The safe and legal supply of controlled drugs (CDs) from pharmacies Flashcards
The Law
Misuse of Drugs Act (1971)
Misuse of Drugs Regulations (2001) as amended
Misuse of Drugs (Safe Custody) Regulations 1973
Health Act (2006)
Controlled Drugs (Supervision of Management and Use) Regulations (2013)
What the law does
MDA (1971) imposes a total ban on the possession, supply, manufacture, import and export of CDs
The MDR (2001) permit possession, supply, manufacture, import and export of some CDs, by some people in certain conditions
The Secretary of State also has the power to grant a licence to permit the above. This is done via the Home Office
The Home Office enforce the above rules via the police
MDR (2001) classification of controlled drugs
Schedule 1 (CD Lic POM)
Drugs with no therapeutic use. A licence needs to be granted for legal production, possession or supply
Examples: Ecstasy (MDMA) and related substances, hallucinogens (e.g. LSD), raw opium
Schedule 2 (CD POM)
Pharmacists (and others named in MDR, 2001) have a general authority to possess, supply and procure these when acting in their professional capacity
Examples: diamorphine, morphine, methadone, amfetamines, ketamine
Schedule 3 (CD No Register POM)
Minor stimulants and various other drugs less likely than schedule 2 to be misused (and less harmful if they are)
Examples: benzphetamine, buprenorphine, temazepam, tramadol, midazolam, phenobarbital
Schedule 4 – split into two parts
Part 1 (CD Benz POM)
Benzodiazepines (bz), non-bz hypnotics (e.g. zopiclone) and Sativex (cannabinoid mouth spray)
Part II (CD Anab POM)
Most anabolic and androgenic steroids, clenbuterol, growth hormones
Schedule 5 (CD Inv POM or P)
Preparations of certain CDs that are exempt from full control because they are present in low strengths (codeine, pholcodeine, morphine)
Can be POM or P
Possession and supply of CDs
The MDR (2001) permit possession, supply, manufacture, import and export of some CDs, by some people in certain conditions
Pharmacists, doctors and dentists when acting in these capacities are empowered under a general authority to possess, supply and procure Schedule 2,3, 4 and 5 CDs
There are other mechanisms for lawful possession of CDs (MEP 3.6.3 p106)
Home Office licence
Home Office Group Authority e.g paramedics - certain drugs
Laws that permit class of person e.g. registered midwives –certain drugs
Patients who have been prescribed a CD (or for animal by vet
Schedule 1 CD normally require a Home Office licence to possess
There are two specific exemptions for pharmacists to take possession of such drugs:
When possession is for the purpose of destruction
When possession is for the purpose of handing to the police
Administration
Schedule 1
Can only be administered or prescribed under Home Office Licence
Schedule 2, 3 or 4 can be administered to a patient by:
Doctor, dentist, pharmacist independent prescriber, nurse independent prescriber acting in own right
A supplementary prescriber acting under a Clinical Management Plan
A person acting in accordance with the directions of a prescriber entitled to prescribe CDs (inc pharmacist independent prescribers)
Schedule 2, 3, 4 and 5 CDs :
Pharmacist independent prescribers can prescribe, administer them in their own right and direct their administration
Note that in some healthcare settings, for example secure environments, independent hospitals etc additional requirements and restrictions may be in place on who can administer and who should witness administration. This is for medicines management, governance and patient safety reasons and not legal requirements
import and export
If a pharmacy is importing or exporting schedule 1, 2, 3 and 4 (part I and part II) CDs a licence is needed
A licence not needed when the patient themselves carries Schedule 4 (part II) CDs abroad or brings then into the UK
Schedule 5 CDs are not restricted on import or export
travelling abroad
Patients travelling abroad carrying less than three months supply of CDs DO NOT currently need a licence to do so
They are advised to carry a letter from their prescriber stating their name, travel plans, name of prescribed CD, total quantity carried and dose taken
The patient should be advised to check with the embassy/high commission of the country/countries they are visiting (and travelling through) to ensure import and export rules are complied with
Also check with travel company/airline any restrictions; remember hand luggage liquid restrictions!
Patients travelling abroad with three months supply of CDs or more:
Need to register with a healthcare professional in the country they are in to access ongoing care
