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Medical watchdog: Doctors too lax with opioid prescriptions

Finland's Supervisory Authority for Welfare and Health (Valvira) says that some doctors are not careful enough about prescribing highly-addictive pharmaceuticals. Meanwhile police say that such drugs are also widely available on city streets.

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Addi Image: Päivi Meritähti / Yle

Doctors in Finland sometimes prescribe painkillers too readily, says a senior official at the National Supervisory Authority for Welfare and Health (Valvira).

Liisa Toppila, head of the unit that oversees medical treatment and prescriptions at Valvira, says that the agency regularly receives tips from police and pharmacies about suspicious prescriptions.

"We get notifications that doctors are handing out prescriptions on a relatively lax basis," Toppila told Yle TV1's morning chat show on Monday.

Valvira also receives reports of questionable prescriptions from family members and other physicians, she says.

The head of the Helsinki police drug squad, Jukka Paasio, says that the misuse of pharmaceuticals has risen. He says there has been a clear, parallel uptick in street sales since last summer. However it is unclear how much overlap there is in those using or obtaining such painkillers from legal and illegal sources.

Yle reported in early July that about 20 Romanians were arrested on suspicion of illicit pill sales on the streets of the capital. Police also seized quantities of Rivotril and Diapam, apparently produced illegally in eastern Europe.

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While street sales of imported pills are a problem, so are overly-lax prescriptions for legal medications.

"Patients have various doctors who may prescribe painkillers on the same or consecutive days. One that seems to be particularly popular is Panacod [which includes codeine and acetaminophen]," Toppila said.

As Toppila sees it, one problem is that physicians generally seem to believe what patients tell them.

"And patients know how to tell a story that will get them a prescription," she says.

Often doctors do not weigh the need for prescriptions carefully enough, she asserts.

"Often one hears a doctor 'I just renewed this medication' instead of each time weighing very precisely whether there is still a reason to prescribe this medicine."

She says that physicians also often attribute improper decisions to a shortage of time.

"Doctors are not in such hurry that they don't have time to evaluate what they're doing to patients," says Toppila.

However she emphasises that the vast majority of medications are properly prescribed.

Pills readily on offer in Helsinki

According to Juha-Pekka Pääskysaari, a practical nurse and former addict who was also interviewed on the programme, such pills are frequently offered in central Helsinki and in the Sörnäinen neighbourhood, for instance.

He says that the tranquilizer clonazepam, known as anti-seizure Rivotril or Rivatril, is commonly sold, mostly by Eastern European Roma. Last spring Helsinki police seized at least 50,000 of the pills. Pääskysaari points out that the content and effects of the pills can vary greatly and unpredictably.

The opioid buprenorphine, sold under the brand names Subutex and Suboxone, is also common. Although intended to help with opioid addiction, the drug has itself been frequently used on a recreational basis in Finland since the late 1990s when a Finnish doctor was convicted of smuggling them into the country for his patients' use, Pääskysaari notes.

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