Since 2016, Section 33 of the Medicinal Products Act has stipulated that prescription medications may only be issued to another person. While the law has long prohibited doctors from prescribing medications to themselves, it wasn't until the end of October that the Health Board began fully enforcing this provision in the electronic prescription system.

Andres Lehtmets, head of the Psychiatric Clinic at Tartu University Hospital, told the "Vikerhommik" radio program that many doctors were unaware of the change.

"As doctors, we don't start every workday by reading the State Gazette. We had been operating under the assumption — based on a ministerial regulation from the early 2000s, if I remember correctly — that doctors are allowed to prescribe medication to themselves. That's the understanding we've lived with and many likely missed the legislative change. Then, all of a sudden, enforcement became much stricter and not just for narcotic and psychotropic drugs — it affected all prescriptions," he said.

A central concern involves psychotropic medications — substances that, when misused, can lead to dependency and serious health risks. According to Lehtmets, however, this doesn't mean that doctors are casually or maliciously abusing such medications.

"The Health Board has found that psychotropic medications appear significantly more often among self-issued prescriptions. But that alone doesn't prove abuse. In many cases, it's simply a practical matter: a doctor may not have timely access to another physician or psychiatrist," he explained.

Lehtmets noted that, in terms of health behavior, doctors don't differ significantly from the general population. "I don't believe that misuse of psychotropic medications is more common among doctors than in society at large," he said.

According to Lehtmets, prescribing psychotropic medications is already strictly regulated in Estonia. Every prescription must be documented, a case file must be opened and all activity is retrospectively traceable through the digital prescription system. "It's not a simple process or something you can do unnoticed," he stressed.

For that reason, he questions whether further restrictions are truly justified. In his view, Estonia has taken a stricter approach than many neighboring countries, where self-prescribing by doctors is treated with more flexibility.

"I'm not claiming that no doctor in Estonia has ever broken the rules. The Estonian Medical Association has for years pointed out the need for stronger oversight mechanisms, specifically where violations occur, including in prescribing practices," he said.

At the same time, he cautioned against overly simplistic solutions. "If there are doctors struggling — perhaps due to their own health conditions — then they need support and guidance, not just an administrative ban," said Lehtmets, comparing such a response to merely dusting around a floor lamp.

He also pointed out that a significant share of psychotropic drugs circulate on the black market, rather than through legitimate prescriptions.

Lehtmets believes the issue should be addressed not only through legislation but also through medical ethics and professional standards. A widely accepted principle is that doctors should not treat themselves. "In exceptional situations, self-prescribing may be a convenient solution, but systematic self-treatment is not appropriate," he said.

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