Learnt from PAPee one!
<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR>Sep 11, 2008
OVER-PRESCRIBING SLEEPING PILLS
</TR><!-- headline one : start --><TR>More docs facing probe
</TR><!-- headline one : end --><TR>19 cases so far this year; Health Ministry reviewing prescription guidelines </TR><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Jessica Jaganathan
</TD></TR><!-- show image if available --><TR vAlign=bottom><TD width=330>
</TD><TD width=10>
</TD><TD vAlign=bottom>
ST FILE PHOTO
</TD></TR></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->MORE doctors are being investigated for prescribing sleeping pills too freely, a growing problem that could soon result in stricter guidelines.
Eighteen doctors were disciplined for related offences in the last four years. This year, there are 19 cases already being investigated by the Singapore Medical Council (SMC).
<TABLE width=200 align=left valign="top"><TBODY><TR><TD class=padr8><!-- Vodcast --><!-- Background Story --><STYLE type=text/css> #related .quote {background-color:#E7F7FF; padding:8px;margin:0px 0px 5px 0px;} #related .quote .headline {font-family: Verdana, Arial, Helvetica, sans-serif; font-size:10px;font-weight:bold; border-bottom:3px double #007BFF; color:#036; text-transform:uppercase; padding-bottom:5px;} #related .quote .text {font-size:11px;color:#036;padding:5px 0px;} </STYLE>ADDICTED TO PILLS
'It came to a point where I would forget what I was doing and even walk out of a shop with a packet of noodles without paying for it.'
Beautician Lily Tan (not her real name), on her past addiction to Dormicum
One pill a day for 2 weeks = Addiction
The more common benzodiazepines are Dormicum, Erimin, Valium and Nitrazepam, which can be addictive when taken in large quantities over a long period.
Current MOH guidelines on benzodiazepines, issued in 2002, warn that one pill a day for just two weeks could lead to addiction.
</TD></TR></TBODY></TABLE>The most problematic pills being commonly dispensed are benzodiazepines such as Dormicum, Erimin, Valium and Nitrazepam.
The Ministry of Health (MOH) is currently reviewing prescription guidelines for these drugs. They will be out by the end of the month.
Benzodiazepines are a class of drugs normally used to treat conditions such as insomnia and anxiety.
They are favoured by drug addicts, who pay two to three times the price to get them on the black market.
Current MOH guidelines on benzodiazepines advise doctors to assess and justify the need for such pills before prescribing them.
But desperate patients will shop around to get them.
Associate Professor Munidasa Winslow of the department of psychological medicine in the National University Health System (NUHS) said the worst case he has seen is a patient who took 46 Dormicum tablets every day.
'Some women patients even have Excel spreadsheets of the different doctors they go to to get their pills,' he said.
Madam Lily Tan (not her real name) became addicted to Dormicum three years ago when she could not cope with her son playing truant. She would take up to 10 tablets a day just to 'keep going'.
'It came to a point where I would forget what I was doing and even walk out of a shop with a packet of noodles without paying for it,' said the 50-year-old beautician.
When all else fails, patients can obtain sleeping pills easily from pharmacies in neighbouring countries, or online.
In 2005, it was reported that about seven million sleeping pills are prescribed here every year.
Doctors told The Straits Times that patients are more well-versed now with these drugs and will ask for them by name.
Doctors may also be more liberal in prescribing benzodiazepines because of the money they make dispensing these pills.
They cost a few cents, but are sold to patients at between 70 cents and $3 a pill.
The scale on which this could become a problem was highlighted in 2004, when eight doctors from the Grace Polyclinic chain were punished for indiscriminately prescribing addictive sleeping pills.
The head of the group was struck off the register and fined $10,000. The others received suspensions of six to 20 months and fines ranging from $3,000 to $10,000.
A lively demand on one side and willing supply on the other have prompted calls to focus on this growing problem.
Left to regulate themselves, some clinics, such as the Raffles Medical Group, prescribe only the minimum dose of a drug like Dormicum for each patient and keep a record of every prescription.
But many doctors often do not have the time or motivation to be so meticulous.
Some places, such as the Australian state of Victoria, have a central registry which records the names of all patients who use benzodiazepines, said Dr Winslow.
The registry is accessible to all doctors, so any abuse can be kept in check.
Madam Halimah Yacob, head of the Government Parliamentary Committee (GPC) for Health, welcomed the idea but raised questions about its practicality.
Doctors are often hard-pressed for time and such a registry calls up issues of information access and patient confidentiality.
Another GPC member, Dr Lam Pin Min, suggested setting guidelines instead on the indications for use, as well as the duration and the amount of medication to be prescribed for each patient.
Doctors should also spend more time with their patients to sort out their sleeping problems instead of resorting to drugs as the only strategy, said others.
Said Dr Kenny Pang, a sleep specialist at Pacific Sleep Centre: 'It's important to ask about their sleep history and habits as most of the time, there is underlying stress, anxiety or depression.' [email protected]
<TABLE cellSpacing=0 cellPadding=0 width="100%" border=0><TBODY><TR>Sep 11, 2008
OVER-PRESCRIBING SLEEPING PILLS
</TR><!-- headline one : start --><TR>More docs facing probe
</TR><!-- headline one : end --><TR>19 cases so far this year; Health Ministry reviewing prescription guidelines </TR><!-- Author --><TR><TD class="padlrt8 georgia11 darkgrey bold" colSpan=2>By Jessica Jaganathan
</TD></TR><!-- show image if available --><TR vAlign=bottom><TD width=330>
</TD><TD width=10>
ST FILE PHOTO
</TD></TR></TBODY></TABLE>
<!-- START OF : div id="storytext"--><!-- more than 4 paragraphs -->MORE doctors are being investigated for prescribing sleeping pills too freely, a growing problem that could soon result in stricter guidelines.
Eighteen doctors were disciplined for related offences in the last four years. This year, there are 19 cases already being investigated by the Singapore Medical Council (SMC).
<TABLE width=200 align=left valign="top"><TBODY><TR><TD class=padr8><!-- Vodcast --><!-- Background Story --><STYLE type=text/css> #related .quote {background-color:#E7F7FF; padding:8px;margin:0px 0px 5px 0px;} #related .quote .headline {font-family: Verdana, Arial, Helvetica, sans-serif; font-size:10px;font-weight:bold; border-bottom:3px double #007BFF; color:#036; text-transform:uppercase; padding-bottom:5px;} #related .quote .text {font-size:11px;color:#036;padding:5px 0px;} </STYLE>ADDICTED TO PILLS
'It came to a point where I would forget what I was doing and even walk out of a shop with a packet of noodles without paying for it.'
Beautician Lily Tan (not her real name), on her past addiction to Dormicum
One pill a day for 2 weeks = Addiction
The more common benzodiazepines are Dormicum, Erimin, Valium and Nitrazepam, which can be addictive when taken in large quantities over a long period.
Current MOH guidelines on benzodiazepines, issued in 2002, warn that one pill a day for just two weeks could lead to addiction.
</TD></TR></TBODY></TABLE>The most problematic pills being commonly dispensed are benzodiazepines such as Dormicum, Erimin, Valium and Nitrazepam.
The Ministry of Health (MOH) is currently reviewing prescription guidelines for these drugs. They will be out by the end of the month.
Benzodiazepines are a class of drugs normally used to treat conditions such as insomnia and anxiety.
They are favoured by drug addicts, who pay two to three times the price to get them on the black market.
Current MOH guidelines on benzodiazepines advise doctors to assess and justify the need for such pills before prescribing them.
But desperate patients will shop around to get them.
Associate Professor Munidasa Winslow of the department of psychological medicine in the National University Health System (NUHS) said the worst case he has seen is a patient who took 46 Dormicum tablets every day.
'Some women patients even have Excel spreadsheets of the different doctors they go to to get their pills,' he said.
Madam Lily Tan (not her real name) became addicted to Dormicum three years ago when she could not cope with her son playing truant. She would take up to 10 tablets a day just to 'keep going'.
'It came to a point where I would forget what I was doing and even walk out of a shop with a packet of noodles without paying for it,' said the 50-year-old beautician.
When all else fails, patients can obtain sleeping pills easily from pharmacies in neighbouring countries, or online.
In 2005, it was reported that about seven million sleeping pills are prescribed here every year.
Doctors told The Straits Times that patients are more well-versed now with these drugs and will ask for them by name.
Doctors may also be more liberal in prescribing benzodiazepines because of the money they make dispensing these pills.
They cost a few cents, but are sold to patients at between 70 cents and $3 a pill.
The scale on which this could become a problem was highlighted in 2004, when eight doctors from the Grace Polyclinic chain were punished for indiscriminately prescribing addictive sleeping pills.
The head of the group was struck off the register and fined $10,000. The others received suspensions of six to 20 months and fines ranging from $3,000 to $10,000.
A lively demand on one side and willing supply on the other have prompted calls to focus on this growing problem.
Left to regulate themselves, some clinics, such as the Raffles Medical Group, prescribe only the minimum dose of a drug like Dormicum for each patient and keep a record of every prescription.
But many doctors often do not have the time or motivation to be so meticulous.
Some places, such as the Australian state of Victoria, have a central registry which records the names of all patients who use benzodiazepines, said Dr Winslow.
The registry is accessible to all doctors, so any abuse can be kept in check.
Madam Halimah Yacob, head of the Government Parliamentary Committee (GPC) for Health, welcomed the idea but raised questions about its practicality.
Doctors are often hard-pressed for time and such a registry calls up issues of information access and patient confidentiality.
Another GPC member, Dr Lam Pin Min, suggested setting guidelines instead on the indications for use, as well as the duration and the amount of medication to be prescribed for each patient.
Doctors should also spend more time with their patients to sort out their sleeping problems instead of resorting to drugs as the only strategy, said others.
Said Dr Kenny Pang, a sleep specialist at Pacific Sleep Centre: 'It's important to ask about their sleep history and habits as most of the time, there is underlying stress, anxiety or depression.' [email protected]
