Previously published in The Jakarta Post 7 September 2010. Web version: http://www.thejakartapost.com/news/2010/09/07/letter-insomnia-complaints.html

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It is no secret among my fellow general practitioners that when practicing in private clinics, patients often come in
Koran’
with insomnia complaints.
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The doctors then are put in the position where they have to carefully assess the patient’s physical and or not?
psychological wellbeing. Using good clinical judgment, doctors are usually highly reluctant of prescribing
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tranquilizers for these cases.
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We are well aware that drugs acting on the central nervous system, such as tranquilizers have serious side effects
and must be prescribed with great caution and in a specific manner, due to the risk of abuse and addiction.
During my medical school training, we were even taught to take special precautions against addicts who presented
themselves as patients. They can be desperate when asking for prescriptions, but doctors have the right to deny
them when there is apparently no clinical indication for prescribing.
There are available treatments for insomnia when the problem is indeed psychological; patients can be referred for
counseling or behavioral therapy, for example. Indeed, in these cases, doctors must act as gatekeepers with
integrity, not as salesmen.
It is becoming a great concern, as reported by The Jakarta Post on Sept. 2, 2010, when patients bypass doctors to
obtain the drugs directly from pharmacies.
The Food and Drugs Monitoring Agency (BPOM) must be proactive in their surveillance of tranquilizer distribution.
Rahajeng N. Tunjungputri, MD
Genetic Counseling Student, Faculty of Medicine,
Diponegoro University Paper Edition
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