Drug Misuse Flashcards
What does the misuse of drugs act 1971 say?
Misuse of Drugs Act 1971- prohibits possession, supply and manufacture of ‘controlled drugs’ (CDs), categorised according to harmfulness when misused
What are the classes of drugs by the act and give examples
Class A - cocaine, diamorphine (heroin) , LSD, morphine, ecstasy, class B substances prepared for injection Class B - amfetamines, barbiturates, cannabis, codeine, pholcodine, ketamine Class C - benzodiazepines, tramadol, zolpidem, zopiclone, anabolic steroids, HCG
What is the role of the accountable officer?
Overarching responsibility for the use of controlled drugs in their organisation
Investigate reported CD incidents /discrepancies /concerns (London, Lancs, Manchester, Midlands use reporting website www.CDReporting.co.uk )
Monitor FP10PCD and FP10CDF use
Contact local intelligence network (police) if necessary
Ensure SOPs for procurement, storage, supply, training, reporting concerns
What experiences would a community pharmacy encounter with drug/substance misuse?
Involvement with local substance misuse treatment services (e.g. prescriptions for maintenance therapy, needle exchange)
Misused prescribed items/ forged prescriptions
Healthcare professional misuse
Sale of medicines (P and GSL) liable to misuse
What sort of substances are misused in the UK?
Opioids/opiates
Alcohol
Non opioid drugs e.g. cannabis, cocaine, amphetamines, ketamine, benzodiazepines
Over the counter and other prescription medicines
Volatile substances, solvents, gases e.g. butanxe, propane, aerosol propellants, ketones, esters - marker pens, nail varnish remover
Legal highs/ club drugs/ new psychoactive substances (NPS)
What act covers any psychoactive substances not covered by the misuse of drugs act?
Psychoactive Substances Act 2016 -illegal to POSSESS (with intent to supply or possess in a custodial institution), SUPPLY, IMPORT, EXPORT, PRODUCE.
What are the routes of administration?
Oral - convenience but Psychotropic effects can take a long time to develop.
Airways– offer a large surface area for absorption through inhalation, snorting etc
Injection - Fastest onset of psychotropic action
What is the most preferred site of injection?
median cubital vein
Give examples of opioids that are misused?
Codeine, dihydrocodeine, morphine Oxycodone Tramadol Fentanyl Methadone Buprenorphine
What are the symptoms of opioid intoxication or overdose?
Respiratory depression, behavioural or psychological changes, slurred speech, impairment of attention or memory, small pupils, death
What is given in the case of opioid intoxication or overdose?
naloxone - it has the exemption of POM requirements when given in a life saving emergency
Who can be supplied with take home naloxone?
someone who is using or has previously used opiates (illicit or prescribed) and is at potential risk of overdose
a carer, family member or friend liable to be on hand in case of overdose
a named individual in a hostel (or other facility where drug users gather and might be at risk of overdose), which could be a manager or other staff
Why should we treat opioid misuse?
Reduce criminal activity
Reduce threat to public health / safety
Improve personal, social and family functioning
Reduce illicit drug use/relapse
Reduce associated risks/morbidity/deaths
Alleviate withdrawal symptoms
What are the most common items on forged prescriptions?
opioids gabapentin pregabalin procyclidine tramadol z drugs benzodiazepines antihistamines
What some of the OTC misused drugs?
codeine
dihydrocodeine - Paramol
morphine - Collis Browne’s mixture Kaolin and morphine mixxture
Alcohol containing products-rhubarb tincture, mineralised methylated spirit, cough mixtures
Pseudoephedrine
pack sizes were restricted to 720mg (60mg x 12)
sale of one pack only
Laxatives-senna, bisacodyl
Antihistamines-Phenergan/ Sominex (promethazine), Nytol (diphenhydramine) , Piriton (chlorphenamine), Valoid (cyclizine
