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Posts Tagged "pharmacist"

28Aug

Pharmacist fights for right to take opioid replacement medication on the job | CBC News

by admin

B.C.’s Human Rights Tribunal will hear the case of a pharmacist who claims restrictions on opioid replacement medication for working healthcare professionals is discriminatory — even though he’s been cleared to re-apply for his licence.

The 16-year pharmacist, who is not named or identified in any way by the tribunal, is now free to return to work following a second opinion from an addictions specialist. It’s unclear if he has applied to do so and he argues his screening process took too long.  

The pharmacist argues there’s no scientific reason to restrict healthcare workers from using medications that curb drug cravings and withdrawal in order to aid addiction recovery.

The 16-year pharmacist, who is not named or identified in any way by the tribunal, was initially denied his license when he tried to return to work two years ago after a voluntary suspension due to an “addiction-related disability” that led to a $1,300-per-week heroin habit.

He wanted to use Suboxone — a medication that curbs opioid cravings — and be allowed to return to his job dealing with high-risk drugs. Doctors and nurses in many U.S. states and Quebec are permitted to take Suboxone, and in some cases methadone, while working.

Suboxone allowed him to live ‘a normal life’

According to an  Aug. 22  tribunal decision, the pharmacist struggled with opioid addiction, including heroin, for several years, then returned to work. But he relapsed in 2015, despite a return-to-work plan that included monitoring. The pharmacist voluntarily suspended his license, returning to in-patient treatment.

He was prescribed Suboxone, a medication used to curb craving for opioids and ultimately taper opioid use, in 2016. The pharmacist reported Suboxone helped him live a normal life.

But when he attempted to return to work in 2017, the addictions specialist who evaluated him determined the pharmacist was not fit for duty in a “safety-sensitive” job — such as a clinical pharmacist who handled opioids — if he continued to take Suboxone. 

The pharmacist who launched the complaint to the B.C. Human Rights Tribunal did get a second opinion when he balked at abstinence as having no scientific basis as successful. That doctor agreed. (Shutterstock / Atstock Productio)

The doctor also recommended he enter a 12-step program, faith-based treatment program that requires abstinence from all drugs. He objected because he is an atheist and claimed the drug-free rule wasn’t based on scientific evidence.

The pharmacist sought a second doctor’s assessment and the college eventually accepted new recommendations in August 2018 which allow him to submit an application to register as a full pharmacist.

The first doctor and the College of Pharmacists of B.C. then requested his human rights complaint be dismissed. But the tribunal ruled Aug. 22 that the hearing will proceed, in part.

‘Hurt and shocked’

In the pharmacist’s initial complaint to the Human Rights Tribunal he argued that he was discriminated against because he was referred to a religious-based treatment program when he’s an atheist, and he wasn’t allowed to return to work unless he stopped using medication needed for his disability.

That precondition prevented his return to work in a “reasonable time frame,” he argued.

The pharmacist said the first doctor who assessed him “demonstrated unfair and offensive stigma and stereotyping of people with addiction issues.”

He described feeling “hurt and shocked” when the assessing doctor asked if a return to work would make him feel “like being a kid in a candy store” since he would be near so many drugs.

Tribunal Member Emily Ohler said she read more than 1,300 page of submissions from all parties before determining a hearing was needed.

Ohler denied the pharmacist’s claim of discrimination based on religion, as the 12-step treatment program was not mandatory. She did order a hearing into the discrimination claim based on mental disability.

In her ruling Ohler cited an expert who confirmed past workplace addictions policies in this province restricted healthcare workers from using drugs like Suboxone, but said that practice needed more study.

In Quebec, doctors overcoming addiction can use methadone. An American study published by the Mayo Clinic in 2012 reported dozens of healthcare worker discipline programs permitting nurses and doctors to return to work while using similar addiction treatments.

Suboxone is a long-acting opioid medication used to replace shorter-acting opioids like heroin, oxycodone, fentanyl or hydromorphone. It can prevent withdrawal symptoms and reduce cravings. (Sally Pitt/CBC)

7Aug

Daphne Bramham: College roots out the bad, white-collar dealers, one pharmacist at a time

by admin

When you think about shady drug dealers, it’s usually in the context of the Downtown Eastside or the Surrey Strip.

But in the last three months alone, the B.C. College of Pharmacists has rooted out some white-collar guys who were running illegal pharmacies, faking prescriptions, doling out methadone improperly, and plumping up their dispensing numbers with made-up prescriptions for over-the-counter drugs and vitamins.

While their crimes don’t have the same kind of mean-streets vibe as the illicit dealers, it doesn’t mean that the guys in white coats didn’t do some seriously bad things.

Let’s start with William Byron Sam, who is still under investigation by the college for “knowingly operating an unlicensed pharmacy.”

A complaint outcome report posted on the college’s website says “serious public risk indicators were present within the pharmacy.“ It doesn’t spell out what those serious risks are and, in an emailed response to my question about where Sam was getting the drugs from, the college refused to say.

In March, the college cancelled the licence for Garlane Pharmacy #2, which Sam was operating at 104-3380 Maquinna Dr. in Vancouver’s Champlain Heights.

(It still has two five-star ratings on Yelp! So, if it’s a legitimate drugstore you’re after, you might want to check the college’s listings.)

Sam’s problems began in 2015 with a practice review, which was followed up by a request for more information. In 2017, the college told him his conduct would be the subject of a hearing, admonishing him for failing to respond to the college after a practice review in 2015 and to a request for more information in 2016.

In May, Salma Sadrudin Damji, another Vancouver pharmacist, was found to have used a prescription pad from a medical clinic and falsified 62 prescriptions for Schedule 1 drugs, which include heroin, LSD, ecstasy and methaqualone (aka Quaalude) using three patient names and two physician names. In May, the college fined her $1,000, imposed a 90-day suspension and forbid her from owning or managing a pharmacy for three years or acting as a preceptor or mentor for pharmacy students.

Beyond that, the college says it can’t comment.

North Vancouver’s Davood Nekoi Panah provided monetary incentives to a patient, dispensed Schedule 1 drugs without an authorized prescription in unlabelled and mislabelled containers — all without taking reasonable steps to confirm the identify of the patients before giving them the drugs.

He was fined $10,000. Starting Sept. 4, he can’t work for two months and can’t be a pharmacy manager or preceptor for two years. Questions about him were also met with a no-further-comment response from the college.

Amandeep Khun-Khun has every appearance of being a good guy. From 2010 until 2012, he was on the college’s community practice advisory committee making recommendations related to community pharmacy practices. He was a preceptor for UBC pharmacy students and was quoted in UBC’s 2013 brochure aimed at recruiting other mentors.

But in June, Khun-Khun was fined $30,000 and suspended from practice for 540 days. He can only return to full pharmacist status if he passes the college’s jurisprudence exam and completes an ethics course.

The mailing address for his company, Khun-Khun Drugs, is the Shoppers Drug Mart on the tony South Granville Rise.

Over three years, the Vancouver pharmacist processed more than 15,000 false prescriptions for vitamins and over-the-counter drugs — things like aspirin and ibuprofen — on the PharmaNet records of seven individuals. But those seven people didn’t know anything about it.

Khun-Khun admitted he “directed pharmacy assistants to process transactions weekly on PharmaNet in order to artificially inflate the pharmacy’s prescription count.”

He did it even though he had previously undertaken to comply with all ethical requirements after earlier complaints.

Part of the reason Khun-Khun didn’t get caught earlier is because neither of the two full-time pharmacists working for him did what they were supposed to. The inquiry committee wrote that both of them “turned a blind eye” to what they knew or should have known was wrong.

They knew or should have known that what was happening was wrong since the transactions were done without patients’ consent and were an improper use and access of personal information.

William Wanyang Lu and Jason Wong were both working for Khun-Khun full-time. Both now have letters of reprimand on their permanent registration file and were required to pass both an ethics course and the college’s law exam or face 30-day suspensions.

Yet Wong hasn’t deleted a comment on his LinkedIn profile that while he worked at Shoppers Drug Mart he was “coached with great mentors at this pharmacy including Amandeep Khun-Khun.”

Among the others disciplined recently is Sing Man Tam. He was fined $10,000 and had a reprimand letter put on his permanent record for his “inadequate diligence and oversight” over two years related mainly to dispensing methadone to addicts to quell their cravings and minimize the effects of opioids.

Tam processed prescriptions without authorization. He also didn’t witness its ingestion, which is legally required (and the reason that pharmacists get $17 for dispensing it rather than the usual $10 for other medications).

He billed for methadone that was marked in the logs as having been “missed” and Tam delivered it without authorization by the doctor who wrote the prescription.

For the past several years, the college has received close to 800 complaints, but many of those don’t require any disciplinary action or even a referral to an inquiry committee. Its statistics cover the 12 months from March 1 to the end of February.

And while the most recent fines and suspensions may not seem to add up to much, the college is not always the final arbiter. The courts are.

In March, Richmond pharmacist Jin Tong (Tom) Li was sentenced to a year of house arrest after pleading guilty to one count of obtaining more than $5,000 under a false pretence.

The charge links back to the college’s disciplinary action in 2016 after it found that Li had submitted more than 2,400 fraudulent claims to PharmaCare between 2013 and 2014 that cost the B.C. government $616,000.

Coincidentally, Li’s pharmacy licence was reinstated as a pharmacist in October 2018, having been suspended for 540 days. He is still banned from being a manager, director or pharmacy owner or preceptor until 2023.

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