Doctors fined for doling out Subutex freely

Two general practitioners are the latest doctors taken to task for prescribing Subutex too freely.

The medication is used to wean addicts off heroin, and Dr Kong Kok Leong, 41, and Dr Eric Chong Yu, 38, were found guilty of prescribing it without a proper management and record-keeping plan.

The Singapore Medical Council (SMC) said yesterday that Dr Kong had been fined $7,000; and Dr Chong, $5,000.

Both were also suspended from Kings Medical Clinic, their medical practice located at Serangoon Garden Way, for four months each, from Monday.

SMC started investigating after complaints were filed by the Health Ministry (MOH) on June 1, 2007.

Dr Kong faced 19 charges and Dr Chong faced 17 charges for failing to carry out proper assessment of the patients' condition before prescribing Subutex, which include urine tests and checking for track marks on the arm.

No management plan

They also failed to come up with or keep to any management plan for patients they had prescribed Subutex to.

Both doctors contested all charges at the Disciplinary Committee Inquiry.

After pondering over the mitigating factor that both doctors carried out periodic reviews of the patients, the committee convicted them on 16 charges each.

Subutex, commonly sold as a pill that dissolves under the tongue, was approved by MOH in 2000 as a form of treatment to wean heroin abusers off their addiction.

But the lack of a proper management plan can result in addiction.

Addicts, having discovered this, were mixing it with other drugs then injecting it into their body to achieve the same high they got from heroin.

Since Subutex was then legal, its abuse soon became rampant - at its peak in 2006 and 2007, it was the most abused drug in Singapore, with more than 30 per cent of abusers taking it.

Instead of using it to wean off heroin, addicts took it to get high, generating a thriving Subutex black market here.

According to a 2006 newspaper report, the Central Narcotics Bureau said doctors treating heroin addicts were making a profit of $15 on each 8mg Subutex tablet.

There were 31 clinics then allowed to prescribe the drug, and between them, they sold 580,000 tablets from November 2005. This means that in less than 10 months, the clinics made a profit of around $8.7 million.

In August 2006, Subutex was reclassified as a controlled drug, making it illegal to stamp out the growing problem of former heroin addicts becoming addicted to the drug.

Doctors were taken to task for their indiscretions when doling out the pill.

Between 2007 and yesterday, 17 GPs have been censured for prescribing Subutex too freely. They faced between 10 and 122 charges.

One doctor was even suspended for 30 months for his indiscretions.

As for Dr Kong and Dr Chong, apart from being fined and suspended from duty, the two were also censured, and provided written undertakings to the SMC that they will not engage in similar conduct.

They also bore the costs of the proceedings.