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A number of doctors, nurses and pharmacists in hospitals and clinics across the country are working under the influence of a powerful opium-based prescription pain killer called Pethidine and in some cases have been busted stealing the drug or illegally altering patient records to fuel their addiction. 'A Weekend Globe' investigation has revealed that a nurse at the Korle Bu teaching Hospital was struck off her duties because she frequently altered patient prescription records to get an extra patch of Pethidine for herself and was endangering patients. The problem is widespread and is threatening health delivery in hospitals across Ghana, according to interviews with various health professionals in Accra. Doctors and nurses are using the drug at work, delivering compromised services to their patients. The drug, Pethidene, is an incredibly powerful painkiller, highly addictive, and in some cases have led to the deaths of health workers who have abused it. The issue is now spiralling out of control: In one hospital, in a period of just four days, six nurses were recently caught altering patients� prescriptions to get a hold of the drug and Korle Bu Teaching Hospital has even set up a rehab center for addicted staff. Health practitioners are calling for more stringent government regulation, but the drug is now being made available more widely than ever before. Charles Ofei Palm, a clinical pharmacist at Korle Bu Teaching Hospital, one of Ghana�s most renowned government hospitals, says Pethidine abuse is a common occurrence at a number of hospitals. He is in charge of receiving and dispensing dangerous drugs, also known as class A drugs. These include drugs such as Pethidine, Morphine, and Methadone. Mr. Ofei Palm, who also conducts research, keeps records of drugs that have been abused by medical officers across the country. Prominent among them is Pethidine He showed The Weekend Globe patients� folders that had been doctored by nurses in order to obtain Pethidine illegally. �In four days, my men intercepted six folders that have been used to request Pethidine for patients who don�t exist,� he said. Ghana�s Pharmacy Act prohibits acquisition of the drug over the counter in pharmacies, he said, and all hospitals have one procedure of dispensing it. �A doctor has to specifically request and sign for it before a pharmacist gives it out,� he said, adding that nurses and some pharmacists have found a way of going around the system. �Nurses request Pethidine in the name of practicing doctors. They even sign. Although the signatures may not be well forged, we don�t have any practical way of verifying signatures at the pharmacies. So most of these defaulters go undetected,� he said. The only reason they get found out is because the details of the folders give them away, Mr. Ofei Palm said, pointing out that one child had been given a dosage more suitable for a 24 year old. �When you look at some of these folders, the patient was probably discharged like a year ahead of the request. Sometimes the folder is for a child and the dosage required is smaller than what is being requested for. That is how we first suspect the nurse or medical officer who puts in the request may be an abuser.� Pethidine is being abused because it is a common painkiller that helps patients relax. According to pharmacists, it is a more synthetic version of morphine used after surgery to manage patients� pain. The emergency units of hospitals as well as maternity wards use the drug regularly. But chronic use can lead to dependence and doctors say the side effects are dire. Abuse of Pethidine, which is injected, can lead to severe organ damage, respiratory depression, infection of the heart, infection and subsequent collapse of the lungs, and kidney and liver failure. Dr. Jacob Jordan Lamptey, a Neuro psychiatrist who owns a rehab centre in Accra, said in an interview that people who use Pethidine sometimes live under the deception that they are using it for pain relief, but are actually using it for ecstatic purposes. �They all say they start using it at a point for medication purposes and they continue to use it to complement their stressful living,� Dr. Lamptey said. He says the trend in the medical profession is worrying. �Substance abuse has become an increasing socio-medical problem across the globe and if medics who know the effect cannot avoid the hazards their very �discipline� tries to protect people from, what will become of their patients?� Dr. Lamptey asked. At Dr. Lamptey�s Valley View Rehab Clinic, one patient says his first contact with Pethidine came when he worked at a hospital as an auxiliary staff shuttling between patient wards and the pharmacy. The man, who wanted to remain anonymous, says he was working while also going to school, and took the drug every day when he left in order to feel stressed about his workload. �I needed to make my grades and I needed to work through school as well,� he said. �It was all tough, so I found support in the drug.� He was found out and sacked from the hospital, but he found other ways of getting high anytime he didn�t get his regular shot of Pethidine. According to him, Pethidine abuse exposed him to the use of other drugs like heroin and even Cocaine. �I never got high enough using just Pethidine,� he added. �So I started trying other drugs and now here I am.� This patient is obviously not the only one who has abused Pethidine. A lot more spoke to the Weekend Globe, but were too afraid to reveal the details of their addiction. They all admit, however, that they have lost people dear to them, their jobs and even their good health to abuse. Dr. Kwadwo Amponsah Dakwa, a senior medical officer at the 37 Military Hospital and a private occupational health practitioner, is one of the many occupational health and safety experts in the country looking into cases of drug abuse among medical professionals. When he started looking into the issue five years ago, only a few medical officers were using Pethidine, and few people outside the medical professions knew much about it. But now, he said, he�s worried about the dramatic increase in abuse cases among medical professionals. He says, �Two out of every ten medics are abusing the drug.� The Ministry of Health, when contacted by The Weekend Globe, has said although they are aware of the situation, further investigations will be conducted to determine the extent to which it is affecting people in the medical sector. The ministry admits one major difficulty it is faced with now is controlling the emergence of the drug on the Ghanaian market. Businessmen are taking advantage of how addictive the drug is by investing in its production and importation, The Weekend Globe has discovered. This has worsened the problem, as some local pharmacies are selling it illegally to anyone who would care to have some � in total violation of the Pharmacy Act. The situation is so bad that the Korle Bu Teaching Hospital in Accra has had to set up a rehabilitation facility on its premises to deal with staff addiction. A senior medical officer said that staff who are found to be abusers are forced to go through rehab, otherwise they lose their jobs. There is not yet any indication of the exercise�s effectiveness. The Pharmacy Council in Ghana is also looking to make the rules for acquisition of dangerous drugs like Pethidine more stringent. In the Pharmacy Act, the supply of all Class A or B drugs such as Pethidine must be properly monitored, recorded and be signed for by a doctor. Government and Hospitals Pharmacist Association president Stephen Okoe Corquaye said in an interview that the association is looking at ensuring all members are more thorough with the, monitoring of their prescriptions. �Although we have put systems in place to manage the use of these drugs, there are people who find ways of getting the product through the same system,� Mr. Okoe Corquaye said. �Because of this development, we are reviewing our rules. There will be more rigid measures implemented.� As a Pharmacist who has sworn to operate by the code of ethics of the Pharmacy Council, he vowed to ensure these violations do not go unpunished. �These medical officers who abuse these drugs will be dealt with according to the law,� he said. �And pharmacists who violate the rule provided in the act to sell these drugs, both Pethidine and Morphine, in their shops, will be shut down if found out.� But Mr. Ofei Palm is still worried the medical profession�s Pethidine addiction problem may get out of control. �If from my little office I can seize six folders that have been cooked up to request the drug, and this is repeated every week, then there is a problem.�