Lecture 18: Controlled drugs Flashcards
What is the classification of controlled drugs?
Classed into 1 of 3 classes.
Class A, B, C
Classification is based upon propensity to cause harm
What are the different drug schedules?
Based on; an assessment of their medicinal or therapeutic usefulness and the need for legitimate access, the potential harm if/ when misused
Scheduling is from 1-5 based on decreasing levels of harm. The higher the schedule eg 1, the more robust is the regimen around its availability/ supply
What is schedule 1 CD?
Substances which have no theraputic value eg hallucinations, cannabis, and synthetics (MDMA, lysergamide)
Mainly used in research
Require a Home Office licence for lawful possession unless transferring to someone authorised for public safety e.g. Police
What is a schedule 2 CD?
Substances/ drugs which have a therapeutic value but are highly addictive eg potent opioids, such as diamorphine, morphine, oxycodone, fentanyl and methadone
Subject to ‘prescription requirements’ relating to their prescribing, dispensing, recording and safe custody.
Safe custody regulations apply e.g. must be kept securely in a CD cabinet
Subject to recording in Controlled Drug Register
What is a schedule 3 CD?
CDs with lower therapeutic value and less propensity for harm eg barbiturates, some benzos, gapapentanoids and weak opiods
Prescription requirements relating to their prescribing and dispensing
Do not require supplies or acquisitions to be recorded in CD register
Safe custody restrictions apply to some eg buprenorphine & temazepam but many are exempt eg tramadol or gabapentin
What is a Schedule 4 drug?
Part 1 - benzodiazepines CD (Benz) POM eg diazepam, lorazepam and Z drug hypnotics. Controls on import and export. Possession without authority is illegal. No prescription requirements
Part 2- Anabolic and androgenic steroids CD POM eg testosterone, nandrolone. Subject to lighter regulation with no possession offence. No prescription requirements
What is a schedule 5 CD?
Non injectable preparations of schedule 2 drugs
CD inv POM - eg morphine (in less than 0.2% concentration: oramorph 10mg in 5mL) or eg dihydrocodeine 30mg or co-codamol 30/500
CD Inv P - often sold over the counter - P meds eg cocodamol 8/500
Invoice copy or record must be kept for two years after the transaction ( a business record)
No prescription requirements
How long are CD prescriptions valid for?
Sch 2 - 28 days
Sch 3 - 28 days
Sch 4 - 28 days
Sch 5 - 6 months
What are the prescription writing requirements for Sch 2 & 3 drugs?
Handwritten or computer generated acceptable
Must be signed by the prescriber - only signature needs to be handwritten
Patient name and address required
Prescriber designation and address required
Must be indelible ink
Must state; drug name, drug form, drug strength, state dose (as required not acceptable), state the total quanity in words and figures
What are the CD register requirements for receipts?
Date, Name and address from whom received, amount received, form of product received, strength of product received
What are the CD register requirements for supplies?
Date, name and address of person to whom supplies, amount supplied, form of product supplied, strength of product supplied, authority under which supply is made eg GP
What are the destruction requirements for a CD?
The drug needs to be rendered irretrievable ie denatured so cannot be used/ reconstituated
Stock destroyed in the presence of an authorised person - records must be kept
Patient returns destroyed by pharmacist
What are the services to substance misuser?
Methadone Sch 2 & Buprenorphine Sch 3
GP10 home office approved wording
Written protocol / SOP/ Addiction services treatment agreement
What are the methadone prescription requirements?
CD Sch 2 POM
Signed by prescriber
Date, supply details
