Misuse of drugs act: Controlled drugs, substance misuse and opioid substiution

Question 1

What is addiction?

Answer 1

When a person is addicted to a drug. Only if the person, as a result of repeat administration, has become so dependent on a drug that they have an overpowering desire for the administration of it to be continued

Question 2

What is dependence?

Answer 2

When someone needs a drug to function. Can be physical or mental

Question 3

What is tolerance?

Answer 3

When someone needs a higher dose to produce the same therapeutic response, which is typical of morphine

Question 4

Can a doctor without a license prescribe cocaine, diamorphine or dipiamine?

Answer 4

No, must have a license to prescribe these drugs. Must be a license authorised by the secretary of state.

Question 5

What is the most common form of treatment for addiction?

Answer 5

Methadone - schedule 2
Bupranorphine - schedule 3
diazepam - schedule 4

Question 6

What prescription is used for Controlled Drugs?

Answer 6

UK FP10 MDA - blue prescription

Question 7

What is the maximum supply that can be given on an FP10 blue prescription?

Answer 7

A maximum of 14 day supply

Question 8

Bupranorphine

Answer 8

Schedule 3 CD
Should not be given to someone with severe addiction as this would cause them to go into withdrawal.
sublingual tablet, patient should be supervised until dissolved

Question 9

Is crushed bupranorphine licensed?

Answer 9

No, although some pharmacies choose to dispense it in this way as it makes it easier to dissolve

Question 10

How are controlled drugs dispensed?

Answer 10

At the prescriber’s discretion. Whether they are supervised/unsupervised must be stated on the FP10. how many containers to be given out must also be considered

Question 11

What happens if a patient misses a dose of a controlled drug?

Answer 11

If 3 consecutive doses are missed, must stop prescription and have it reassessed by the prescriber as poses risk of withdrawal

Question 12

Who is allowed to possess and supply controlled drugs?

Answer 12

• pharmacists, doctors, dentists acting in this capacity
• home office license holders
• home office group authority
• postal operator or registered practicing midwife
• patients that have been prescribed

Question 13

What happens if a pharmacist comes into contact with schedule 1 CD?

Answer 13

They can possess the drugs for the purpose of destruction and for handing over to a police officer.
Patient’s confidentiality should always be respected. If quantity is larger than what would be expected for personal use, then the patients identity may be revealed. Under no circumstances should the drugs be handed back to the patient

Question 14

What are the legal requirements on a CD requisition?

Answer 14

• signature of recipient
• name of recipient
• address of recipient
• profession or occupation
• total quantity of drug
• purpose of requisition

Question 15

What are the legal requirements for CD prescriptions?

Answer 15

• signature of prescriber
• date
• address of prescriber
• dose in both words and figures
• form
• strength, if available in more than one strength
• total quantity in both words and figures
• quantity prescribed, should not exceed 30 days
• dental wording where required
• instalment wording where required
• patient name
• patient address

Question 16

How long is a controlled drug prescription valid for from signature date?

Answer 16

28 days from signature date or any other date indicated. Drugs cannot be dispensed before this date

Question 17

What are the directions for instalments of CDs?

Answer 17

• should be an interval between each time medicine is supplied
• dispense instalments due on pharmacy closed days on appropriate prior day
• instalments collection day missed, still dispense remaining
• consult prescriber if 3 consecutive days missed
• observe consumption on collection days

Question 18

What can a pharmacist do if the CD prescription has some errors?

Answer 18

If it is a typographical error or spelling mistake, can amend the prescription indelibly. Cannot correct other things like missing doses or incorrect doses/strength

Question 19

What is the name of the private prescription for CD?

Answer 19

FP10 PCD

Question 20

What rules is there regarding private prescriptions?

Answer 20

Must be on standardised forms, must include prescriber identification number. Medicines that are not controlled drugs should not be prescribed on the same form as schedule 2 & 3 controlled drugs.

Question 21

What should be done if a patient representative wishes to collect a controlled drug prescription?

Answer 21

• obtain letter from misuser that authorises and names representative.
• must have a separate letter every time
• must contact prescriber if supervision is required

Question 22

Which drugs require safe custody?

Answer 22

• schedule 1
• schedule 2 except some liquid preparations
• schedule 3 unless exempt
• applies to patient returned drugs, out of date and obsolete until they can be destroyed

Question 23

Which records should be kept about Controlled drugs that have been received?

Answer 23

• date received
• name and address from whom received
• quantity recieved

Question 24

What records should be kept for Controlled drugs Supplied?

Answer 24

• date
• name and address of patient
• details of authority to possess
• quantity supplied
• details of person collecting schedule 2 or 3
• whether proof of identity was required