controlled drugs - misuse of drugs regulations

Question 1

misuse of drugs schedules

Answer 1

schedule 1 - cd - have no recognised medical use ( lsd_)

schedule 2 -cd - fully controlled drugs (morphine)

schedule 3 - cd - barbiturates (buprenorphine , temazepam )

schedule 4 - p1 cd - benzodiazepines
( diazepam , lorazepam )

schedule 4 - p2 cd - anabolic steroids and growth hormones

schedule 5 - cd - produced from s2 ads , low strength/non injectable

Question 2

Schedule 1

Answer 2

no real medical purpose
research and other special purposes
license required to import/export/produce/supply
safe custody requirements apply
examples - lsd ,MDMA

Question 3

schedule 2

Answer 3

fully controlled drugs
do have a medical use
license required to import/export
a pharmacist may supply a patient against a rx in the required form issued by an appropriate practitioner
statutory storage arrangements apply
CD rx requirements apply
records must be maintained in cd register
authorised witness for destruction of own stock
examples - morphine , fentanyl

Question 4

schedule 3

Answer 4

different classes of persons may posses/supply
no requirement for retailers/pharmacists to maintain records in CD register
no requirement for authorised witness for destruction
statutory storage requirements do apply although most are exempt
CD rx requirements apply
retain invoices and other like records for 2 yrs
example- buprenorphine , temazepam , tramadol , pregnablin

Question 5

schedule 4 part 1

Answer 5

statutory storage requirements do not apply
no requirement for pharmacies to maintain records in CD register
rx requirements as per HMR 2012 only
rx , however , are valid for 28 days
examples - diazepam , lorazepam

Question 6

schedule 4 part 2

Answer 6

statutory storage requirements do not apply
no requirement for retailers to maintain records in CD register
prescription requirements as per HMR 2012
rx lasts 28 days
differ from part 1 due to importation and possession arrangements
examples - testosterone and nandrolone

Question 7

schedule 5

Answer 7

minimal restrictions on import/export and possession/administration
statutory storage requirements do not apply
no requirement for retailers to maintain records in CD register
invoices and other like records retained for 2 years
destruction does not require an authorised witness
legal category may be pom or p
no injections can be in this schedule

Question 8

possession and supply

Answer 8

the misuse of drugs act makes it unlawful for any person to be in possession of CD but the regulation provides exemptions to certain persons
1) he is a member of a class specified in the regulations ;
2) he holds an appropriate license or authority from the DH
3) the regulations provide that possession of that drug is not unlawful

Question 9

requisitions - S2 + S3 CDS

Answer 9

note the difference between a requisition and prescription
a prescription is for a patient
a number of other persons can ‘requisition’ CDS for their stock or own use
a supplier must not deliver any CD to the following persons unless they have obtained a requisition in writing :
1) a practitioner
2) a person or acting person in charge of a hospital or nursing home
3) a person who is in charge of a laboratory
4) the owner of a ship that does not carry a doctor
5) the installation manager of an offshore installation
6) a supplementary prescriber
7) a nurse independent prescriber
8) a pharmacist independent prescriber

Question 10

legal requirements for a requisition

Answer 10

must be signed by the recipient
must state his name , address , profession
specify the total quantity of the drug and the purpose for which it is required
supplier must be satisfied that the signature is genuine and the person is engaged in the occupation stated
the supplier must mark his name
must be sent to the relevant NHS authority

Question 11

prescriptions

Answer 11

‘prescription’ in the MoD regs means a prescription issued by a doctor , a supplementary prescriber , a nurse independent prescriber or a pharmacist independent prescriber , podiatrist , physiotherapist for the medical treatment of a single individual .

Question 12

prescriptions - physios and podiatrists

Answer 12

a physio may administer by specific method -
diazepam by oral admin
dihydrocodeine by oral admin
fentanyl by transdermal admin
lorazepam by oral admin
morphine by oral admin
oxycodone by oral admin
temazepam by oral admin

a podiatrist may administer by specific method -
diazepam by oral admin
lorazepam by oral admin
temazepam by oral admin

Question 13

rx requirements - S2 AND S3

Answer 13

be written/printed/typed so as to be indelible
be signed by the person issuing it with his/her usual signature
be dated
except in the case of a NHS rx - specify the address of the person issuing it
must contain a dose
must contain a form
must contain strength
must contain total quantity to be supplied
must contain patient name and address

Question 14

rx requirements - S2 AND S3 - private rx’s

Answer 14

private prescriptions must be written on a standardised form called the PCD1
these forms are issued and monitored by the health and social care board
PCD1 forms are not needed in hospitals or for veterinary prescriptions

Question 15

safe custody

Answer 15

schedule 2 and 3 drugs must be kept in a locked cabinet
does not apply to controlled drugs under the personal supervision of a pharmacist
retail dealers , nursing homes and private hospitals must ensure that all CDs are kept in a locked safe, cabinet or room which is constructed and maintained as to prevent unauthorised access to drugs

Question 16

Record keeping requirements

Answer 16

any person authorised to supply schedule 1 or 2 CDs must keep a record detailing transactions involving the drugs
these transactions are recorded in a CD register
for controlled drugs received :
date supply received
name and address from whom received
quantity received

for controlled drugs supplied
date supplied
name/ address of person or firm supplied
details of authority to posses
quantity supplied
person collecting schedule 2 controlled drug and if healthcare professional , name and address
was proof of identity requested of patient/ patients rep
was proof of identity of person collecting provided

Question 17

Emergency supplies

Answer 17

emergency supplies of schedule 2 and 3 drugs are not permitted (except phenobarbitone for the treatment of epilepsy)
a supply of s4 or s5 for up to 5 days treatment may be made at the request of a patient

Question 18

repeats

Answer 18

no repeats for schedule 2 and 3 drugs
repeats of schedule 4 and 5 are allowed