Doctor's licence pulled for abusing narcotics

A Winnipeg doctor has been stripped of his ability to practise medicine after regulators discovered he was propagating some of the worst OxyContin prescription abuse Manitoba has ever seen.

The College of Physicians and Surgeons of Manitoba revoked Dr. Anthony Hlynka's licence and medical registration on Feb. 25 after he was found guilty of prescribing highly addictive painkillers such as OxyContin and Percocet in a "reckless manner."

Details about the investigation were posted online this week. They reveal that Hlynka exploited 25 patients at his cityplace medical clinic to obtain and prescribe large quantities of narcotics for an "extended period of time."

Hlynka wrote OxyContin prescriptions for some patients he knew well, and arranged for them to provide him with some or all of their painkillers for his own use. Patients asked Hlynka for OxyContin prescriptions for other people, and he wrote prescriptions in the name of patients he had never met or assessed to be handed over to third parties.

In other cases, Hlynka wrote prescriptions to patients with "no medical rationale" because he believed they would give the drugs to another patient of his who would supply him with some of the painkillers.

College registrar Dr. Bill Pope said it's the worst case of OxyContin prescription abuse he's ever seen.

"Certainly in other jurisdictions we read about this happening, but this is the first time I've seen it in Manitoba," he said.

"It just reinforces our concern about the risks this medication has."

OxyContin is a strong narcotic that contains oxycodone and other opiates and is prescribed as a long-release painkiller. Some addiction experts call it "hillbilly heroin," and much of the abuse is propagated by "drug shoppers" who sell their prescription painkillers on the street or to dealers at a lucrative profit.

Opiate addiction has ballooned in Winnipeg in the last two years, and frontline addiction workers have seen an alarming increase in the number of suburban teens and inner-city residents abusing and injecting the drugs.

Pope called Hlynka's situation "terribly sad," since the young physician was hooked on the painkillers and used his medical position to feed his addiction.

Pope said Hlynka was a "local boy" who graduated from University of Manitoba's medical school and practised medicine for about five years.

Pope couldn't confirm how long Hlynka propagated the abuse, but said the physician was suspended in May 2009 after another doctor raised concerns over Hlynka's prescribing practices. He said there's no evidence any of the 25 patients were harmed or that any of the drugs were diverted and sold on the street.

Winnipeg police said they are not aware of any investigation into the matter. A spokesperson was unavailable to comment on whether any charges could be laid against local doctors who overprescribe narcotics to vulnerable patients.

In the United States, some physicians have been criminally charged for improper prescriptions or over-prescribing medications to patients who are addicted.

"It became obvious it was a very large issue," Pope said. "This is not something we treat lightly at all."

The body that regulates Manitoba physicians rarely revokes both a doctor's medical registration and licence, but Pope said there were serious concerns Hlynka's behaviour could harm patients.

According to the college's inquiry decision, Hlynka failed to obtain a medical history before prescribing the painkillers, and in most cases, falsified medical records to cover up the opiates he doled out.

He repeatedly prescribed improper amounts of narcotics to multiple patients, including many who were "innocent, vulnerable or subordinate."

"He issued prescriptions to a significant number of patients and he exploited those patients to his own advantage," the decision states. "Recklessness was evident by the large quantity of drugs prescribed and the way in which he issued prescriptions."

jen.skerritt@freepress.mb.ca

Powerful addiction

What is OxyContin?

It's a powerful opiate that's also a commonly prescribed painkiller. In the last two years, front-line addiction workers have seen an alarming rise in the number of Manitobans addicted to painkillers such as OxyContin. The abuse is propagated by "drug shoppers" who visit multiple physicians for prescriptions and resell the drugs.

What is being done to curb abuse?

Manitoba recently announced that prescriptions will be restricted to cancer patients or those with chronic conditions who can't tolerate or benefit from other medications. More physicians will be trained to prescribe methadone to addicts to help ease the strain on current treatment programs. Manitoba is also launching a brochure campaign to educate physicians, pharmacists and patients about the drug.

Can opiate addiction be treated?

Yes, with abstinence or methadone. Methadone is a synthetic opiate that suppresses symptoms of withdrawal, but is tightly controlled. Increased demand for methadone treatment in Manitoba has resulted in long waits for treatment. Some patients drop out of touch while on the waiting list, or resort to crime to feed their addiction. Others are prescribed doses of opiates to tide them over until they can get into the methadone program.

Republished from the Winnipeg Free Press print edition April 10, 2010 A5