This post was originally published on this site
A Muskegon County nurse practitioner with her own family medicine practice has had her license suspended for allegedly overprescribing commonly abused medications, including opioids.
Susan Drust of Susan Drust Family Medicine, Norton Shores, has been among the state’s “highest-volume prescribers of commonly abused and diverted controlled substances,” according to the state’s administrative complaint against her.
Those substances include hydrocodone, methadone and codeine, according to the complaint.
On April 24, the Michigan Department of Licensing and Regulatory Affairs suspended Drust’s nurse practitioner license on an emergency basis following a review of her practices and the files of 18 patients, state records show.
Two of those patients died in 2014 of “mixed drug intoxication” and “mixed drug overdose,” according to the complaint against her.
“The allegations against the licensee indicate that she put public health and safety at risk,” said LARA Director Orlene Hawks. “Based on our findings, it was crucial for LARA to summarily suspend this licensee to protect patients in Michigan.”
Drust has been in practice since 2005, and hires a physician to oversee her practice, according to her practice’s website. On advice of her attorney, Drust would not comment on the allegations, according to a spokeswoman for her office.
Among the allegations against Drust are that she prescribed drugs “for other than lawful diagnostic or therapeutic purposes.”
The complaint originated with a review of the Michigan Automated Prescription System (MAPS), which gathers data about controlled substances dispensed throughout the state. An investigator interviewed Drust about overprescribing controlled substances and “other risky practices,” including prescribing unsafe combinations of drugs, the administrative complaint states.
Drust told the investigator she “is not familiar with what controlled substances are abused and diverted,” the complaint said. She also “only recently understood” that the same dose of one pain medication is not equivalent to the same dose of a different one, the complaint says.
Drust also told the investigator she did not know the specifics of the Centers for Disease Control’s Guidelines for Opioid Prescribing for Pain, of which she only recently became aware, according to the complaint.
The complaint states that a state expert reviewed 18 patient files and found the following issues with Drust’s conduct:
–Failure to refer patients with anxiety to psychotherapy.
–Prescribing controlled substances to patients with documented evidence of alcohol abuse.
–Prescribing unsafe drug combinations without documenting why. Three patients whose files were reviewed had been prescribed a combination of several different drugs that could lead to “coma and death.” Two of those died in 2014 of “mixed drug” intoxication and overdose.
–Failure to address “problematic urine drug screens.”
–Frequently using “boilerplate” treatment notes.
–Not documenting any consideration of alternatives to opioids.
–“Often fails to practice in due care.”
A review of the records showed that 11 of the 18 patients reviewed had urine screens that didn’t test positive for the drugs that Drust was prescribing them, which is a sign of possible drug diversion by the patients, the complaint states.
In one instance, it appeared that the patient “may be filling controlled substances” for family members who were Drust’s patients but were incarcerated, the complaint states.
The MAPS review found that Drust was among the state’s highest prescribers of abused and diverted pharmaceuticals in 2017 and 2018, according to the complaint.
Those included prescriptions in 2018 for 110,451 tablets of a combination of acetaminophen and the opioid hydrocodone, 73,200 methadone tablets and 23,040 tablets of the pain reliever carisoprodol commonly known as Soma, the complaint shows.
Drust has 30 days to respond to the administrative complaint. A final determination of Drust’s license will be made following a formal hearing.