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A second Ontario doctor is facing a disciplinary hearing in connection with a province-wide investigation of opioid providers – and in this case, the physician is accused of improperly prescribing drugs for herself and her relatives.

The College of Physicians and Surgeons of Ontario (CPSO), the self-regulating body that oversees doctors, is alleging that St. Catharines family doctor Tetyana Yaremivna Hurmatov engaged in unprofessional conduct by prescribing “narcotics and controlled substances” for herself between 2011 and 2017.

The CPSO is also alleging that Dr. Hurmatov wrote prescriptions for family members and failed to properly document her treatment of those family members, both of which violate College rules.

The CPSO prohibits doctors from providing medical care to themselves or their relatives unless there is no other health-care professional available to respond to a minor ailment or an emergency.

None of the allegations has been proven. A date has not yet been set for Dr. Hurmatov’s disciplinary hearing.

Dr. Hurmatov’s name emerged Monday when the CPSO announced it had completed the final three of 84 investigations into doctors who had been flagged by the province for prescribing large amounts of opioids, the powerful painkillers at the root of an epidemic of abuse and overdose.

That epidemic is growing deadlier in Ontario: Last year, there were 1,261 confirmed and probable opioid-related deaths across the province, up from 867 in 2016 and 728 in 2015.

The arrival in Ontario of illicit fentanyl – a potent opioid that is now regularly found cut into street drugs such as heroin – is the driving force behind the spike in opioid-related deaths.

But for many users, their dependency on opioids began with doctors overzealously prescribing drugs such as oxycodone and hydromorphone.

The CPSO has taken a “remedial” approach in the vast majority of the 84 investigations sparked by the opioid crisis, mindful that the threat of serious discipline could lead some doctors to abandon opioid-addicted patients, leaving them at the mercy of a potentially contaminated street supply.

All 84 doctors wound up on the CPSO’s radar after the Ontario Ministry of Health and Long-Term Care in 2016 searched its narcotics monitoring system for physicians who were prescribing more than the equivalent of 650 milligrams of morphine per day to eight or more patients and who had issued at least one, usually long-term, prescription exceeding 20,000 milligrams of morphine equivalent.

Canada’s new guidelines on prescribing opioids for patients with chronic, non-cancer pain, which the CPSO adopted last year, recommend strongly against prescribing more than the equivalent of 90 milligrams of morphine per day.

Of the 84 cases, the CPSO took no action in 22; provided advice in five; ordered remedial self-study in two; and ordered mandatory remediation, a formal caution or prescribing restrictions in 49. Four doctors agreed to stop practising medicine.

The only doctor on the list to be formally disciplined so far was Robert Cameron of Windsor, who agreed to give up his licence and never practise medicine again at a disciplinary hearing in March.

Cameron pleaded guilty to professional misconduct for doling out astonishingly high doses of painkillers to patients whose cases should have raised red flags, but he also defended himself by saying that some of his struggling patients deserved second chances and needed their high doses to function.

Pending the disciplinary hearing, Dr. Hurmatov is barred from prescribing a wide variety of medications, including narcotics and benzodiazepines, which are minor tranquilizers such as Valium and Xanax.

A summary of the allegations against her says she is also incompetent and has failed to maintain the standards of the profession “in her care of patients, including in her prescribing.”

Dr. Hurmatov declined to comment on the case.

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