[비즈한국] With non-face-to-face medical treatment approaching formal institutionalization, poor management regarding the prescription of psychotropic drugs has once again come under fire. Following the recent incident involving singer Psy and the proxy pickup of medication, critics argue that the case has dampened the safety and reliability of the system by revealing that drugs which should strictly require in-person prescriptions can still be distributed through remote channels.
Singer Psy is currently under police investigation on charges of having his manager and others pick up prescribed psychotropic medications on his behalf. According to the Seodaemun Police Station, from 2022 to recently, Psy was prescribed ‘Xanax’ (a tranquilizer) and ‘Stilnox’ (an insomnia treatment)—both psychotropic drugs—at Severance Hospital and had them collected by others, including his manager.
Psy and his medical team argue that although the medication was picked up by a proxy, it was done in accordance with legitimate ‘non-face-to-face treatment.’ However, this explanation itself is controversial. The drugs prescribed to Psy are psychotropic substances with high dependency risks, which is why they are required to be prescribed in person. These are medications that cannot be obtained through non-face-to-face treatment. Following criticisms regarding the indiscriminate prescription of such drugs, ‘in-person prescriptions’ became mandatory in November 2021.
Psy’s agency, P NATION, stated in an official release, “Psy has been diagnosed with chronic sleep disorders and has been taking sleeping pills under the prescription of medical staff. He has been taking the prescribed dosage under medical guidance, and there was no proxy prescription.” They added, “There were instances during that process where a third party picked up the sleeping pills on his behalf, which the police are currently investigating.” The professor who prescribed the medication denied the allegations, stating, “The consultation was conducted remotely.”
How was a ‘Non-Face-to-Face Prescription’ for Psychotropic Drugs Possible?
The Psy incident has fueled concerns about the safety of the ‘non-face-to-face medical treatment pilot project,’ which has been in operation for six years. According to the Ministry of Health and Welfare, approximately 23,000 medical institutions have conducted at least one non-face-to-face consultation during the pilot period, with 4.92 million citizens utilizing the service. Non-face-to-face treatment accounts for about 0.2% to 0.3% of all outpatient care, averaging about 200,000 cases per month.
With the number of users rising sharply, this incident has exposed that even medications strictly prohibited from being prescribed via ‘non-face-to-face treatment’ can be obtained through the system. Currently, narcotics, psychotropic drugs, drugs with high potential for abuse, and emergency contraceptives cannot be prescribed remotely. However, the system failed to filter this out from the point where the medical staff prescribed the drugs remotely to when the pharmacy received the prescription and filled it. While the prescribing doctor is at fault, this also reveals that the non-face-to-face treatment system has not been properly established at the pharmacy level.
There have been countless cases of celebrities using ‘proxy pickups’ for narcotic drugs in the past. If Psy’s explanation that his actions were based on ‘non-face-to-face treatment’ is accepted, it could create room for ordinary patients to make similar claims in the future.
Doctors Even Prescribed Narcotics via Proxy and Exfiltrated Them
The flaws in the ‘Psychotropic Drug Management System’ are also under scrutiny. With the 2015 amendment to the Narcotics Control Act, a full-scale reporting system for narcotics handling was implemented starting in 2018. Handlers or those authorized to handle narcotics must report details regarding the import, export, manufacture, sale, transfer, acquisition, purchase, use, disposal, preparation, or administration of such drugs—as well as information on drugs provided for medical administration or academic research—to the Minister of Food and Drug Safety.
The Narcotics Information Management System designates drugs with high potential for social abuse or frequent illegal leakage as ‘priority management items,’ while others are classified as ‘general management items.’ It requires the reporting of personal information (traders, medical personnel, patients), product information (name, manufacturing number, item code, minimum distribution unit, serial number), and dispensing/administration information (doses, prescription details).
However, there remains room for erroneous reporting based on the intentions of medical staff and nurses. Recently, a doctor at a hospital in Suncheon, Jeollanam-do, was referred to the prosecution on charges of prescribing psychotropic drugs by proxy for years. The nurse involved is suspected of falsely registering usage amounts in the Narcotics Information Management System. It is alleged that the doctor even took the remaining narcotics out of the hospital.
Health authorities are currently preparing for the ‘institutionalization of non-face-to-face medical treatment.’ Three related bills are currently pending in the National Assembly, and the incident involving Psy’s proxy pickup of sleeping pills has added fuel to the concerns surrounding the system.