Controlled drugs

Question 1

2 legislations defining controlled drugs

Answer 1

• Misuse of Drugs Act 1971
• Misuse of Drugs Regulations 2001

Question 2

What is Misuse of Drugs Act 1971?

Answer 2

• Prohibits manufacture, supply & possession of certain drugs
• Intended to ensure accountability for the use of certain drugs and prevent misuse
• Drugs subject to this Act are known as ‘controlled’ drugs.
• It divides them into classes A, B and C according to harmfulness (most to least)
• Penalties applicable to offences against the Act reflect their harmfulness

Question 3

Example of Class A, B, and C drugs

Answer 3

Cocaine, Amphetamine, Benzodiazepine

Question 4

What is Misuse of Drug Regulations 2001?

Answer 4

Defines which professionals can supply/ possess CDs & the conditions which must be met.
* Divides CDs into 5 schedules according to level of control (most to least)
* Schedule 1 has the highest level of control, virtually never used as medicines
* Schedule 5 has the lowest level of control

Question 5

Describe the 5 schedules

Answer 5

1 - Prohibited, need home office authority
2 - Medicinal, CD regulation re prescribing, safe keeping and registers.
3 - Medicinal, CD regulation re prescribing and safe keeping. (no register needed but invoices for 2 years needed)
4 - Medicinal, no special prescribing or safe keeping
5 - No control but retain in voices for 3 years

Question 6

What is a standard operating procedure?

Answer 6

• A SOP describes the responsibilities and procedures necessary to manage CDs safely and accountably.
• Health Act 2006 requires healthcare organisation to appoint Accountable Officer.

Question 7

CD storage

Answer 7

• Must be stored in metal cupboard, restricted access.
• must have a CD register

Question 8

3 main responsibilities for prescribing drugs most likely to cause dependance or misuse.

Answer 8

• To avoid creating dependence by introducing drugs to patients without sufficient reason
• To see that the patient does not gradually increase the dose of a drug, given for good medical reasons, to the point where dependence becomes more likely
• To avoid being used as an unwitting source of supply for addicts

Question 9

What to take into account when prescribing CDs?

Answer 9

• The benefits of controlled drug treatment
• The risks of prescribing, including dependency, overdose and diversion
• All prescribed and non prescribed medicines the person is taking‑
• Evidence based sources, such as NICE and the (BNF)‑

Question 10

What to do when prescribing CDs?

Answer 10

• Document clearly the indication and regimen for the controlled drug in the person’s care record
• Check the person’s current clinical needs and, if appropriate, adjust the dose until a good balance is achieved between benefits and harms
• Discuss with the person the arrangements for reviewing and monitoring treatment
• Be prepared to discuss the prescribing decision with other health professionals if further information is requested about the prescription

Question 11

What to do when administering CDs?

Answer 11

• Whether the prescribed dose is safe for the person
• Whether other formulations have already been prescribed for the person
• Whether the formulation is appropriate
• That any past doses prescribed have been taken