Fears over missing prescription forms

Notes from the Health Authority can be used to obtain drugs so tightly controlled that some are kept in a safe.

ABU DHABI // Forty-one prescription forms for powerful and addictive medicines have gone missing in recent weeks, health officials said.

The blank specialised notes can be filled for controlled, drugs such as antidepressants, muscle relaxants, sedatives, and painkillers such as Tramadol, methadone, Subutex and Valium. Many of these drugs are so tightly controlled that they are required to be stored in a metal safe.

Three alerts from the Health Authority - Abu Dhabi (Haad), issued from October 18 to November 2, list the serial numbers of the forms and call on medical workers to contact police if they are encountered.

Dr Jamal al Kaabi, head of corporate communication and customer service at Haad, said every precaution would be taken to catch anyone using the forms to try to obtain drugs illegally.

"There is a risk that these prescription forms are being used by people to get medications they should not be getting," he said. "They could be selling them, giving them to other people or using them themselves. Any way, it is unacceptable."

The first notice, sent to all hospitals and clinics, lists the consecutive serial numbers of 15 forms missing from a clinic in Abu Dhabi emirate. A second circular lists the consecutive numbers of 23 forms. The final notice lists three numbers.

"The Health Authority-Abu Dhabi has received a report of a number of narcotic prescription forms unaccounted for from a healthcare facility in the emirate of Abu Dhabi," the second notice said. It calls on facilities to notify Haad if any of the prescriptions have been presented to pharmacies.

Dr Usama Abu Shaban, head of the health audit pharmacy section at Haad, said the burst of "unaccounted for" prescriptions stemmed from enforcement efforts.

"It is a combination of a crackdown by us and better compliance from facilities," he said. "We require every hospital and clinic to report incidents like this and we are enforcing this rule strongly. Any misuse is a criminal matter."

Poor security was also a factor, he added. All controlled drugs and forms should be kept locked away and out of reach of patients. Prescriptions for such medicines can only be issued and filled at a hospital and its pharmacy.

"In theory, the doctor should be known by the pharmacy so there should be no mistake," Dr Abu Shaban said. "It should limit the opportunity for fraud."

No accurate countrywide data exists for prescription medication misuse in the UAE. Globally, it is accepted that addiction to these medicines is overtaking addiction to other illicit substances.

A 2010 report by the United Nations Office on Drugs and Crime stated: "Particularly in the USA, cannabis is the only illicit drug that is more widely abused than prescription drugs, including analgesics, stimulants, sedatives and tranquillisers."

A senior psychologist at a public hospital, who did not want to be identified, said cases of patients taking blank prescription forms to self-prescribe was not uncommon in the past.

"The prescription [forms] should be kept locked away," he added. "The medicines are strong and as professionals, we have to be very careful with the dosage, and make sure patients do not get addicted."

The majority of narcotic drugs are prescribed in public hospitals. The private sector is allowed to distribute them with consent from the health authority.

Dr Emal Shaiko, a specialist psychiatrist, used to work in private practice before moving to a public hospital. She said using an electronic system to store medical records and prescribe medication would diminish the risk of patients getting access to unauthorised drugs.

"This is a major treatment," she said. "It is very important that medications do not fall into the wrong hands."