Scheduling and legality of drugs Flashcards
(9 cards)
Historical landmarks in drug scheduling
Sales of Spirits Act (Gin Act) of 1750 - British Act of Parliament intended to reduce crime and increase productivity during the industrial revolution. It prohibited the sale of gin to unlicensed merchants.
1841 - Pharmaceutical Society established. Members were only a small proportion of drug sellers.
The Pharmacy Act of 1852 set up a ‘Register of Pharmaceutical Chemists’, limited to those that had passed the Society’s exams.
The Medical Act of 1858 set up the General Council of Medical Education and Registration of the United Kingdom, now known as the General Medical Council.
The Pharmacy Act of 1868 set up a register of people qualified to sell, dispense and compound poisons. All poisons had to be entered in a Poison Register. All drugs had to be sold in containers with the seller’s name and address. Established restrictions on fifteen named poisons in a two-part schedule.
- Part 1 - strychnine, potassium cyanide and ergot, could only be sold if the purchaser was known to the seller or to an intermediary known to both.
- Part 2 - opium and all preparations of opium/poppies
Origins of drug scheduling
Drug scheduling was established by the WHO at the 1971 Vienna Convention.
Schedule I - Substances whose liability to abuse constitutes an especially serious risk to public health and which have very limited, if any, therapeutic usefulness.
Schedule II - Substances whose liability to abuse constitutes a substantial risk to public health and which have little to moderate therapeutic usefulness.
Schedule III - Substances whose liability to abuse constitutes a substantial risk to public health and which have moderate to great therapeutic usefulness.
Schedule IV - Substances whose liability to abuse constitutes a smaller but still significant risk to public health and which have a therapeutic usefulness from little to great.
Misuse of Drugs Act (MDA)
The Misuse of Drugs Act of 1971 (MDA) controls drugs that are ‘dangerous or otherwise harmful’ when misused, under a three-tier system of classification (Class A, B and C). This framework sets criminal penalties with reference to the harm a drug has when misused and the type of illegal activity undertaken in regard to that drug.
Section 1 - it is the duty of the Advisory Council on the Misuse of Drugs (ACMD) to keep under review the situation in the UK with respect to drugs which are being or are likely to be misused.
Section 4 sets the restriction of production or supply on controlled drugs.
Section 5 sets restriction of possession of controlled drugs (possession and/or possession with intent to supply, depending on the drug).
- It would be in the defence of the accused to prove that, knowing or suspecting it to be a controlled drug, he took possession of it for the purpose of preventing another from committing an offence in relation to the drug and that after possession they took steps to destroy the drug or to deliver it into the custody of a person lawfully entitled to take custody of it, or for the purpose of delivering it into the custody of a person lawfully entitled to take custody of it (e.g. delivering morphine to someone it was prescribed to).
Sections 6 and 7 set the restriction of cultivation of the cannabis plant - illegal to cultivate any plant of the Cannabis genus, even those with very low THC levels, without a license.
Section 9 prohibits certain activities relating to opium. It is an offence for a person to use opium, frequent places used for opium smoking or possess utensils associated with opium smoking.
Section 28 states that proof of lack of knowledge can be a defence in proceedings for certain offences, but it is difficult to apply.
Section 27 concerns forfeiture - allows possession and destruction or otherwise handling of controlled drugs or associated products, including money associated with drug trade.
MDA drug classes
MDA uses drug classes rather than schedules.
Class A e.g. Diamorphine (heroin), Hydrocodone, Lysergide and other N-alkyl derivatives of lysergamide, Mescaline, Methadone
Class B e.g. Amphetamine, Methylphenidate, cannabis, ketamine
Class C anabolic steroids e.g. Nandrolone and Stanozolol
This provides guidance for sentencing and the punishment of offenders, rather than being concerned with social or health implications.
MDA prosecution and punishment
Section 25 of the MDA concerns the prosecution and punishment of offenders.
Punishment depends on the drug class.
Class C: <2 years prison and/or fine for possession and <14 years and/or fine for supply.
Class B: <5 years prison and/or fine for possession and <14 years and/or fine for supply.
Class A: <7 years prison and/or fine for possession and <life and/or fine for supply.
Drug penalties - Psychoactive substances penalties
The government website classifies psychoactive substances as things that cause hallucinations, drowsiness or changes in alertness, perception of time/space and mood or empathy with others. Food, alcohol, nicotine, caffeine, medicine and illegal drugs do not count as psychoactive substances. Psychoactive substances are ‘legal highs’, or unclassified drugs that demonstrate psychoactivity.
There is no penalty for possession of psychoactive substances unless you are in prison.
For supply and production, you can get up to 7 years in prison, an unlimited fine or both if you:
- carry a psychoactive substance and you intend to supply it
- make a psychoactive substance
- supply (sell, deal or share) a psychoactive substance
Misuse of Drugs Regulations (MDR)
Misuse of Drugs Regulations of 2001 (MDR) allow for the lawful possession and supply of controlled (illegal) drugs for legitimate purposes. They cover prescribing, administering, safe custody, dispensing, record keeping, destruction and disposal of controlled drugs to prevent diversion for misuse.
Regulation 7 concerns the administration of drugs in schedules 1-5
- anyone can administer a drug in schedule 5, and doctors, dentists, or a person in accordance to either, may administer drugs in schedules 2-4.
Regulation 8 concerns the production and supply of drugs in schedules 2 and 5 - practitioners and pharmacists can manufacture any of these compounds.
The MDR also offers a lot of information about:
- Marking of bottles and other containers
- Record-keeping requirements
- Requirements as to registers
- Preservation of registers, books and other documents
- Destruction of controlled drugs
Scheduling 1-5
UK scheduling is more complicated than the initial 4 described schedules.
Difficult for drugs to move between schedules, even if the ACMD recommends so, as this is ultimately up to politicians.
Psilocin may have therapeutic benefit as an antidepressant, as might cannabinoids, but these are still classified as schedule I drugs, which puts a lot of barriers up for carrying out clinical trials.
How can you prove that something has therapeutic value and therefore shouldn’t be in schedule I if you cannot carry out research?
Schedule 1 (drugs not used medicinally): Cannabis and cannabis resin, Coca leaf, Concentrate of poppy-straw, Lysergide and other N-alkyl derivatives of lysergamide, Mescaline, Psilocin (Psylocibin), Raw opium
Schedule 2: Amphetamine, Cocaine, Diamorphine, Dronabinol, Fentanyl
Schedule 3: Buprenorphine, Flunitrazepam, Temazepam
Schedule 4:
- Part I: Diazepam and Midazolam
- Part II: “Controlled drugs excepted from the prohibition on possession when in the form of a medicinal product” - Nandrolone and Stanazolol
Schedule 5: preparations of certain Controlled Drugs which due to their low strength, are exempt from virtually all requirements other than retention of invoices for two years
The Advisory Council on the Misuse of Drugs (ACMD)
The members of the Advisory Council (>20) shall be appointed by the Secretary of State.
The Advisory Council may appoint committees, which may consist in part of persons who are not members of the Council, to consider and report to the Council on any matter referred to them.
The ACMD is made up of psychiatrists, pharmacologists, social workers, police officers and lawyers.
It is an attempt to rationalise the harm associated with drug consumption.
It is debatable if drug classification is backed by scientific evidence of the harms of these substances.
A potential method for exploring harms caused by drugs has been developed that assesses harms across nine domains; three relate to the personal harms of the drug [acute harms e.g., from overdose, chronic harms and harms due to intravenous use], three relate to its propensity to cause dependence [liking, physical dependence and psychological dependence] and three cover social harms [harms from intoxication, (including anti-social behaviour), harms from supply/dealing, associated acquisitive crime and health care costs].
- Each can be scored on a 0–3 scale and a value for each drug derived from which a rank order of harm may be produced.
- Alcohol and tobacco were added as anchor points, and these scored higher than some illegal drugs like cannabis, LSD and ecstasy.
Politicians often go against ACDM’s advice.
Media reports deaths caused by illegal drugs more, shifting public perception of the harms: A review of 10-year media reporting of drug deaths in Scotland illustrates the distorted media perspective: the likelihood of a newspaper reporting a death from paracetamol was in per 250 deaths, for diazepam it was 1 in 50, whereas for amphetamine it was 1 in 3 and for ecstasy every associated death was reported.
