Combating addiction? LRH bans prescription of injectable meds for outpatients

Will be prescribed oral formulas of the same medication, says OPD director

PESHAWAR: Lady Reading Hospital (LRH) administration has banned the provision of certain injectable medicines for out-patients visiting the medical facility. If “patients insist”, they can be prescribed the medication but only to be procured at pharmacies outside LRH.

A notification to this effect was issued from the office of the Accident and Emergency department at LRH, dated February 25.

It reiterated no such demands should not be entertained and only those patients who have been properly assessed should be provided the medicine if need be but in an oral formula. However, the notification goes on to create a loophole for when patients insist, doctors can issue a prescription, but the drugs must be purchased from the market.



The medicines include diclofenac, a nonsteroidal anti-inflammatory drug used to treat mild to moderate pain; drotaverine, an anti-spasmodic and ranitidine, used for ulcers in the stomach and intestines. Others on the list included tramadol, an analgesic painkiller; dimenhydrinate (better known as Gravinate), used to treat nausea, vomiting, and Risek or Omeprazole which treats acid reflux, and stomach ulcers.

“People coming for IV fluids should be properly assessed for dehydration,” the notification read. Dehydrated patients should be referred to the medical unit on call and its opinion should be sought before the patient is started on the IV, added the order.

Officials at LRH said an average of 4,000 people visited the accident and emergency department on a daily basis. Many complained of muscle pains and demanded painkillers.

Bringing the crowd

An official stated people had become addicted to painkillers. He added sometimes technicians running clinics in villages were considered more competent compared to a specialised doctor.

“People get [temporary] relief from what the technician prescribes and then refuse to get an appointment with specialist doctors since they believe the former knows best,” LRH Outpatient Department (OPD) Director Dr Khalid told The Express Tribune. “Patients don’t know the technician is playing with their health by prescribing just a painkiller.”

He assured prescriptions will only be given to those who required it – after they are properly assessed. “A labourer usually feels pain in the muscles after a hectic day, but it does not mean he should demand a painkiller shot,” Khalid said. He added, “It provides temporary relief, but is injurious in the long run [if taken repeatedly].”

The OPD director said these measures were taken for those addicted to painkillers,” he informed. “Those in need will be provided the medicine after a doctor’s examination and others will be discouraged.”

When asked, Khalid said some health employees and pharmacy stores outside the health facility were involved in the propaganda against the LRH administration.

The director said the hospital had started achieving its objectives since over 400 patients were examined at the evening OPD which clearly suggested people were being provided relief. He claimed the public were provided Rs0.4 million worth of treatment.

“Patients would previously be prescribed laboratory tests in the morning OPD and they would then pay Rs1,000 consultancy fee to show test results at clinics. Now, the same doctor will be at the OPD till 4:30pm and patients will be able show the results for free.”

Published in The Express Tribune, February 29^th,  2016.