Three family doctors in Nova Scotia have been sanctioned by the College of Physicians and Surgeons for overprescribing narcotics, such as hydromorphone, to patients.
In the most startling case, Dr. Philip Davis — a Halifax doctor in practise for 43 years — wrote a prescription for a nine-month supply of Dilaudid for a patient he knew was undergoing methadone treatment for a drug addiction.
The pharmacy was concerned about filling the prescription for 2,360 eight-milligram tablets and notified officials with the Nova Scotia Prescription Monitoring Program more than a year ago, in August 2013.
Kevin Lynch, the manager of the drug monitoring program, interviewed Davis, who admitted his long-time patient was not complaining of pain when he prescribed the opioid. Davis also admitted he failed to follow up with the patient later.
Lynch referred the case to the College of Physicians and Surgeons of Nova Scotia because he believed the doctor's behaviour posed a "public safety issue," especially given the patient's addiction issues and his job as an electrician.
According to the written decision, Davis felt it was more beneficial for his patient to "continue to receive his medication through his prescription, than to acquire the drugs on the street."
"A prescription providing a total of nine months of part-fills to a patient with addiction issues, with no formalized plan for re-assessment or monitoring is, in PMP's [Prescription Monitoring Program] opinion, an inappropriate approach to the prescribing of monitored drugs."
Davis not suspended
The investigation committee of the college has not suspended Davis's licence, but issued a reprimand and ordered the doctor — a first-time offender — to take a records-keeping course.
The committee said it will conduct an audit of the doctor's prescribing practices in six months. He has been charged a $5,000-fee to cover the cost of the investigation.
CBC News asked Dr. Gus Grant, the registrar and CEO of the College of Physicians and Surgeons of Nova Scotia, to explain why Davis's licence was not suspended or withdrawn and whether the Committee considers him a safety risk.
"The decision speaks for itself," said Grant.
"The college believes in education as an important tool in protecting the public. In Dr. Davis's case — and Dr. Davis has agreed — the prescribing patterns found were not in keeping with the standards of the profession. The steps taken by the college are in support of improving and educating Dr. Davis with respect to his prescribing."
Two other family physicians in Nova Scotia have also been sanctioned for overprescribing narcotics.
Dr. Stephen Harley, of Dartmouth, has had his licence suspended for a fourth time pending a disciplinary hearing at which the College of Physicians and Surgeons of Nova Scotia will request his licence be revoked.
Dr. Trevor Locke, a family physician in Truro, has had a condition placed on his licence while a complaint is being investigated. Locke is not allowed to prescribe narcotics.
Grant said the college is "concerned" about the overprescribing of opioids by doctors.
"I think the public and the profession should be concerned about the appropriateness of prescribing," he said. "In this situation, it's just a coincidence that three complaints came together at largely the same time involving opioids."