25 - 8. Prescribing controlled drugs

8. Prescribing controlled drugs

© SPMM Course 8. Prescribing controlled drugs

1971 MISUSE OF DRUGS ACT UK Class A drugs: Ecstasy, LSD, heroin, cocaine, crack, magic mushrooms (whether prepared or fresh), methylamphetamine (crystal meth), other amphetamines if prepared for injection o Penalties for possession: Up to seven years in prison or an unlimited fine. Or both o Penalties for dealing: Up to life in prison or an unlimited fine. Or both Class B drugs: Amphetamines, Methylphenidate (Ritalin), Pholcodine o Penalties for possession: Up to five years in prison or an unlimited fine. Or both o Penalties for dealing: Up to 14 years in prison or an unlimited fine. Or both. Class C drugs: Cannabis, tranquilisers, some painkillers, GHB (Gamma-hydroxybutyrate), ketamine o Penalties for possession: Up to two years in prison or an unlimited fine. Or both o Penalties for dealing: Up to 14 years in prison or an unlimited fine. Or both

2001 MISUSE OF DRUGS REGULATIONS Schedule Examples Regulations Coca leaf, cannabis, LSD, mescaline No recognized medicinal use. Supply is limited to research or other special purposes judged to be in the public interest.
 Requires Home Office licence to possess. Diamorphine, dipipanone, morphine, remifentanil, pethidine, secobarbital, glutethimide, amphetamine and cocaine

Subject to special prescription requirements and safe custody requirements (with the exception of secobarbital). Stock drugs must be recorded in a register that meets the requirements of the 2001 Regulations, and drug stock must only be destroyed in the presence of an appropriately authorized person. The barbiturates (except secobarbital), buprenorphine, diethylpropion, mazindol, meprobamate, pentazocine, phentermine, and temazepam These drugs are subject to the special prescription requirements (except for temazepam) but not to the safe custody requirements (except for buprenorphine, diethylpropion, flunitrazepam and temazepam) or to the need to keep a register, although there are requirements for the retention of invoices for 2 years Part 1 Benzodiazepines (not temazepam) and zolpidem These drugs are not subject to the special prescription requirements or to safe custody requirements. There

© SPMM Course Part 2 Androgenic and anabolic steroids, clenbuterol, chorionic gonadotrophin (HCG), non-human chorionic gonadotrophin, somatotropin, somatrem, and somatropin is no need to keep a register, although there are requirements for the retention of invoices for 2 years Weak preparations of drugs usually in other schedules, for example, morphine, codeine Exempt from all controlled drug regulations except the need to keep invoices for at least 2 years All controlled drug prescriptions should have The  patient’s  full  name,  address  and  age If  a  patient  is  homeless,  ‘no  fixed  abode’  is  an  acceptable  address   The name and form of the drug MUST be written The strength of the preparation, where appropriate The dose to be taken MUST be written The total quantity of the preparation, or the number of 
dose units, to be supplied in both words and figures 
 A patient identifier number (e.g. NHS number) should be included on prescriptions for controlled drugs Prescriptions must be signed by the prescriber with their usual signature (this must be handwritten) along with GMC number as a good practice The validity period of prescriptions for Schedule 1, 2, 3 and 4 controlled drugs have been restricted to 28 days. Schedule 2 and 3 drugs cannot be prescribed on repeat prescriptions or under repeat dispensing schemes. Patients ideally should collect the controlled drug in person after showing their identification on the first occasion and signing the back of the prescription form. Substitute opioids should be prescribed in daily instalments whenever required. Prescriptions of instalments must specify o The number of instalments o The interval between instalments, o Instructions for supplies at weekends or bank 
holidays o The total quantity to provide 
treatment for a period (this must not be exceeding 14 days generally) o The quantity to be supplied in each instalment along with the duration of the instalments  to  be  set  out  on  the  prescription,  for  example  ‘dispense  daily  for fourteen days starting on 3rd September  2015’.