AGV10
06-09-2009, 08:29 AM
Some light reading ……..
Spent a couple years in the USA (California) recently. Found doctors quite liberal in dispensing narcotic analgesics – and the prescription forms pretty basic (i.e. could easily be counterfeited).
By contrast, in the UK doc’s are a lot more conservative, and as for counterfeiting prescription forms – near to impossible if you are using an NHS doctor (there are 2 separate multi-digit serial numbers on the prescription – which when presented to a pharmacist are entered into the national ordering system, and cross-referenced with the national prescription database. If that actual prescription, and what it was written for, was not legitimately issued, it should be flag up immediately).
UK docs’ who practise privately use a different secure prescription form – it looks very secure but how well it is tied into the national prescribing database, I haven’t a clue.
In both cases the prescriptions have to be presented and used within 28days.
Southern Ireland is a joke by comparison.
I was recently there and had to see a doc to get replacement meds – he took out his prescribing pad and wrote it all out. I was honest about what I was using what I needed to get me through the time I would be there, and asked for nothing different, or any more, as I had meds back home, but it was apparent the whole system was a complete joke.
The form itself was no more than a piece of white paper with newspaper quality black printing on it – easily copied on a computer and/or printer – it had zero zero security features.
I raised the issue with the pharmacist – she shook her head - her comments were not without merit. While recognising that although the prescription form its self has no secure features, the point remained that, weather it is Ireland, USA, UK or anywhere else … there is actually little to no evidence that secure prescription forms reduce abuse. One argument in Southern Ireland (and the matter has been discussed there at policy level several times) is that it moved the problem to another level – a level that inevitably raised the criminal aspect to narcotic abuse, increasing the potential for violence i.e. whether it be by way of robbing pharmacies, increased drug dealing on the streets …. or whatever, drug users were by and large going to get their fix – all the better if it was not associated with violence.
And how true this is ….. speak to career cops who work in narcotics in the UK: I have, and other than for stamping out forging, they share with me much the same story - that the additional security procedures in place regards narcotic medication dispensing have had min impact on narcotic abuse. Many acknowledge that the more procedures (security) in place, the more underground and harder it makes the issue to deal with – and year in year out, the amount of narcotic use and importation to the UK, has gone up and up and up……..
What additional secure prescription procedures have done is enabled health professionals and policy advisors to say “we are doing something about it”, “we are tackling the issue” – it makes them look good.
But let’s not forget what the catalyst for increased prescription security in the UK was (?).
It came about not through Joe Bloggs or Jane Doe s’ use and abuse of narcotic meds’ and prescriptions, but through the actions of one of their own – a one Dr Harold Shipman, who for the benefit of USA members, was a UK based National Health service doctor who murdered his patients on a grand scale, with large doses of morphine or diamorphine.
His modis operandi: targeting elderly single women on home visits, injecting them with lethal amounts of MO or DMO, then returning to his surgery to backdate and/or modify their health records.
Shipman was ultimately caught, but not before it has now been calculated/estimated he had murdered some 200 plus persons over his 25year career (about one a month!). Dr. S ranks as one of the worlds most prolific mass-murderers.
Shipman hanged himself in a UK prison a couple years back (while under suicide watch – just to rub salt into the wounds of his jailers, who had had their cards marked that it was just what he was likely to do!)
As a side note, he was a pethadine abuser for many years, had once had his practise license suspended for that, then had it given back to him.
Here’s another note regards use and abuse in the professional community: demographically the largest group of narcotic abusers in the medical professional (in the UK – so I don’t see why it should be different elsewhere) are – yup, you guessed right: anaesthetists. I have seen figures ranging from just over 1% to just over 6%!
Why?
Good question, but easy legitimate access, and the opportunity to manipulate auditing must play some role, and unlike alcohol abuse, narcotic abuse can be concealed a lot more easily (and for many years) from those they work and live with.
In short: the policies in place to police, monitor and/or stamp out abuse have not had much success – it’s been good window dressing which has kept policy makers and law enforcement looking active, but its done little over the years to reduce abuse and the crime associated with abuse.
My personal opinion: if an informed and free to choose adult wishes to use narcotics, so long as their lifestyle, behaviour and actions do not infringe/impact on others, then they should be free to do so.
Some 90% plus of the deaths/violence/crime against others, and “crime” in general (period) associated with narcotic usage arises from the legislation that has criminalised it – not actual usage.
There is no disputing that fact, but the other side of the coin, is I think equally valid i.e. that to decriminalise usage will result in so many people using the stuff, that while there will always be a small percentage of folk who will be able to live normal lives, its impact on the behaviour of the majority of users will lead to a whole bunch of problems in society that will result in a greater mess in society than illegal usage has caused.
I dare say, just as law enforcement/cops and policy makers have been reluctant to acknowledge publicly the overall failure of enforcement policy over the years, most abusers are reluctant to admit the impact usage has had on their lives over the years.
All parties are equally in denial (!)
Thoughts and comments from others ……..
PLEASE NOTE – I don’t want this to turn into a slagging match argument - let’s keep it a discussion to share thoughts and opinion.
Thanks folks.
Spent a couple years in the USA (California) recently. Found doctors quite liberal in dispensing narcotic analgesics – and the prescription forms pretty basic (i.e. could easily be counterfeited).
By contrast, in the UK doc’s are a lot more conservative, and as for counterfeiting prescription forms – near to impossible if you are using an NHS doctor (there are 2 separate multi-digit serial numbers on the prescription – which when presented to a pharmacist are entered into the national ordering system, and cross-referenced with the national prescription database. If that actual prescription, and what it was written for, was not legitimately issued, it should be flag up immediately).
UK docs’ who practise privately use a different secure prescription form – it looks very secure but how well it is tied into the national prescribing database, I haven’t a clue.
In both cases the prescriptions have to be presented and used within 28days.
Southern Ireland is a joke by comparison.
I was recently there and had to see a doc to get replacement meds – he took out his prescribing pad and wrote it all out. I was honest about what I was using what I needed to get me through the time I would be there, and asked for nothing different, or any more, as I had meds back home, but it was apparent the whole system was a complete joke.
The form itself was no more than a piece of white paper with newspaper quality black printing on it – easily copied on a computer and/or printer – it had zero zero security features.
I raised the issue with the pharmacist – she shook her head - her comments were not without merit. While recognising that although the prescription form its self has no secure features, the point remained that, weather it is Ireland, USA, UK or anywhere else … there is actually little to no evidence that secure prescription forms reduce abuse. One argument in Southern Ireland (and the matter has been discussed there at policy level several times) is that it moved the problem to another level – a level that inevitably raised the criminal aspect to narcotic abuse, increasing the potential for violence i.e. whether it be by way of robbing pharmacies, increased drug dealing on the streets …. or whatever, drug users were by and large going to get their fix – all the better if it was not associated with violence.
And how true this is ….. speak to career cops who work in narcotics in the UK: I have, and other than for stamping out forging, they share with me much the same story - that the additional security procedures in place regards narcotic medication dispensing have had min impact on narcotic abuse. Many acknowledge that the more procedures (security) in place, the more underground and harder it makes the issue to deal with – and year in year out, the amount of narcotic use and importation to the UK, has gone up and up and up……..
What additional secure prescription procedures have done is enabled health professionals and policy advisors to say “we are doing something about it”, “we are tackling the issue” – it makes them look good.
But let’s not forget what the catalyst for increased prescription security in the UK was (?).
It came about not through Joe Bloggs or Jane Doe s’ use and abuse of narcotic meds’ and prescriptions, but through the actions of one of their own – a one Dr Harold Shipman, who for the benefit of USA members, was a UK based National Health service doctor who murdered his patients on a grand scale, with large doses of morphine or diamorphine.
His modis operandi: targeting elderly single women on home visits, injecting them with lethal amounts of MO or DMO, then returning to his surgery to backdate and/or modify their health records.
Shipman was ultimately caught, but not before it has now been calculated/estimated he had murdered some 200 plus persons over his 25year career (about one a month!). Dr. S ranks as one of the worlds most prolific mass-murderers.
Shipman hanged himself in a UK prison a couple years back (while under suicide watch – just to rub salt into the wounds of his jailers, who had had their cards marked that it was just what he was likely to do!)
As a side note, he was a pethadine abuser for many years, had once had his practise license suspended for that, then had it given back to him.
Here’s another note regards use and abuse in the professional community: demographically the largest group of narcotic abusers in the medical professional (in the UK – so I don’t see why it should be different elsewhere) are – yup, you guessed right: anaesthetists. I have seen figures ranging from just over 1% to just over 6%!
Why?
Good question, but easy legitimate access, and the opportunity to manipulate auditing must play some role, and unlike alcohol abuse, narcotic abuse can be concealed a lot more easily (and for many years) from those they work and live with.
In short: the policies in place to police, monitor and/or stamp out abuse have not had much success – it’s been good window dressing which has kept policy makers and law enforcement looking active, but its done little over the years to reduce abuse and the crime associated with abuse.
My personal opinion: if an informed and free to choose adult wishes to use narcotics, so long as their lifestyle, behaviour and actions do not infringe/impact on others, then they should be free to do so.
Some 90% plus of the deaths/violence/crime against others, and “crime” in general (period) associated with narcotic usage arises from the legislation that has criminalised it – not actual usage.
There is no disputing that fact, but the other side of the coin, is I think equally valid i.e. that to decriminalise usage will result in so many people using the stuff, that while there will always be a small percentage of folk who will be able to live normal lives, its impact on the behaviour of the majority of users will lead to a whole bunch of problems in society that will result in a greater mess in society than illegal usage has caused.
I dare say, just as law enforcement/cops and policy makers have been reluctant to acknowledge publicly the overall failure of enforcement policy over the years, most abusers are reluctant to admit the impact usage has had on their lives over the years.
All parties are equally in denial (!)
Thoughts and comments from others ……..
PLEASE NOTE – I don’t want this to turn into a slagging match argument - let’s keep it a discussion to share thoughts and opinion.
Thanks folks.