Irish doctors not following prescription guidelines, Facebook survey suggests

Self-prescribing and prescribing for friends and family is widespread among young Irish doctors, in contravention of official guidelines, a new survey suggests.

Significant numbers of doctors are prescribing addictive and controlled medicines, such as sedatives and opiates, the study says.

The results were mined from an online survey of a closed Facebook group for young Irish doctors in the spring of 2017. Some 729 of the 4,445 doctors – most of them in their 20s – completed the questionnaire, a response rate of 16 per cent.

Two-thirds of those who responded had prescribed for themselves, and three-quarters had done so for family. Over half had prescribed for friends and colleagues.

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Nearly all the doctors (93 per cent) had been approached by friends, family or colleagues to prescribe drugs suggesting, according to the authors, they may feel under pressure to prescribe to those they know personally.

Self-medication

The over-30s were twice as likely to self-medicate as their younger peers, and older doctors were more likely to prescribe psychotropic drugs for mental health issues.

Between 3 and 7 per cent of respondents had self-medicated with a benzodiazepine (sedative), an opiate or other mind-altering drug.

The study, by psychiatrists from St Patrick's hospital and Tallaght hospital in Dublin and doctors from Trinity College Dublin is published in the online Journal of Medical Ethics.

Men were more likely than women to self-medicate with opioids, it found. They were also more than three times as likely to prescribe these drugs to friends, and more than seven times as likely to do so for colleagues.

Nearly half of the women who responded (43 per cent) had prescribed the contraceptive pill for themselves.

GPs, paediatricians and hospital doctors were more likely to prescribe to a family member, while surgeons were more likely to prescribe to a friend and psychiatrists less likely to do so.

Anaesthetists were more likely to self-medicate with opiates and benzodiazepines and to prescribe opiates to family and friends. Surgeons were also more likely to prescribe opiates for themselves and their friends, while psychiatrists were more likely to prescribe benzodiazepines to family members and colleagues.

The respondents to the survey were drawn from a variety of specialities. Two-thirds were women.

Prescribing outside a professional relationship can compromise the doctor and is unlikely to be covered by malpractice insurance, the researchers warn. But it also raises many ethical patient safety implications, including for the prescribing doctor, they point out.

The authors call for further education on the risks involved, which include addiction and suicide. Medical Council guidelines warn doctors against treating or prescribing for themselves, and against doing so for friends and family "except in emergencies".