About 8,000 doctors prescribed medical narcotics to themselves annually for the past three years, prompting calls for banning doctors from self-prescribing narcotic drugs by law.

These and other facts were revealed at a public debate organized by Rep. Choi Youn-suk of the ruling People Power Party (PPP) on “How to restrict doctors’ self-prescription of narcotic drugs” at the National Assembly on Monday.

Earlier, Rep. Choi analyzed data from the Ministry of Food and Drug Safety and found that about 8,000 doctors, representing 11.0 percent of all doctors, including dentists, self-prescribed medical narcotics every year for the past three years. One in four self-prescribing doctors repeatedly did so for more than three years in the past three years and five months.

Professor Kim Jong-ho of law and police administration at Hoseo University spoke on the topic of “Legislative responses to prohibiting doctors from self-prescription.”

Professor Kim explained overseas regulations on physicians’ self-prescribing. According to Kim, Canada prohibits physicians from prescribing or administering controlled substances, including narcotics, to themselves or their family members.

Australia also prohibits doctors from treating themselves or their family members under the Medical Board Code of Conduct. The United Kingdom guides doctors to avoid self-prescribing as much as possible.

In the United States, regulations vary by state. For instance, Connecticut prohibits physicians from prescribing or administering controlled substances to themselves or their immediate family members except in an emergency.

Kim emphasized it is necessary to limit physicians’ self-prescribing of narcotics. He noted that physician use of dependency-inducing drugs is dangerous and can affect optimal physical functioning and put themselves and their patients at risk.

"The potential problems of self-prescribing have been recognized as a serious issue for many years, but we have not been able to impose the prohibitions and sanctions that we should," Professor Kim said. "If we waste time now, health standards will only decline."

He said, "We should not expect doctors to be licensed to practice medicine and not self-prescribe. I believe it is appropriate for the minister of food and drug safety to control the supervisory authority for prohibiting doctors from self-prescribing narcotic and psychotropic drugs."

Kim suggested possible ways to legislate a ban on self-prescribing, such as predetermining prohibited drugs and prohibiting only those drugs, comprehensively prohibiting self-prescribing unless there is a legitimate reason, allowing doctors to prescribe up to a specific limit, and prohibiting them from exceeding it.

However, the professor said that restricting doctors’ self-prescription is restraining the prescription rights that fall within the scope of a doctor's license, which must be set by law. It is appropriate to ban doctors' self-prescription of psychotropic drugs in the Narcotics Control Act rather than the Medical Service Act.

In addition, the Narcotic Drugs Control Act should require pharmacists to establish a system to check the facts in cases where the prescribing doctor and the person receiving the prescription are suspected of being the same person. The Pharmaceutical Affairs Act should be amended to allow pharmacists to refuse to dispense prescriptions if they have reason to suspect that the prescription amount is excessive for a certain period.

"When establishing regulations that prohibit doctors from self-prescribing psychotropic drugs, it is essential to include penalties for violations of such regulations," Kim said. "Legislating such administrative penalties should be based on the principles of criminal justice and clarity of legal content."

"I think it is a key role and task for regulators to educate doctors about the risks of self-prescribing," Professor Kim said. "For this legislation on the prohibition of self-prescribing by doctors to be effective in practice, statutory education must be provided, and there must be penalties for not completing the specified statutory education."

In the discussion following the presentation, many participants said doctors should be banned from self-prescribing narcotic drugs.

"It is a necessary measure for the health of doctors to prohibit them from using medical narcotics and require them to use them under the correct diagnosis and prescription with the help of fellow doctors," said Cho Yoon-mi, executive director of Future Consumer Action.

Cho went on to say, "We believe it is appropriate to manage prescriptions for family members by clarifying the scope of family members and establishing an additional administrative management system to supervise whether proxy prescriptions are made."

Lee Ji-Young, a lawyer at the law firm Lawis Law Group, said, “The recent increase in doctors' self-prescription of narcotics, some of which are suspected of misusing narcotics, is a social problem leading to health risks for patients treated by such doctors and illegal distribution of narcotics, beyond the concern of drug addiction for the doctors themselves.”

While there is a need to limit the self-prescription of narcotics by doctors, it may be overregulation to regulate the issuance and administration of narcotic prescriptions to doctors and their family members as a possible cause of narcotic misuse, Lee pointed out, adding that it is necessary only to limit the prescription to doctors themselves.

On the other hand, Dr. Min Yang-ki, medical director of the Korean Medical Association, said that the problem is the misuse of narcotic drugs, not self-prescription.

"We must first understand that narcotics and drugs are different. Contraindicated drugs and medical drugs are also completely different," he said. "Contraindicated drugs should not be taken (even by doctors), which is a matter that should be dealt with by criminal law.

Min said, “(Doctors' self-prescribing of narcotics) is controlled through the Integrated Narcotics Management Site. We are discovering self-prescription but haven't announced it because the system is in its early phase. In the future, however, relevant administrative measures will be taken."

Min noted that if there is a problem (with doctors self-prescribing narcotic drugs), the KMA also makes self-corrective efforts, such as requesting an investigation and filing a prosecution complaint.

“The prosecutor's office can handle illegal use or misuse of (narcotic drugs). Doctors' prescriptions should not be restricted for this reason," he emphasized.

Kim Myung-ho, a drug safety planner at the Ministry of Food and Drug Safety, also said that not all doctors self-prescribe and abuse narcotic drugs.

"It's hard to say that all those thousands of doctors who self-prescribe (narcotic drugs) are abusing them," Kim said. "You have to look at the circumstances and the amounts of drugs they prescribe. Self-prescribing is not the same as addiction."

Kim noted that because the number of people in the relevant departments at the MFDS is limited, they continue to target first the most frequently self-prescribing doctors with high prescription volumes. If the officials think there is a problem, they hand over such doctors to the prosecutor's office. Then the prosecutor's office makes their judgment, he added.

"Doctors are experts, so it's easier for them to use (narcotic drugs) than the general public, so I think it's necessary to punish doctors who misuse them more severely than the general public," Kim said. "We should discuss the issue of doctors’ self-prescription of narcotics and reach a social consensus instead of concluding it overnight."