Doctors warned about over-prescribing anxiety and sleeping medicine

Doctors warned about over-prescribing anxiety and sleeping medicine

Doctors have six months to change how they prescribe anxiety and sleeping medicine to avoid disciplinary action by the Medical Council.

The council has warned doctors that they could face an investigation if found to be over-prescribing benzodiazepines, z-drugs and Pregabalin.

President of the Medical Council, Dr Rita Doyle said information on GP prescribing for medical card holders shows that about half of doctors are prescribing above the average and 80 GPs are overprescribing.

Dr Doyle said they have been working with the HSE, the Department of Health, the Pharmaceutical Society of Ireland, the Irish College of General Practitioners and the medical profession to see if better supports can be provided for doctors and patients.

She said it is vitally important that any patient who is taking benzodiazepines or z-drugs does not stop taking them without advice and guidance from their doctor.

Dr Doyle pointed out that doctors have a “very clear” ethical responsibility to safely prescribe these drugs as set out in the council's guide to professional conduct and ethics for registered medical practitioners.

She agreed during an interview on RTÉ radio that mental health services are not good enough but said doctors should not “compound the problem” by excessive prescribing:

“Any doctor whose level of prescribing is above the normal range, and who is not working in an exceptional area of practice, and who does not make any effort to refer their patients to support or reduce their high-prescribing levels may require formal investigation by the Medical Council."

Benzodiazepines
Benzodiazepines

The Irish Medical Organisation said that GPs are acutely aware of the dangers and difficulties in prescribing benzodiazepines and other sedatives.

IMO president, Dr Padraig McGarry, who is a practising GP, said the warning from the Medical Council about the drugs is welcome and will generate an important debate on the issue.

Dr McGarry said a patient/doctor relationship could become tense if a GP is not willing to prescribe them: “Every GP will be familiar with tense exchanges with patients who believe they should be prescribed such drugs and in some cases that can escalate to threatening behaviour."

Dr McGarry said GPs also have to “weigh up the reality” that it might take weeks to access alternative treatments for conditions such as anxiety.

In some circumstances, a prescription of a sedative might be warranted as an initial intervention while the patient begins alternative therapies. From the outset, GPs set out a plan about how the drugs would be prescribed and used.

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