Medications being sold online include controlled drugs such as benzodiazepines and opioids and also erectile dysfunction drugs. Many are advertised on Facebook groups and online auction sites.
Dr Ellie Mein, MDU medico-legal adviser, explained:
'Most prescription drugs can only be legally supplied by a pharmacy, but doctors have contacted us with concerns that patients may be selling prescribed drugs online.
'Doctors are concerned about whether they might be unknowingly drawn into the illegal supply of the drugs. They also question whether future prescriptions should be issued to the patient and if the police need to be informed.
'Our advice is for doctors to contact the patient to give them a chance to explain and consider issuing them with a warning if they admit selling the drugs. If they deny it, doctors may need to keep the situation under review if there isn't enough information to take the matter forward. Doctors should weigh up whether the matter should be reported to the police in the public interest.'
The government warns patients about buying drugs online explaining: 'Medicine sold from disreputable websites can be poor quality at best and dangerous at worst. What you receive in the post could be counterfeit, substandard or unapproved new drugs, which can put your safety at risk.' It adds that buying drugs online without a GP prescription, 'is risky, as medications should only be taken under the supervision of a health professional.'
The MHRA issued a warning earlier this year about a £200 million black market in prescription drugs being bought from pharmacists and wholesalers before being illegally sold online.
The MDU's advice to doctors who become aware that a patient may be selling prescribed drugs online is to take the following steps:
- Contact the patient to ask them about your suspicions. Give them a chance to explain.
- If the patient admits selling the drugs, consider issuing them with a warning explaining their behaviour is detrimental to the ongoing doctor-patient relationship.
- If the patient denies being involved, you should weigh up whether you have enough evidence to justify taking the matter further. If you don't, keep the situation under review.
- Consider whether the matter needs to be reported to the police in the public interest. Informing them without the patient's consent, or after refusal of consent, may be justified if failure to make the disclosure could expose others to a risk of serious harm or death.
- Review the patient's medication and any repeat prescriptions to ensure they are still required and make any adjustments necessary.
- Carefully document discussions with the patient and what actions were taken and why.
- Removing the patient from the practice list should only be considered as a last resort, for example after a warning has been issued and ignored.
- Contact the MDU for advice if you are unsure.
The MDU has also published an anonymised GP case on its website.
This guidance was correct at publication 23/04/2018. It is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.