDU said Facebook groups and online auction sites are now often used to advertise prescription medicines for sale, especially controlled drugs such as opioids and benzodiazepines, and medicines to treat erectile dysfunction. It has published an anonymised case history of a GP who contacted its advice line after a practice staff member noticed a Facebook page through which one of their patients appeared to be selling on their prescribed drugs, including diazepam and oxycodone.

Separately, the Medicines and Healthcare products Regulatory Agency reported earlier this year that it is investigating the diversion of prescription-only medicines from the regulated supply chain. It issued a warning about a £200m black market in prescription drugs being bought from pharmacists and wholesalers before being illegally sold online.

The MDU advises GPs who become aware that a patient might be selling prescribed drugs online is to:

  • Contact the patient to ask them about your suspicions. Give them a chance to explain.
  • If they admit selling the drugs, consider issuing them with a warning explaining that their behaviour is detrimental to the ongoing doctor-patient relationship.
  • If they deny being involved, weigh up whether you have enough evidence to justify taking the matter further. If you don’t, keep the situation under review.
  • Consider whether the matter needs to be reported to the police in the public interest. Informing the police without the patient’s consent, or after refusal of consent, might be justified if failure to make the disclosure could expose others to a risk of serious harm or death (General Medical Council guidance on confidentiality).
  • Review the patient’s medication and any repeat prescriptions to ensure they are still required, and make any adjustments necessary.
  • Carefully document discussions with the patient and what actions were taken and why.
  • Removing the patient from the practice list should only be considered as a last resort, for example after a warning has been issued and ignored.
  • Contact the MDU for advice if you are unsure.
MDU medico-legal adviser Dr Ellie Mein said: “Doctors have contacted us with concerns that patients may be selling prescribed drugs online.

“Doctors are concerned about whether they might be unknowingly drawn into the illegal supply of the drugs. They also question whether future prescriptions should be issued to the patient and if the police need to be informed.

“Our advice is for doctors to contact the patient to give them a chance to explain and consider issuing them with a warning if they admit selling the drugs. If they deny it, doctors may need to keep the situation under review if there isn’t enough information to take the matter forward. Doctors should weigh up whether the matter should be reported to the police in the public interest.”

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