City doctor charged in opioid probe

Sandwich clinic physician only one of 84 to face discipline hearing

A Windsor doctor was the only one to be charged with professional misconduct after Ontario’s medical regulator investigated more than 80 physicians across the province for possibly overprescribing opioids.

The Ontario College of Physicians and Surgeons has scheduled a discipline committee hearing for Dr. Robert Cameron from March 26-29. A woman who answered the phone Wednesday at the Sandwich walk-in medical clinic where Cameron works said the doctor had “no comment.”

The college looked into 84 doctors flagged by the province for allegedly prescribing high doses of opioids to several patients in 2015, but Cameron was the only one to be charged.

In most of those cases, the college went for remedies other than punishment, since harsh treatment, it said, could scare some doctors away from prescribing needed medication. “Understanding and questioning prescribing practices is not intended to discourage appropriate opioid prescribing, as we know that prescribing opioids under the right conditions is critical to good patient care,” college spokeswoman Tracey Sobers said Wednesday by email.

“The college has not asked physicians to stop prescribing opioids but to prescribe responsibly and in line with best practices.” Current Canadian guidelines recommend not prescribing more than the equivalent of 90 milligrams of morphine a day — less than the old recommendation of no more than 200 milligrams.

Of the 84 doctors involved in the opioid investigation, the college took no action against 22, provided advice to six and suggested self-study for two. Three are no longer practising medicine, while 47 were given some combination of mandated remediation and prescribing restrictions. Cameron is the only one to face a disciplinary hearing. The College of Physicians and Surgeons banned Cameron on June 29 from prescribing narcotics and certain other drugs pending the outcome of the upcoming hearing.

The college’s website reads: “It is alleged that Dr. Cameron is incompetent and/or failed to maintain the standard of practice of the profession in his care of patients.”

An opioid epidemic has hit Canada, with some experts citing over-prescription of such drugs as oxycodone, hydromorphone and fentanyl as one element of a complex problem.

“We don’t need the volumes being prescribed,” said Dr. Tony Hammer, a Windsor addictions doctor who believes the college was right to investigate opioid prescribing.

“The risks exceed the benefits. But it took us awhile to awaken to the dangers — and we’re now paying for it.”

Use of opioids has shot up in recent years in Canada and elsewhere. Addicts have provided harrowing reports of withdrawal, while the cycle of continually trying to get enough money to buy more drugs has led to crime and other issues.

A report released in December by the Public Health Agency of Canada showed there were 2,861 opioid-related deaths in the country in 2016. Though the statistics weren’t all compiled yet, numbers through the first half of 2017 indicated that opioid deaths in Canada were on track to surpass 4,000, a record. The Windsor-Essex County Health Unit in January released a report showing that while the provincial opioid death rate is about 6.2 per 100,000 population, Windsor-Essex’s is 9.1, or 46 per cent higher.

The Ontario Ministry of Health and Long-Term Care used its recently implemented narcotics monitoring system to highlight doctors who seemed to be prescribing high doses of opioids — the equivalent of more than 650 milligrams of morphine a day to a number of patients.

This isn’t Cameron’s first runin with the College of Physicians and Surgeons.

In 2013, Cameron was suspended for three months for making “inappropriate remarks of a sexual nature” to a nurse between 2008-10.

In 2011, Cameron was suspended for one month because he “failed to see, assess, treat or respond to a two-year-old boy while the boy was in the clinic and suffering from a life-threatening anaphylactic reaction.” Paramedics treated the boy, who recovered.

The college is still looking into three doctors as part of its opioid prescription investigation.