A doctor who overprescribed appetite suppressants — commonly known as "butterfly pills" — to non-obese patients over several years has been referred to prosecutors. It marks the first case in which an investigation into the misuse of medical narcotics has been extended to a medical professional.
The Ministry of Food and Drug Safety (MFDS) announced on Monday that it had caught doctor "A," who illegally prescribed appetite suppressants to patients at a family medicine clinic in Yongin, Gyeonggi Province, and referred the case to prosecutors on charges of violating the Narcotics Control Act.
The investigation found that from 2019 through January this year, A prescribed a total of 52,841 appetite suppressant pills across 907 occasions to 24 patients whose body mass index (BMI) was around 20, well below the obesity threshold. The drugs involved are classified as psychotropic substances, including phentermine and phendimetrazine.
In some cases, A prescribed more than 17,000 pills to individual patients over a span of 147 months. Methods included issuing prescriptions without medical examinations and writing duplicate prescriptions while previous ones were still active.
Appetite suppressants are in principle approved only as short-term adjunctive therapy for patients with a BMI of 30 or above, or those with a BMI of 27 or above accompanied by risk factors such as hypertension or diabetes. MFDS guidelines also recommend prescriptions of no more than four weeks at a time, with total use not exceeding three months.
The so-called "butterfly pills" can cause dependency and withdrawal symptoms, and carry risks of cardiovascular abnormalities and psychiatric side effects including anxiety and insomnia, requiring strict prescription management.
This case is the first criminal action against a medical professional's illegal prescribing since the MFDS launched a dedicated narcotics investigation unit last year. The agency detected abnormal prescription patterns through big data analysis of the Narcotics Information Management System (NIMS) and initiated a compulsory investigation after review by external experts.
"We plan to continue monitoring illegal prescriptions and use of medical narcotics, including not only appetite suppressants but also ADHD medications and propofol," the MFDS said. "We will respond strictly to any misuse that deviates from therapeutic purposes."