NSW dentist banned for opioid misconduct

Jeremy Booth, Dental Tribune International

Thu. 8. October 2020

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SYDNEY, Australia: A New South Wales (NSW) dentist found guilty of professional misconduct has been banned from practising dentistry for a period of 12 months. Dr Peter Joseph Brian Buys was censured and found guilty of a number of breaches of conduct relating to the prescription of opioids, including that of prescribing excessive quantities of oxycodone to patients without appropriate documentation.

Buys’ registration was cancelled by the occupational division of the NSW Civil and Administrative Tribunal after he was prosecuted in April by the NSW Health Care Complaints Commission. His offences occurred between February 2007 and September 2016 at two dental practices that he operated—Lisarow Dental Care and Wyong Dental Care, both located in NSW.

According to the tribunal’s judgment, dated 10 September, Buys failed to demonstrate appropriate knowledge or judgement in a number of instances, including when he prescribed the Schedule 8 drug oxycodone to ten patients in excessive quantities over excessive periods without the use of proper monitoring or review. He also failed to document prescriptions in patient records or consult with the medical practitioners who were treating his patients for other conditions.

“Assuming that it was the intention of the respondent to competently practise safe dentistry, he was clearly out of his depth in prescribing drugs of addiction”
– NSW Civil and Administrative Tribunal

Examples of Buys’ prescribing patterns include one patient having been prescribed 350 oxycodone tablets in varying strengths between 5 December 2014 and 21 July 2016, and another having been prescribed 220 20 mg tablets of the same drug between 27 June 2015 and 17 May 2016.

He was found to have obtained almost 2,000 tablets of Schedule 4, Schedule 4D and Schedule 8 drugs in the period 2013–2016 through prescriptions that were issued using his own name or that of his dental practices. The tribunal detailed these prescriptions as including 744 tablets of ondansetron—a nausea-inhibiting medication that is rarely used in dental settings—between 14 March 2013 and 6 June 2016, 300 tablets of alprazolam between 17 May 2013 and 3 January 2014, and 300 tablets of diazepam between 20 June 2014 and 26 November 2015.

Buys, who has not practised as a dentist for more than 36 months, expressed regret to the tribunal and said that his prescribing patterns had been misguided attempts to relieve pain. He was first registered as a dental practitioner in December 2004.

Emphasising dentists’ privilege to prescribe addictive drugs

The tribunal said in its 30 April judgment: “Assuming that it was the intention of the respondent to competently practise safe dentistry, he was clearly out of his depth in prescribing drugs of addiction. He has demonstrated an inadequate knowledge of the circumstances in which drugs of addiction should be prescribed and all of the cautionary measures which should attend their prescription.”

It referred to the 1981 case of Spicer v. NSW Medical Board and ors, in which the presiding judge said that “the proper handling and prescribing of drugs by medical practitioners are of the greatest importance to the community”. The tribunal said that there was no reason why this precedent “should not apply equally in the case of a dentist who is also given the privilege of prescribing to the public restricted drugs, including drugs of addiction”.

The overprescription of opioids within dentistry was highlighted in a 2019 study by researchers from the University of Illinois at Chicago in the US and the University of Sheffield in England, who found that US dentists wrote 37 times more prescriptions than their English counterparts did in 2016—a year thought to be the peak of the US opioid crisis. Earlier this year, Dental Tribune International spoke with Prof. Katie J. Suda from the Division of General Internal Medicine at the University of Pittsburgh School of Medicine about the role of dentists in the opioid epidemic.