Controlled Drug in the United Kingdom
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The
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain, is a country in Europe, off the north-western coast of the continental mainland. It comprises England, Scotland, Wales and North ...
Misuse of Drugs Act 1971 The Misuse of Drugs Act 1971 is an Act of the Parliament of the United Kingdom. It represents action in line with treaty commitments under the Single Convention on Narcotic Drugs, the Convention on Psychotropic Substances, and the United Nation ...
aimed to control the possession and supply of numerous listed drugs and drug-like substances as a
controlled substance A controlled substance is generally a drug or chemical whose manufacture, possession and use is regulated by a government, such as illicitly used drugs or prescription medications that are designated by law. Some treaties, notably the Single C ...
. The act allowed and regulated the use of some Controlled Drugs (designated CD) by various classes of persons (e.g. doctors) acting in their professional capacity. In clinical practice, this mostly applies to the use of strong
opiate An opiate, in classical pharmacology, is a substance derived from opium. In more modern usage, the term ''opioid'' is used to designate all substances, both natural and synthetic, that bind to opioid receptors in the brain (including antagonis ...
s for
pain management Pain management is an aspect of medicine and health care involving relief of pain (pain relief, analgesia, pain control) in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professionals pr ...
and some
amphetamine Amphetamine (contracted from alpha- methylphenethylamine) is a strong central nervous system (CNS) stimulant that is used in the treatment of attention deficit hyperactivity disorder (ADHD), narcolepsy, and obesity. It is also commonly used ...
-like
stimulant Stimulants (also often referred to as psychostimulants or colloquially as uppers) is an overarching term that covers many drugs including those that increase activity of the central nervous system and the body, drugs that are pleasurable and inv ...
s used for
Attention-deficit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...
; both of which are regulated under Schedule 2. The
Royal Pharmaceutical Society The Royal Pharmaceutical Society (RPharmS or RPS) is the body responsible for the leadership and support of the pharmacy profession (pharmacists) within England, Scotland, and Wales. It was created along with the General Pharmaceutical Council ...
maintains a live database of the legal classification of medicines.


Schedules

Special responsibilities are placed upon pharmaceutical wholesalers, pharmacies and doctors in the stocking, distribution, issuing of prescriptions, supply and disposal of items listed under the first three of the schedules. The regulations have been further tightened since Dr.
Harold Shipman Harold Frederick Shipman (14 January 1946 – 13 January 2004), known by the public as Doctor Death and to acquaintances as Fred Shipman, was an English general practitioner and serial killer. He is considered to be one of the most prolif ...
used
diamorphine Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brown ...
to murder hundreds of his patients during the late 20th century.


Schedule 1 - CD Lic

Drugs which are not used medically, and thus their possession and supply is prohibited; e.g. DMT and
LSD Lysergic acid diethylamide (LSD), also known colloquially as acid, is a potent psychedelic drug. Effects typically include intensified thoughts, emotions, and sensory perception. At sufficiently high dosages LSD manifests primarily mental, vi ...
except when licensed by the Home Office to carry out research.


Schedule 2 - CD

Substances subject to the full controlled drug requirements; e.g.
Cannabis ''Cannabis'' () is a genus of flowering plants in the family Cannabaceae. The number of species within the genus is disputed. Three species may be recognized: ''Cannabis sativa'', '' C. indica'', and '' C. ruderalis''. Alternatively ...
,
diamorphine Heroin, also known as diacetylmorphine and diamorphine among other names, is a potent opioid mainly used as a recreational drug for its euphoric effects. Medical grade diamorphine is used as a pure hydrochloride salt. Various white and brown ...
(heroin),
pethidine Pethidine, also known as meperidine and sold under the brand name Demerol among others, is a synthetic opioid analgesic, pain medication of the phenylpiperidine class. Synthesized in 1938 as a potential anticholinergic agent by the German chemis ...
,
cocaine Cocaine (from , from , ultimately from Quechuan languages, Quechua: ''kúka'') is a central nervous system (CNS) stimulant mainly recreational drug use, used recreationally for its euphoria, euphoric effects. It is primarily obtained from t ...
,
methadone Methadone, sold under the brand names Dolophine and Methadose among others, is a synthetic opioid agonist used for chronic pain and also for opioid dependence. It is used to treat chronic pain, and it is also used to treat addiction to heroin ...
,
methylphenidate Methylphenidate, sold under the brand names Ritalin and Concerta among others, is the most widely prescribed central nervous system (CNS) stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser extent, ...
,
dextroamphetamine Dextroamphetamine is a central nervous system (CNS) stimulant and an amphetamine enantiomer that is prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is also used as an athletic performance and ...
,
fentanyl Fentanyl, also spelled fentanil, is a very potent synthetic opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocaine ...
and
oxycodone Oxycodone, sold under various brand names such as Roxicodone and OxyContin (which is the extended release form), is a strong, semi-synthetic opioid used medically for treatment of moderate to severe pain. It is highly addictive and a commonly ...
. Under the Act, a prescription for these drugs need to show full details including the form and strength of the preparation, with the total quantity written out in both words and figures. It is an offence for a doctor to issue an incomplete prescription or for a pharmacist to dispense a controlled drug unless all the required details are given. It is the prescriber's responsibility to minimize the risk of dependence or misuse by ensuring that such drugs are not started for a particular patient without good cause, that the dose is not increased to the point where dependency is more likely, and to avoid being an unwitting source of supply for addicts. The quantities of controlled drugs prescribed should match the likely needs of the patients until the next clinical review and prescription forms should be secured against theft. Requirements for safe custody in pharmacies apply to all Sch 2 Controlled Drugs except quinalbarbitone. The safe custody requirements ensures that pharmacists and doctors holding stock of controlled drugs must store them in securely fixed double-locked steel safety cabinets and maintain a written register, which must be bound and contain separate entries for each drug and must be written in ink with no use of correction fluid. Disposal of expired stock must be witnessed by a designated inspector (either a police officer or a suitably qualified official). Until 2005 prescriptions for most schedule 2 & 3 drugs required certain details to be handwritten by the prescriber, unless he or she held a handwriting exemption certificate. The Shipman Inquiry however, found that this was one of the weaknesses in the audit system. Whereas computer generated prescriptions automatically left an audit trail which was easy to follow, handwritten prescriptions did not, even though all filed prescriptions are eventually sent to a central UK depositary. Therefore, good practice now calls for these prescriptions to be computer generated.


Schedule 3 - CD No Reg

Include drugs subject to the same prescription requirements as Schedule 2 drugs, but without the requirement to maintain registers. With the exception of phenobarbitone or related drugs for treatment of epilepsy, no Sch 3 drug can be given as an emergency supply. Safe custody is currently only required for Tenuate Dospan (diethylpropion),
buprenorphine Buprenorphine is an opioid used to treat opioid use disorder, acute pain, and chronic pain. It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), ...
products, temazepam and flunitrazepam (Rohypnol). Neither phenobarbitone nor midazolam require safe custody. Other Sch 3 drugs can be stored in the general dispensary.


Schedule 4

Controlled drug prescription requirements and safe custody requirements do not apply. Included drugs are
Benzodiazepine Benzodiazepines (BZD, BDZ, BZs), sometimes called "benzos", are a class of depressant drugs whose core chemical structure is the fusion of a benzene ring and a diazepine ring. They are prescribed to treat conditions such as anxiety disorders, ...
s (Subclass CD Benz), other than
temazepam Temazepam (sold under the brand names Restoril among others) is a medication of the benzodiazepine class which is generally used to treat severe or debilitating insomnia. It is taken by mouth. Temazepam is rapidly absorbed, and significant hypno ...
,
flunitrazepam Flunitrazepam, also known as Rohypnol among other names, is a benzodiazepine used to treat severe insomnia and assist with anesthesia. As with other hypnotics, flunitrazepam has been advised to be prescribed only for short-term use or by those ...
or
midazolam Midazolam, sold under the brand name Versed among others, is a benzodiazepine medication used for anesthesia and procedural sedation, and to treat severe agitation. It works by inducing sleepiness, decreasing anxiety, and causing a loss of a ...
, and androgenic and anabolic
steroid A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and a ...
s (Subclass CD Anab). However CD Benz products- which also include mild stimulants such as
mesocarb Mesocarb (brand names Sidnocarb, Sydnocarb) is a drug that is currently being developed for Parkinson's disease. The drug was originally developed in the USSR in the 1970s for a variety of indications including asthenia, apathy, adynamia and ...
and femcamfamine, formerly prescribed as anorectics- are illegal to supply or possess without prescription and all Sch 4 drugs cannot be legally supplied without medical authority. As of April 2014 "
Sativex Nabiximols (USAN, trade name Sativex) is a specific ''Cannabis'' extract that was approved in 2010 as a botanical drug in the United Kingdom. Nabiximols is sold as a mouth spray intended to alleviate neuropathic pain, spasticity, overactive bla ...
", the cannabis derived medicine prescribed for
spasticity Spasticity () is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles. ...
due to Multiple Sclerosis, is listed as a Schedule 4 Part 1 drug, whereas before that date it was a Schedule 1 drug requiring reporting and recording protocols (as earlier indicated on this page).


Schedule 5 - CD Inv P & CD Inv POM

Includes items which, because of their strength, are exempt from all requirements other than the need to retain invoices for two years.


See also

*
Drug policy of the United Kingdom Drugs considered addictive or dangerous in the United Kingdom are called "controlled substances" and regulated by law. Until 1964 the medical treatment of dependent drug users was separated from the punishment of unregulated use and supply. Under ...
*
Drugs controlled by the UK Misuse of Drugs Act These drugs are known in the UK as ''controlled drugs'', because this is the term by which the act itself refers to them. In more general terms, however, many of these drugs are also controlled by the Medicines Act 1968, there are many other drug ...


References


External links

* {{Cite book, last1=British Medical Association, url=https://www.worldcat.org/title/british-national-formulary/oclc/780551036?referer=di&ht=edition, title=British national formulary., last2=Pharmaceutical Society of Great Britain, date=2010, publisher=
British Medical Association The British Medical Association (BMA) is a registered trade union for doctors in the United Kingdom. The association does not regulate or certify doctors, a responsibility which lies with the General Medical Council. The association's headquar ...
and
Royal Pharmaceutical Society of Great Britain The Royal Pharmaceutical Society of Great Britain (RPSGB) existed from its founding as the Pharmaceutical Society of Great Britain in 1841 until 2010. The word "Royal" was added to its name in 1988. It was the statutory regulatory and professional ...
, isbn=978-0-85369-929-3, location=London, language=English, oclc=780551036 Laws in the United Kingdom Misuse of Drugs Act 1971 Drug control law in the United Kingdom Pharmacy in the United Kingdom de:Betäubungsmittel hy:Վերահսկվող թմրադեղեր ru:Наркотики