Angry Doctor

Thursday, August 10, 2006

Putting the Genie back...

... into the drug bottle.

Subutex is now a Class A Controlled Drug, and will have to be taken in the presecnce of a doctor or pharmacist.

You can read the full Ministry of Health press release here, and the Channel NewsAsia story here.

According to the CNA story:

"Medical sources tell Channel NewsAsia that some clinics in Singapore have made as much as one million dollars a year by selling Subutex to their patients."


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  • Nothing wrong in earning from drug abusers to subsidize the poor patients.

    Ethics is a matter of opinions

    By Anonymous Anonymous, At August 10, 2006 11:26 pm  

  • Actually MOH knows who are the ones who made how much money.

    Based on the patient database they could check to see how many of these patients actually kicked their drug addiction habit and how many did not. From there you can make further investigations accordingly.

    As it is I read that Subutex was found to be 80% successful in getting patients off heroin. NO mention was made as to whether this meant replacing the heroin problem with another drug eg Subutex itself.

    Fishy statistics and studies.....

    Everyone just act blur I guess.

    By Blogger Dr Oz bloke, At August 11, 2006 9:09 am  

  • "Nothing wrong in earning from drug abusers to subsidize the poor patients.

    Ethics is a matter of opinions"

    You are making an assumption that they subsidize the poor.

    I am sure SMC would be enlightened to note that it is 'ethical' to keep drug abusers in addiction so that DR can subsidize the poor patients. Bravo!

    By Blogger palmist, At August 11, 2006 12:21 pm  

  • I don't think it's right to hand out free subutex to drug abusers, like what they do in the UK.

    At least if someone switches from heroin to subutex, it reduces their risk of getting hepatitis and other blood borne disease.

    By Blogger tscd, At August 11, 2006 4:26 pm  

  • Well, the Minister of Health recognises that the clinic with the largest usage of subutex lies in his constituency!
    Subtle message here : WE ARE WATCHING YOU. We know who you are and what you do.
    I am glad that we have him as the Minister of Health. He has gotten rid of quite a few drug pushers masquerading as doctors.

    By Anonymous Anonymous, At August 11, 2006 4:33 pm  

  • So you mean those GPs are not really doctors with MBBS? They are drug traffickers pretending to be doctors?

    Hmm that's quite smart I guess! The penalty for masquerading as a doctor is probably not the death penalty!

    So now we know the real answer liao!

    The drug traffickers all ended up becoming Subutex sellers pretending to be doctors along the way!

    So maybe the "GPs" who earned 1 million were not even doctors with MBBS at all!

    By Blogger Dr Oz bloke, At August 11, 2006 5:05 pm  

  • tscd, the problem is that locally, heroin is usually smoked ('chasing the dragon') rather than injected, which ironically makes Subutex a worse problem than heroin.

    Subutex was (well, still is and will be until next week) also more easily available and cheaper than heroin.

    By Blogger angry doc, At August 11, 2006 5:11 pm  

  • Ethics is a matter of opinion.

    However, in this specific case, it is the opinion of the SMC on what constitutes 'unethical' behaviour that counts.

    By Blogger angry doc, At August 11, 2006 5:53 pm  

  • I wonder if there will be a "mad rush" to get Subutex before Monday?

    Firesale perhaps? To clear stock also? LOL!

    Hurry while stocks last!

    Speaking of which can I quickly order 100,000 tablets from the drug company and make some money over the next 2 days? LOL!

    By Blogger Dr Oz bloke, At August 11, 2006 6:09 pm  

  • "According to Dr John Tan (not his real name), the black market offers good profits.

    A doctor can make $20 for every pill he sells, said Dr Tan. "Imagine, if you sell 500 a day. It doesn't matter whom you sell the tablets to, you can rest for the entire month."

    Dr Tan, who has a clinic in Bedok, said there is a nearby clinic that sells only Subutex to "druggies".

    The clinic has no signboard and does not open every day, said Dr Tan. But "patients" seem to know when the clinic will be open and they always enter it by the back door, he added. "

    Dear Ozbloke

    It was almost the case. Sad but true there will be a few unrepresentive doctors who would tarnish the good name of the noble profession.

    By Blogger palmist, At August 11, 2006 6:13 pm  

  • Dear dr oz bloke,
    Ha ha. These "traffickers" are the stupid ones who spent 5 years in Medical School + 1 year of Housemanship (Slavery)to be fully registered as Doctors. Imagine the millions they lost in income in these 6 years, not to mention the amount they "owe" the Government for their bonds. The smart ones, just became traffickers.

    Maybe we'll see a "great Subutex" sale in the next 2 days. These clinics could well put up a "Closing Down sale - everything MUST go" sign!
    Wish they could do this to Erimin 5 and Dormicum too.

    By Anonymous Anonymous, At August 11, 2006 11:16 pm  

  • My friend and I were calculating yesterday.....there are 8,000 estimated Subutex users in Singapore (tip of the iceberg only apparently).

    Let's say each of them take 1 tablet a day. That means 8,000 tablets are sold a day. Each tablet gives a profit of $20.

    Subutex has been around for 4 years?

    So in total the profits over the past 6 years = 8000 x $20 x 365 x 4 = $233,600,000!

    $233.6 million over the past 4 years! And if you divide it by the 35 GPs registered to sell Subutex, each GP made $6.67 million over the past 4 years!

    That's an incredible amount of money!

    Yeah I feel like a F#@#ing idiot. Should have been a drug trafficker instead.

    And I just had another patient who complained that my $10 consult fee was too high....sigh

    By Blogger Dr Oz bloke, At August 12, 2006 9:39 am  

  • That's the wrong way to think.
    U should think that becuase of the money they made, they are able to help poor patients waive consult fees and probably donate to charity like Warren Buffett.

    The rich definitely donate more to the poor than the poor.
    What's wrong with making money from drug abusers who abuse drugs meant to help them

    By Anonymous Anonymous, At August 12, 2006 12:47 pm  

  • Eh, I thought subutex is in tablet formulation? How come it's available as an injectable? That kind of defeats the purpose.

    By Blogger tscd, At August 12, 2006 11:19 pm  

  • Subutex doesn't give the same 'high' as heroin, I understand, which is why it is supposed to be easier to wean off it.

    But it definitely should be a controlled drug and given out only on a named patient basis. Otherwise nurses, porters, doctors, pharmacists can anyoldhow nick some off the shelves and sell em on the black market. Or use it themselves.

    By Blogger tscd, At August 12, 2006 11:24 pm  

  • anon, I don't believe Warren Buffett sold habit-forming drugs.

    By Blogger angry doc, At August 12, 2006 11:31 pm  

  • tscd, Subutex abusers dissolve the tablet and mix it with other drugs like Dormicum and inject the mixture intravenously to get a high.

    Some abusers claim it gives a 'better' high than heroin when used that way. It is also cheaper and more easily available, and has become the first drug of abuse for some addicts.

    The drug manufacturer is aware of the abuse potential, which is why buprenorphine is also available as Suboxone - a formulation with naloxone - to 'guard against abuse'. Subutex is supposed to be used for initiation of therapy and Subuxone for maintenance, but I don't suppose the people selling them wondered why they were (presumably) selling more Subutex than Suboxone.

    By Blogger angry doc, At August 12, 2006 11:42 pm  

  • Warren Buffet once owned a beer company in Britain
    There are many ways to make money
    Just remember to give back what don't to the needy

    By Anonymous Anonymous, At August 13, 2006 1:42 am  

  • What?! They dissolve the tablets and make up some kind of tablet soup IV? That is impressive, I must say. Singaporeans have more creative potential than I thought. I'm not sure the Brits can be bothered to do that sort of thing.

    Now the Singaporean docs better guard against druggies who come into A&E to get an IV line put in.

    By Blogger tscd, At August 13, 2006 4:27 pm  

  • I can't imagine how anyone got the idea to do that, but there you have it.

    They are quite good at injecting themselves, actually - but the complications are ghastly.

    By Blogger angry doc, At August 13, 2006 5:37 pm  

  • Was curious - how ghastly are the complications?

    By Blogger SM, At August 24, 2006 1:16 am  

  • SM, check out the link in the 10th Jul entry.

    By Blogger angry doc, At August 24, 2006 4:52 pm  

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