3.6 Controlled Drugs

Question 1

Schedule 1

Answer 1

Hallucinogens e.g. LSD
Ecstasy
Raw Opium

Question 2

Schedule 2

Answer 2

Opiates e.g. Diamorphine, Morphine, Methadone, Oxycodone, Pethidine

Major Stimulates e.g. Amphetamines

Quinalbarbitone

Ketamine

Question 3

Schedule 3 (non register POM)

Answer 3

Minor stimulants e.g. Buprenorphine, Temazepam, Tramadol, Midazolam, Phenobarbital

Gabapentin

Pregabalin

Question 4

Schedule 4, Part 1 (CD Benz POM)

Answer 4

Benzodiazepines e.g. diazepam

Z drugs e.g. Zopiclone

Sativex (cannabinols oromucosal mouth spray)

Question 5

Schedule 4, Part 2 (CD Anab POM)

Answer 5

Anabolic
Androgenic
Clenbuterol
Growth hormone

Question 6

Schedule 5

Answer 6

Preparations of certain CD e.g. codiene, pholcodine, morphine

Question 7

Prescription requirements for Schedule 2 and 3 [13]

Answer 7

1. Signature
2. Date - valid 28 days from appropriate date
3. Prescriber address - must be within the UK
4. Name of CD - good practice to write in full
5. Formulation - abbreviation are acceptable
6. Strength - only if CD has more than one strength
7. Dose - clearly define
8. Total Quantity - words and figures
9. Quantity prescribed - Sch 2, 3 or 4 prescribed should not exceed 30 days
10. Name of Pt
11. Address of Pt - can be NFA: No Fixed Abode
12. Dental prescriptions - must state “for dental treatment only”
13. Instalment direction -

Question 8

Examples of doses that are and not legally acceptable on a CD prescription

Answer 8

Not legal: As directed; When required; PRN; As per chart; Titration dose; Weekly; Decrease dose by x mL every four days; BD

Legal: One as directed; Two when req; One PRN; one - two when req.

Question 9

What drug require

Safe Custody

Answer 9

Scheduled 1
Schedule 2
Schedule 3 ONLY Temazepam and Buprenorphine

Question 10

Which do NOT drug require

Safe Custody

Answer 10

Schedule 3:
Gabapentin 
Pregabalin
Tramadol
Phenobarbital 
Mazindol
Meprobamate 
Midazolam
Pentazocine
Phentermine

Question 11

Discuss pharmacies and the distraction of CDs [3]

Answer 11

• Pharmacies are req to denature CDs prior disposal
• Usually an appropriate license is req but pharmacist are exempt
• T28 exemption- has to register with environment agency

Question 12

Distractions of Patients Returned CDs

Answer 12

Does NOT require witnessing by an authorised person

Question 13

Destruction of Pharmacy Stock CDs

Answer 13

• CDs that need to be entered into a register require witnessing by an authorised person
• Typically schedule 2 CDs

Question 14

Method of CD Destruction

Answer 14

Denaturing
Grind (some kits place whole) into kit
Pour liquid into kit
Open ampules and empty contents 
Remove patch backing and fold into self
Expel aerosol into water and pour into kit

Question 15

Record keeping

Answer 15

Retain for 2 years from the date of entry

Question 16

How often should a balance check occur

Answer 16

At least once a week - once a week not necessarily the same day every week

Question 17

Representative collecting CD

Answer 17

• A letter from drug misuser that authorises and names representative must be given to pharmacy (each time a representative is sent)
• Be satisfied letter is genuine
• Representative must bring ID
• Try arrange seeing the drug misuser at least once a week

Question 18

Legislation applied to CD

Answer 18

The Misuse of Drug Act 1971
The Misuse of Drug (Safe Custody) Regulations 1973
The Misuse of Drug Regulations 2001
The Health Act 2006
Controlled Drugs Regulation 2013

Question 19

What are the legal requirements of a controlled drug requisition

Answer 19

1. Signature of recipient
2. Name of recipient
3. Address of recipient
4. Profession or Occupation
5. Total quantity of drug
6. Purpose of requisition

Question 20

Midwife CD supply order

Answer 20

Only includes: Diamorphone, Morphine, Pethidine

Must include: name and occupation of midwife, name of person it’ll be administered too, purpose, total quantity, signature of appropriate medical officer

Question 21

HOME OFFICE APPROVED WORDING

Answer 21

1.Please dispense instalments due on pharmacy closed days on a prior suitable day.
2 If an instalment’s collection day has been missed, please still dispense the amount due for any remaining day(s) of that instalment.
3 Consult the prescriber if three or more
consecutive days of a prescription have been missed.
4 Supervise consumption on collection days.
5 Dispense daily doses in separate containers.

NB: If you decide to supply against a prescription
that uses wording not approved by the Home Office, it will not provide the same protection from enforcement when making the supply. In this instance, if practical, you should try to get the prescriptions amended