Podcast
Questions and Answers
What does CD stand for?
What does CD stand for?
Controlled Drug
The Misuse of Drugs Act 1971 prohibits the possession of controlled drugs for any purpose.
The Misuse of Drugs Act 1971 prohibits the possession of controlled drugs for any purpose.
True (A)
Which of the following drugs is classified as Class A?
Which of the following drugs is classified as Class A?
- Tramadol
- Cannabis
- Codeine
- Cocaine (correct)
What is the primary reason for classifying some drugs as controlled?
What is the primary reason for classifying some drugs as controlled?
Which of the following substances is included in Schedule 2?
Which of the following substances is included in Schedule 2?
The Misuse of Drugs Act 1971 was enacted to control _____ drugs.
The Misuse of Drugs Act 1971 was enacted to control _____ drugs.
What significant event influenced changes in CD legislation?
What significant event influenced changes in CD legislation?
What role does the Advisory Council on Misuse of Drugs have?
What role does the Advisory Council on Misuse of Drugs have?
Schedule 1 controlled drugs include _____ and MDMA.
Schedule 1 controlled drugs include _____ and MDMA.
What are the penalties for possession of Class B drugs?
What are the penalties for possession of Class B drugs?
Which of the following drugs are classified as Schedule 2 CDs? (Select all that apply)
Which of the following drugs are classified as Schedule 2 CDs? (Select all that apply)
All Schedule 3 CDs should be written up in the CD register.
All Schedule 3 CDs should be written up in the CD register.
Dronabinol is classified as Schedule 2 CD.
Dronabinol is classified as Schedule 2 CD.
Which statement is true regarding Schedule 4 CDs?
Which statement is true regarding Schedule 4 CDs?
What is the classification of Sativex?
What is the classification of Sativex?
All Schedule 5 CDs have restrictions on possession.
All Schedule 5 CDs have restrictions on possession.
Dihydrocodeine for parenteral use is classified as a CD ___ ______.
Dihydrocodeine for parenteral use is classified as a CD ___ ______.
Which of these cannabinoids is not controlled under the Misuse of Drugs Act?
Which of these cannabinoids is not controlled under the Misuse of Drugs Act?
What is the maximum prescription validity for Schedule 3 CDs?
What is the maximum prescription validity for Schedule 3 CDs?
What type of medical conditions is Nabilone used for?
What type of medical conditions is Nabilone used for?
Raw cannabis is classified as a Schedule 2 CD.
Raw cannabis is classified as a Schedule 2 CD.
Controlled drugs in the UK are classified into ___ schedules and classes.
Controlled drugs in the UK are classified into ___ schedules and classes.
The legal requirements for controlled drugs become more stringent as the level of control increases.
The legal requirements for controlled drugs become more stringent as the level of control increases.
Cannabis is completely unrestricted under UK drug legislation.
Cannabis is completely unrestricted under UK drug legislation.
Dronabinol is considered a Schedule 3 controlled drug in the UK.
Dronabinol is considered a Schedule 3 controlled drug in the UK.
The Shipman murders had no impact on drug control legislation in the UK.
The Shipman murders had no impact on drug control legislation in the UK.
Following the Shipman case, the duration of validity for a controlled drug prescription was increased to 28 days.
Following the Shipman case, the duration of validity for a controlled drug prescription was increased to 28 days.
Controlled Drug Accountable Officers (CDAOs) were introduced as part of the changes in legislation post-Shipman.
Controlled Drug Accountable Officers (CDAOs) were introduced as part of the changes in legislation post-Shipman.
The introduction of running balances in controlled drug registers is a legal requirement.
The introduction of running balances in controlled drug registers is a legal requirement.
Mrs. Brant was found guilty of failing to observe an unusual pattern of prescribing.
Mrs. Brant was found guilty of failing to observe an unusual pattern of prescribing.
Private prescriptions for controlled drugs are no longer required to be written on a standardized form.
Private prescriptions for controlled drugs are no longer required to be written on a standardized form.
Dr Harold F Shipman was known for using morphine to treat his patients.
Dr Harold F Shipman was known for using morphine to treat his patients.
The Misuse of Drugs Act 1971 initially included controls on both opiates and cocaine.
The Misuse of Drugs Act 1971 initially included controls on both opiates and cocaine.
Diamorphine is classified as a non-controlled substance under current drug regulations.
Diamorphine is classified as a non-controlled substance under current drug regulations.
The addition of tramadol to drug regulations occurred before 2019.
The addition of tramadol to drug regulations occurred before 2019.
Benzodiazepines were part of the regulations established prior to the Misuse of Drugs Act 1971.
Benzodiazepines were part of the regulations established prior to the Misuse of Drugs Act 1971.
Dr Shipman was highly regarded by his patients and healthcare professionals.
Dr Shipman was highly regarded by his patients and healthcare professionals.
Gabapentin and pregabalin were classified as controlled drugs in 2020.
Gabapentin and pregabalin were classified as controlled drugs in 2020.
The Misuse of Drugs Act 1971 has remained unchanged since its enactment.
The Misuse of Drugs Act 1971 has remained unchanged since its enactment.
Possessing a Schedule 1 controlled drug can result in a penalty of up to 5 years in prison.
Possessing a Schedule 1 controlled drug can result in a penalty of up to 5 years in prison.
A pharmacist can take possession of a Schedule 1 controlled drug without any special exemptions.
A pharmacist can take possession of a Schedule 1 controlled drug without any special exemptions.
Drugs classified as Schedule 1 have significant medical value and are strictly controlled.
Drugs classified as Schedule 1 have significant medical value and are strictly controlled.
Dealing with Schedule 1 controlled drugs can lead to a penalty of up to 14 years in prison.
Dealing with Schedule 1 controlled drugs can lead to a penalty of up to 14 years in prison.
Researching the medical use of controlled substances does not require a license from the Home Secretary.
Researching the medical use of controlled substances does not require a license from the Home Secretary.
A CDAO is responsible for prescribing controlled drugs as part of their regular duties.
A CDAO is responsible for prescribing controlled drugs as part of their regular duties.
Class A drugs include substances like cocaine and LSD.
Class A drugs include substances like cocaine and LSD.
Penalties for possession of Class C drugs can include up to 5 years in prison.
Penalties for possession of Class C drugs can include up to 5 years in prison.
The Advisory Council on Misuse of Drugs consists of representatives from multiple fields such as medicine and dentistry.
The Advisory Council on Misuse of Drugs consists of representatives from multiple fields such as medicine and dentistry.
Keithamine is classified as a Class B drug.
Keithamine is classified as a Class B drug.
Class B drugs include oral amfetamines and barbiturates.
Class B drugs include oral amfetamines and barbiturates.
Community pharmacies must appoint a CDAO.
Community pharmacies must appoint a CDAO.
Penalties for dealing Class A drugs can include life imprisonment.
Penalties for dealing Class A drugs can include life imprisonment.
Tramadol is classified as a Class C drug.
Tramadol is classified as a Class C drug.
The penalties for dealing Class B drugs include a maximum of 10 years in prison.
The penalties for dealing Class B drugs include a maximum of 10 years in prison.
Cannabidiol (CBD) is classified as a Schedule 1 controlled drug under the Misuse of Drugs Act.
Cannabidiol (CBD) is classified as a Schedule 1 controlled drug under the Misuse of Drugs Act.
Dihydrocodeine injections are classified as a CD Inv POM.
Dihydrocodeine injections are classified as a CD Inv POM.
The maximum strength for non-parenteral dihydrocodeine tablets to be classified as CD Inv POM is 150mg.
The maximum strength for non-parenteral dihydrocodeine tablets to be classified as CD Inv POM is 150mg.
Schedule 4 Part II controlled drugs have no restrictions on possession when contained in a medicinal product.
Schedule 4 Part II controlled drugs have no restrictions on possession when contained in a medicinal product.
All Schedule 3 controlled drugs have a valid prescription period of 60 days.
All Schedule 3 controlled drugs have a valid prescription period of 60 days.
Methadone is listed as a Schedule 2 controlled drug.
Methadone is listed as a Schedule 2 controlled drug.
Cannabis-based products for medicinal use are classified as Schedule 3 controlled drugs.
Cannabis-based products for medicinal use are classified as Schedule 3 controlled drugs.
Prescription requirements for Schedule 5 CDs stipulate that invoices must be retained for 12 months.
Prescription requirements for Schedule 5 CDs stipulate that invoices must be retained for 12 months.
Buprenorphine is an example of a Schedule 4 controlled drug.
Buprenorphine is an example of a Schedule 4 controlled drug.
Dronabinol is an example of a Schedule 2 controlled drug.
Dronabinol is an example of a Schedule 2 controlled drug.
For Schedule 4 controlled drugs, there are no safe custody requirements.
For Schedule 4 controlled drugs, there are no safe custody requirements.
Schedule 1 controlled drugs include synthetic cannabinoids.
Schedule 1 controlled drugs include synthetic cannabinoids.
Phenobarbital is classified as a Class B drug.
Phenobarbital is classified as a Class B drug.
Alprozolam is an example of a Schedule 4 Part 2 controlled drug.
Alprozolam is an example of a Schedule 4 Part 2 controlled drug.
Controlled drugs in the UK are classified into three schedules and classes.
Controlled drugs in the UK are classified into three schedules and classes.
The validity period for a controlled drug prescription was decreased following the Shipman murders.
The validity period for a controlled drug prescription was decreased following the Shipman murders.
Diamorphine is considered a controlled substance under current drug regulations.
Diamorphine is considered a controlled substance under current drug regulations.
Researching the medical use of controlled substances is permitted without any licensing requirements.
Researching the medical use of controlled substances is permitted without any licensing requirements.
Drugs classified as Schedule 1 have significant medical value and are subject to strict control.
Drugs classified as Schedule 1 have significant medical value and are subject to strict control.
The maximum quantity of controlled drugs on a prescription is a legal requirement under current legislation.
The maximum quantity of controlled drugs on a prescription is a legal requirement under current legislation.
Following the Shipman case, the duration of validity for a controlled drug prescription was reduced to 28 days.
Following the Shipman case, the duration of validity for a controlled drug prescription was reduced to 28 days.
Recording running balances in controlled drug registers is mandated by law after the Shipman case.
Recording running balances in controlled drug registers is mandated by law after the Shipman case.
Controlled Drug Accountable Officers (CDAOs) were introduced as a measure to enhance oversight in organizations handling controlled drugs.
Controlled Drug Accountable Officers (CDAOs) were introduced as a measure to enhance oversight in organizations handling controlled drugs.
Mrs. Brant was subject to disciplinary actions due to her failure in recognizing the unusual prescribing pattern.
Mrs. Brant was subject to disciplinary actions due to her failure in recognizing the unusual prescribing pattern.
Possessing a Schedule 1 controlled drug can result in a penalty of up to 2 years in prison.
Possessing a Schedule 1 controlled drug can result in a penalty of up to 2 years in prison.
A pharmacist may take possession of a Schedule 1 controlled drug for research purposes without special exemptions.
A pharmacist may take possession of a Schedule 1 controlled drug for research purposes without special exemptions.
Penalties for dealing Schedule 1 drugs include a maximum prison sentence of 14 years.
Penalties for dealing Schedule 1 drugs include a maximum prison sentence of 14 years.
LSD is classified as a Class B controlled drug.
LSD is classified as a Class B controlled drug.
The production, possession, and supply of Schedule 1 drugs are limited only to medical purposes.
The production, possession, and supply of Schedule 1 drugs are limited only to medical purposes.
Mrs. Brant thought that Dr. Shipman was using 30mg of diamorphine for treating patients with suspected ____ pain.
Mrs. Brant thought that Dr. Shipman was using 30mg of diamorphine for treating patients with suspected ____ pain.
Dr. Shipman was sentenced to 10 life sentences for his crimes.
Dr. Shipman was sentenced to 10 life sentences for his crimes.
Every line recorded in the CD register for Dr. Shipman's 30mg ampoules was associated with the same patient.
Every line recorded in the CD register for Dr. Shipman's 30mg ampoules was associated with the same patient.
Mrs. Brant thought Shipman's prescription requests were unusual and raised concerns about them.
Mrs. Brant thought Shipman's prescription requests were unusual and raised concerns about them.
The BNF recommends a slow IV injection of 5mg of diamorphine followed by further doses if necessary for myocardial infarction.
The BNF recommends a slow IV injection of 5mg of diamorphine followed by further doses if necessary for myocardial infarction.
Mrs. Brant was interviewed by the police only after Shipman's trial concluded.
Mrs. Brant was interviewed by the police only after Shipman's trial concluded.
The requests made by Dr. Shipman for diamorphine were consistent with standard medical practices for treating heart attacks.
The requests made by Dr. Shipman for diamorphine were consistent with standard medical practices for treating heart attacks.
The police investigation into Dr. Shipman led to concerns about the management of controlled substances.
The police investigation into Dr. Shipman led to concerns about the management of controlled substances.
The FSA website can be used to check if a CBD product has been authorised for sale.
The FSA website can be used to check if a CBD product has been authorised for sale.
Sativex is classified as a Schedule 4 part 1 controlled drug and requires specific prescription requirements.
Sativex is classified as a Schedule 4 part 1 controlled drug and requires specific prescription requirements.
Doctors on the Specialist Register of the General Medical Council are required to prescribe unlicensed cannabis medicines.
Doctors on the Specialist Register of the General Medical Council are required to prescribe unlicensed cannabis medicines.
THC is permitted in CBD products if it is below 0.3% concentration.
THC is permitted in CBD products if it is below 0.3% concentration.
Unlicensed medicinal products must have clear published evidence of benefit before they can be prescribed.
Unlicensed medicinal products must have clear published evidence of benefit before they can be prescribed.
NICE guidance recommends the use of cannabis-based products to treat chronic pain.
NICE guidance recommends the use of cannabis-based products to treat chronic pain.
All cannabis-based products are classified as licensed medicines under UK regulations.
All cannabis-based products are classified as licensed medicines under UK regulations.
Pharmacists are required to maintain records of Sativex despite it being a Schedule 4 CD.
Pharmacists are required to maintain records of Sativex despite it being a Schedule 4 CD.
Dihydrocodeine is classified as a Schedule 5 controlled drug due to its high strength.
Dihydrocodeine is classified as a Schedule 5 controlled drug due to its high strength.
Cannabidiol (CBD) is a psychoactive compound that is controlled under the Misuse of Drugs Act.
Cannabidiol (CBD) is a psychoactive compound that is controlled under the Misuse of Drugs Act.
All controlled drugs within Schedule 3 are considered to be more likely to be misused than those in Schedule 2.
All controlled drugs within Schedule 3 are considered to be more likely to be misused than those in Schedule 2.
Flunitrazepam and diazepam are both classified as Schedule 4 controlled drugs.
Flunitrazepam and diazepam are both classified as Schedule 4 controlled drugs.
The prescription validity for Schedule 4 CD drugs is 28 days.
The prescription validity for Schedule 4 CD drugs is 28 days.
Alfentanil is an example of a Schedule 3 controlled drug.
Alfentanil is an example of a Schedule 3 controlled drug.
The MHRA states that CBD products marketed for medical purposes should be regulated as medicines.
The MHRA states that CBD products marketed for medical purposes should be regulated as medicines.
The law requires all Schedule 4 Part II controlled drugs to be kept under safe custody.
The law requires all Schedule 4 Part II controlled drugs to be kept under safe custody.
Morphine is an example of a drug listed under Schedule 1 controlled drugs.
Morphine is an example of a drug listed under Schedule 1 controlled drugs.
Possession of Schedule 5 controlled drugs has no restrictions on import, export, or administration.
Possession of Schedule 5 controlled drugs has no restrictions on import, export, or administration.
A cannabis-based product used for medicinal purposes is classified as a Schedule 1 controlled drug.
A cannabis-based product used for medicinal purposes is classified as a Schedule 1 controlled drug.
Buprenorphine is an example of a controlled drug that is classified under Schedule 4.
Buprenorphine is an example of a controlled drug that is classified under Schedule 4.
Nandrolone is classified as a Schedule 4 Part II controlled drug.
Nandrolone is classified as a Schedule 4 Part II controlled drug.
Prescription validity for Schedule 5 controlled drugs is valid for 6 months.
Prescription validity for Schedule 5 controlled drugs is valid for 6 months.
What are controlled drugs (CDs)?
What are controlled drugs (CDs)?
What led to changes in CD legislation following the Shipman murders?
What led to changes in CD legislation following the Shipman murders?
Give two examples of drugs classified as Class A.
Give two examples of drugs classified as Class A.
What are the legal requirements for Schedule 2 controlled drugs?
What are the legal requirements for Schedule 2 controlled drugs?
Other regulations exist on the safe custody of controlled drugs.
Other regulations exist on the safe custody of controlled drugs.
The ______ introduced maximum quantities for controlled drugs on prescriptions.
The ______ introduced maximum quantities for controlled drugs on prescriptions.
What does CDAO stand for?
What does CDAO stand for?
Which drug is considered a Class B controlled substance?
Which drug is considered a Class B controlled substance?
What role does the Advisory Council on Misuse of Drugs play?
What role does the Advisory Council on Misuse of Drugs play?
Describe one consequence of Dr. Harold Shipman's actions.
Describe one consequence of Dr. Harold Shipman's actions.
What schedule does cannabis (non-medicinal use) fall under?
What schedule does cannabis (non-medicinal use) fall under?
Which of these are examples of Schedule 2 controlled drugs (CDs)? (Select all that apply)
Which of these are examples of Schedule 2 controlled drugs (CDs)? (Select all that apply)
All Schedule 2 controlled drugs must be kept in the CD cupboard.
All Schedule 2 controlled drugs must be kept in the CD cupboard.
Schedule 3 controlled drugs must be recorded in the CD register.
Schedule 3 controlled drugs must be recorded in the CD register.
Schedule 4 Part I includes most benzodiazepines, such as nitrazepam.
Schedule 4 Part I includes most benzodiazepines, such as nitrazepam.
Class A controlled drugs are also classified as Schedule 2 CDs.
Class A controlled drugs are also classified as Schedule 2 CDs.
Codeine phosphate tablets 30mg are classified as CD Inv POM.
Codeine phosphate tablets 30mg are classified as CD Inv POM.
Co-codamol tablets 30/500 are classified as CD Inv POM.
Co-codamol tablets 30/500 are classified as CD Inv POM.
Co-codamol tablets 8/500 can be classified as CD Inv P.
Co-codamol tablets 8/500 can be classified as CD Inv P.
Temazepam elixir 10mg/5ml which has been returned by a patient should be stored in the CD cabinet.
Temazepam elixir 10mg/5ml which has been returned by a patient should be stored in the CD cabinet.
MST tablets which have been dispensed but are waiting for collection by the patient should be stored in the CD cabinet.
MST tablets which have been dispensed but are waiting for collection by the patient should be stored in the CD cabinet.
What does Schedule 5 contain?
What does Schedule 5 contain?
What is one drug classified as a Schedule 3 controlled drug?
What is one drug classified as a Schedule 3 controlled drug?
What is the classification of Sativex?
What is the classification of Sativex?
Which cannabinoid gives cannabis its psychoactive effect?
Which cannabinoid gives cannabis its psychoactive effect?
Flashcards
Controlled Drugs (CDs)
Controlled Drugs (CDs)
Drugs subject to strict controls due to potential harm, abuse, or misuse.
Misuse of Drugs Act 1971
Misuse of Drugs Act 1971
Legislation controlling dangerous or harmful drugs in the UK.
Shipman Murders
Shipman Murders
A series of murders committed by Dr. Shipman with misuse of diamorphine.
Controlled Drugs Schedules
Controlled Drugs Schedules
Classifications of CDs based on the level of control, based on medicinal use.
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Schedules 1-5
Schedules 1-5
Classifies controlled drugs with increasing levels of permissible medicinal use. Schedule 1 has the strictest control.
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Class A CDs
Class A CDs
Most harmful drugs with severe penalties for possession or dealing.
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Class B CDs
Class B CDs
Controlled drugs with penalties less severe than Class A.
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Class C CDs
Class C CDs
Controlled drugs with the least severe penalties of the three classes (B,A).
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Controlled Drugs Accountable Officer (CDAO)
Controlled Drugs Accountable Officer (CDAO)
A senior person responsible for managing controlled drugs within an organisation.
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Medicinal use of CDs
Medicinal use of CDs
Legitimate use of controlled drugs as medicines, by permitted practitioners.
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CD Prescription Validity
CD Prescription Validity
Prescriptions for controlled drugs are valid for 28 days.
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CD safe custody
CD safe custody
Strict regulations on storing and securing controlled drugs.
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Shipman's Method of Murder
Shipman's Method of Murder
Using prescribed diamorphine, sometimes in excess of the clinical need. Patients often did not realize this.
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CD Register
CD Register
A record of all transactions involving controlled drugs.
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CD Invoices
CD Invoices
Records of CD purchases.
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Schedule 2 CDs
Schedule 2 CDs
This category includes highly addictive drugs with a high potential for misuse and harm, requiring strict controls on storage, handling, and prescribing.
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Schedule 3 CDs
Schedule 3 CDs
Drugs in this category have a lower potential for misuse and harm compared to Schedule 2, with some custody requirements, but differences in who can possess/supply, and no destruction for old stock.
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Schedule 4 CDs Part 1
Schedule 4 CDs Part 1
This part of Schedule 4 primarily contains benzodiazepines and 'z' hypnotics, with some restrictions on import/export, possession, and no safe custody.
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Schedule 4 CDs Part 2
Schedule 4 CDs Part 2
This part of Schedule 4 primarily contains anabolic and androgenic steroids, with some exceptions to restrictions on import/export, possession; no safe custody or CD register entries.
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Schedule 5 CDs
Schedule 5 CDs
Medicines that have low strength and are in a medicinal product, with less control on import, export, possession, and no safe custody or register requirements.
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Cannabis-based medicinal products
Cannabis-based medicinal products
Products derived from cannabis, intended for medicinal use, and classified as Schedule 2 CDs.
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Cannabidiol (CBD)
Cannabidiol (CBD)
A non-psychoactive cannabinoid, not controlled under the Misuse of Drugs Act, available as oils and tinctures.
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Sativex
Sativex
Cannabis-based oromucosal mouth spray, used for spasticity treatment, classified as Schedule 4 part 1, requiring fridge storage but no lock.
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Nabilone
Nabilone
Synthetic cannabinoid, used for chemotherapy-induced nausea and vomiting, classified as Schedule 2.
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Dronabinol
Dronabinol
Synthetic cannabinoid, THC version, also for chemotherapy-induced nausea and vomiting.
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Prescription validity (Schedule 2-5)
Prescription validity (Schedule 2-5)
Prescriptions for Schedule 2-5 vary, with some valid for 28 days, others for 6 months.
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CD Register
CD Register
A record keeping system for controlled drugs.
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Safe Custody
Safe Custody
Storing controlled drugs according to regulations to prevent theft and misuse.
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Inv POM
Inv POM
Controlled drug products exempt from full control due to a low strength in medicinal products.
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Class A CDs
Class A CDs
CDs that are also classified under Schedule 2, exhibiting a high risk of misuse and harm.
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Controlled Drugs (CDs)
Controlled Drugs (CDs)
Drugs with special controls due to potential harm or abuse.
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CD Legislation Changes
CD Legislation Changes
Changes in laws governing controlled drugs, often after serious events.
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CD Schedules
CD Schedules
Classifying controlled drugs based on their level of control (safety).
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Why Control Drugs?
Why Control Drugs?
Controlled drugs are controlled to mitigate harm and misuse.
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Legal Requirements (CDs)
Legal Requirements (CDs)
Legal rules changing with decreasing control level, affecting storage, records, etc.
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CDAO Responsibilities
CDAO Responsibilities
Senior person managing controlled drugs within an organization, ensuring compliance with regulations.
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Post-Shipman CD Changes
Post-Shipman CD Changes
Legislation changes after the Shipman case, including shorter prescription validity and extra record keeping requirements.
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CD Prescription Duration
CD Prescription Duration
Controlled drug prescriptions are now valid for 28 days.
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Private CD Prescription Forms
Private CD Prescription Forms
Private prescriptions for controlled drugs must use a specific standardized form.
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Shipman Pharmacist Ruling
Shipman Pharmacist Ruling
The RPSGB Fitness to Practice Committee concluded that the pharmacist had no wrongdoing in the Shipman case.
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Shipman's Method
Shipman's Method
Dr. Shipman murdered patients by overprescribing diamorphine, often using it for his own purposes, despite not always clinically needing it.
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Misuse of Drugs Act
Misuse of Drugs Act
UK law controlling harmful drugs, initially focusing on opiates, cannabis and cocaine, expanded to include more drugs over time.
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Controlled Drugs
Controlled Drugs
Substances subject to strict controls due to their potential harm, abuse or misuse.
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Shipman Murders
Shipman Murders
A series of murders committed by Harold Shipman, who used diamorphine prescriptions illicitly to kill his patients.
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Diamorphine
Diamorphine
A potent opiate used by Dr. Shipman to commit murders, as it was controlled, yet frequently misused.
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Drug Controls
Drug Controls
Regulations to prevent misuse and harm from drugs; These regulations changed to reflect more frequent drug misuse patterns.
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Amphetamines
Amphetamines
A controlled drug added to the Misuse of Drugs Act 1971, reflecting changing patterns of misuse.
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Benzodiazepines
Benzodiazepines
A class of drugs that are now considered controlled drugs due to the changing patterns of misuse related to their widespread use and abuse.
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CDAO
CDAO
A designated person responsible for safe and effective controlled drug (CD) management in an organization.
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Class A CDs
Class A CDs
Most harmful drugs; severe penalties for possession or dealing.
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Class B CDs
Class B CDs
Harmful drugs with penalties less severe than Class A.
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Class C CDs
Class C CDs
Drugs with less severe penalties.
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CD Schedules
CD Schedules
Classifies controlled drugs by their level of control regarding permissible medicinal use.
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Advisory Council on Misuse of Drugs
Advisory Council on Misuse of Drugs
Advises the government on matters related to drug misuse.
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Controlled Drugs
Controlled Drugs
Drugs with strict controls due to potential harm, abuse, or misuse.
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Different CDs classification ways
Different CDs classification ways
Controlled drugs can be classified by schedules which indicate the levels of control and classes relating to penalties for illegal use or possession
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Why Control Drugs?
Why Control Drugs?
Controlled drugs are controlled to minimize harm and misuse.
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CD Local Intelligence Network
CD Local Intelligence Network
A network dedicated to sharing information about controlled drugs.
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Schedule 1 Drugs
Schedule 1 Drugs
Drugs with the strictest controls; limited medical use, high misuse potential.
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Schedule 1 Pharmacist Restrictions
Schedule 1 Pharmacist Restrictions
Pharmacists can only possess Schedule 1 drugs for destruction or transfer to police.
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Schedule 1 Penalties
Schedule 1 Penalties
Severe consequences for possession or dealing, up to 14 years in prison.
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Possession Penalty (Nitrous Oxide)
Possession Penalty (Nitrous Oxide)
Up to 2 years in prison, unlimited fine, or both for possession of nitrous oxide.
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Dealing Penalty (Nitrous Oxide)
Dealing Penalty (Nitrous Oxide)
Up to 14 years in prison, unlimited fine, or both for dealing with nitrous oxide.
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Schedule 2 CDs
Schedule 2 CDs
Highly addictive drugs with high misuse potential, requiring strict controls.
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Schedule 3 CDs
Schedule 3 CDs
Drugs less likely to be misused or cause harm, with some custody requirements.
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Schedule 4 CDs (Part 1)
Schedule 4 CDs (Part 1)
Primarily benzodiazepines and 'z' hypnotics, with some import/export and possession restrictions
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Schedule 4 CDs (Part 2)
Schedule 4 CDs (Part 2)
Anabolic and androgenic steroids; import/export/possession with fewer restrictions
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Schedule 5 CDs
Schedule 5 CDs
Low strength drugs in medicinal products; minimal controls, including no safe custody.
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Cannabis medicinal products
Cannabis medicinal products
Cannabis-derived products for medicinal use, classified as Schedule 2.
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Cannabidiol (CBD)
Cannabidiol (CBD)
Non-psychoactive cannabinoid used in oils and tinctures, not controlled.
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Prescription validity (Schedule 2-5)
Prescription validity (Schedule 2-5)
Prescription durations vary for different Schedules: 28 days common.
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Controlled Drugs Register
Controlled Drugs Register
Record-keeping system for controlled drug transactions.
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Safe Custody
Safe Custody
Strict regulations to prevent theft and misuse of controlled drugs.
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Inv POM
Inv POM
Controlled drug products (low strength) in medicines, exempt from full control.
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CD Invoices
CD Invoices
Records of controlled drug purchases kept for a set period.
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Sch 2 Examples
Sch 2 Examples
Alfentanil, Morphine are some Schedule 2 drugs.
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Sch 3 Examples
Sch 3 Examples
Buprenorphine, Phenobarbital and Temazepam are examples
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Why control drugs?
Why control drugs?
To limit harm and misuse due to the potential for addiction, overdose, or other dangerous effects.
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CD Legislation Changes
CD Legislation Changes
Modifications to the laws governing controlled drugs, often due to events highlighting problematic misuse or safety concerns.
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Controlled Drugs Schedules
Controlled Drugs Schedules
Classifications of drugs based on their potential for misuse and the level of control needed.
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Shipman Murders
Shipman Murders
The murders committed by Dr. Shipman, which led to changes in related legislation surrounding the use of prescription controlled drugs.
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Legal Requirements (CDs)
Legal Requirements (CDs)
Changing regulations related to the storage, record-keeping, destruction, and sale of controlled drugs, based on the drug's risk level.
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Shipman's actions
Shipman's actions
Dr. Shipman murdered patients by overprescribing diamorphine, potentially exceeding clinical need.
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Pharmacist's role
Pharmacist's role
Mrs. Brant dispensed most of Shipman's diamorphine prescriptions.
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Diamorphine prescriptions
Diamorphine prescriptions
Shipman frequently prescribed single 30mg ampoules of diamorphine, often unusually in large quantities and in the name of different patients.
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Mrs. Brant's belief
Mrs. Brant's belief
Mrs. Brant believed Shipman's actions were justifiable and thought to be for patients with chest pain/heart trouble.
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Unusual requests
Unusual requests
The prescriptions for single 30mg ampoules were unusual given the standard diamorphine dosage for acute MI.
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Acute MI treatment
Acute MI treatment
The typical method for treating acute MI involves a slow IV injection of 5mg diamorphine, followed by progressively less if necessary.
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Prescriptions wastage
Prescriptions wastage
The dispensing of single 30mg ampoules, each prescribed in the name of a separate patient, suggests possible unnecessary or excessive drug provisioning by Dr. Shipman.
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Pharmacist's negligence?
Pharmacist's negligence?
Mrs. Brant's failure to notice the unusual nature of the prescriptions raises the question of potential negligence.
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Nitrous Oxide Schedule
Nitrous Oxide Schedule
Nitrous Oxide is a Class A (or Schedule 2) controlled drug with severe penalties for possession and dealing.
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Schedule 1 CD Penalties
Schedule 1 CD Penalties
Schedule 1 controlled drugs (CDs) have the strictest controls. Penalties for production, possession, and supply are very high.
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Schedule 1 CD Use
Schedule 1 CD Use
Schedule 1 CDs have little to no medical value but can cause significant social issues when misused.
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Pharmacist Schedule 1 Possession
Pharmacist Schedule 1 Possession
Pharmacists can only legally possess Schedule 1 CDs for destruction or transfer to law enforcement.
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Dealing with Nitrous Oxide
Dealing with Nitrous Oxide
Dealing with nitrous oxide can lead to penalties of up to 14 years imprisonment.
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Post-Shipman CD Changes
Post-Shipman CD Changes
Legislation changes after the Shipman case, including shorter prescription validity and increased record-keeping requirements for controlled drugs (CDs).
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Controlled Drugs Accountable Officer (CDAO)
Controlled Drugs Accountable Officer (CDAO)
A senior person responsible for managing controlled drugs within an organization, ensuring compliance with regulations.
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Prescription Validity (CDs)
Prescription Validity (CDs)
Prescriptions for controlled drugs (CDs) are now valid for 28 days.
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Private CD Prescription Forms
Private CD Prescription Forms
Private prescriptions for controlled drugs must use a standardized form (FP10PCD).
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Shipman Pharmacist Ruling
Shipman Pharmacist Ruling
The RPSGB Fitness to Practice Committee ruled that the pharmacist had no wrongdoing in the Shipman case.
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CBD Products Regulation
CBD Products Regulation
CBD products must not contain THC (a controlled substance) and require pre-market authorization (risk assessment) by the FSA.
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Unlicensed Cannabis Medicines
Unlicensed Cannabis Medicines
Most cannabis-based medicines, excluding Sativex, Epidyolex, and nabilone, are not officially approved for use.
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Sativex Classification
Sativex Classification
Sativex, a cannabis-based mouth spray, is a Schedule 4 part 1 controlled drug used to treat spasticity.
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Medicinal Cannabis Prescribing
Medicinal Cannabis Prescribing
Prescribing unlicensed cannabis medicines is restricted to specialists on the General Medical Council's Specialist Register.
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CBD Product Authorization
CBD Product Authorization
The Food Standards Agency (FSA) website provides details of authorized CBD products and is a critical tool to verify product legitimacy.
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Sativex Pharmacist Duties
Sativex Pharmacist Duties
While Sativex does not strictly require entry into the controlled drug register, pharmacists must maintain records of Sativex prescriptions.
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Unlicensed Medicine Justification
Unlicensed Medicine Justification
Unlicensed cannabis medicines should only be prescribed when supported by specific published evidence or suggested in UK guidelines.
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Chronic Pain Treatment Restrictions
Chronic Pain Treatment Restrictions
NICE guidelines do not currently recommend cannabis-based medicine use for chronic pain treatment.
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Schedule 2 CDs
Schedule 2 CDs
Highly addictive drugs with high misuse potential, requiring strict controls on storage, handling, and prescribing.
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Schedule 3 CDs
Schedule 3 CDs
Drugs with lower misuse potential than Schedule 2, with some custody requirements, but differences in who can possess/supply, and no destruction for old stock.
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Schedule 4 CDs (Part 1)
Schedule 4 CDs (Part 1)
Primarily benzodiazepines and 'z' hypnotics, with some import/export and possession restrictions.
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Schedule 4 CDs (Part 2)
Schedule 4 CDs (Part 2)
Anabolic and androgenic steroids; import/export/possession with fewer restrictions.
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Schedule 5 CDs
Schedule 5 CDs
Low strength drugs in medicinal products; minimal controls, including no safe custody.
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Cannabis-based medicinal products
Cannabis-based medicinal products
Cannabis-derived products for medicinal use, classified as Schedule 2 CDs.
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Cannabidiol (CBD)
Cannabidiol (CBD)
Non-psychoactive cannabinoid used in oils and tinctures, not controlled.
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CD Prescription Validity
CD Prescription Validity
Prescriptions for controlled drugs are valid for 28 days.
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CD Safe Custody
CD Safe Custody
Strict regulations on storing and securing controlled drugs to prevent theft or misuse.
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Inv POM
Inv POM
Controlled drug products (low strength) in medicines, exempt from full control.
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CD Invoices
CD Invoices
Records of controlled drug purchases kept for a set period.
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Schedule 2 Examples
Schedule 2 Examples
Alfentanil, Morphine are Schedule 2 drugs.
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Schedule 3 Examples
Schedule 3 Examples
Buprenorphine, Phenobarbital and Temazepam are examples.
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Controlled Drugs (CDs)
Controlled Drugs (CDs)
Drugs with strict controls due to potential harm, abuse, or misuse.
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Misuse of Drugs Act 1971
Misuse of Drugs Act 1971
UK law controlling dangerous drugs, used to prevent misuse.
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Shipman Murders
Shipman Murders
Murders committed by Dr. Shipman using controlled drugs inappropriately.
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CD Schedules
CD Schedules
Classifications of controlled drugs based on level of control in medicinal use.
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Schedules 1-5
Schedules 1-5
Categorization of CDs with Schedule 1 having the strictest control and decreasing to 5.
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Class A CDs
Class A CDs
Most harmful drugs; severe penalties for possession or dealing.
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Controlled Drugs Accountable Officer (CDAO)
Controlled Drugs Accountable Officer (CDAO)
Senior person responsible for managing controlled drugs in an organization.
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Prescription Validity (CDs)
Prescription Validity (CDs)
Prescriptions for controlled drugs are valid for 28 days
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CD Register
CD Register
Record of all controlled drug transactions, including in/out movement.
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Safe Custody (CDs)
Safe Custody (CDs)
Regulation of handling and storing controlled drugs to prevent theft or misuse.
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Schedule 2 CDs
Schedule 2 CDs
Highly addictive drugs with high potential for misuse and harm, requiring strict controls on storage, handling, and prescribing.
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Schedule 3 CDs
Schedule 3 CDs
Drugs with lower misuse potential than Schedule 2, with some custody requirements but differences in who can possess/supply and no destruction for old stock.
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Schedule 4 Part 1 CDs
Schedule 4 Part 1 CDs
Primarily benzodiazepines and 'z' hypnotics, with some import/export and possession restrictions.
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Schedule 4 Part 2 CDs
Schedule 4 Part 2 CDs
Anabolic and androgenic steroids; import/export/possession with fewer restrictions.
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Schedule 5 CDs
Schedule 5 CDs
Low strength drugs in medicinal products; minimal controls, including no safe custody.
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Cannabis-based medicinal products
Cannabis-based medicinal products
Cannabis-derived products for medicinal use, classified as Schedule 2.
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Cannabidiol (CBD)
Cannabidiol (CBD)
Non-psychoactive cannabinoid; not controlled, available as oils and tinctures.
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Sativex
Sativex
Cannabis-based oromucosal spray for spasticity treatment, Schedule 4 Part 1; fridge storage, no lock required.
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Nabilone
Nabilone
Synthetic cannabinoid for chemotherapy-induced nausea and vomiting, Schedule 2.
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Dronabinol
Dronabinol
Synthetic cannabinoid, THC version, also for chemotherapy-induced nausea and vomiting, Schedule 2.
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Controlled Drugs
- Controlled Drugs (CDs) are classified by the Misuse of Drugs Act 1971.
- CD stands for Controlled Drug.
- The Misuse of Drugs Act 1971 was enacted to control psychoactive drugs.
- The Misuse of Drugs Act 1971 prohibits the possession of controlled drugs for any purpose.
- The primary reason for classifying some drugs as controlled is to limit misuse and prevent harm.
- The Advisory Council on Misuse of Drugs provides expert advice to the UK government on drug control.
- The Shipman murders had a significant impact on the Misuse of Drugs Act 1971 and led to various changes in drug control legislation.
- Controlled drugs in the UK are classified into five schedules and three classes.
- The legal requirements for controlled drugs become more stringent as the level of control increases.
- Schedule 1 controlled drugs include heroin, cocaine and MDMA.
- Schedule 1 drugs have high potential for misuse and addiction.
- Possession of a Schedule 1 controlled drug can result in a penalty of up to 5 years in prison.
- Dealing with Schedule 1 controlled drugs can lead to a penalty of up to 14 years in prison.
- Schedule 2 controlled drugs include cannabis, amphetamines and ketamine.
- Schedule 3 controlled drugs are those with lower potential for misuse compared to Schedule 1 and 2, but still have significant abuse potential, including some benzodiazepines and codeine.
- All Schedule 3 CDs should be written up in the CD register.
- Schedule 4 controlled drugs include some benzodiazepines, gabapentin and pregabalin.
- Schedule 5 controlled drugs include dihydrocodeine and pholcodine.
- Schedule 5 CDs have restrictions on possession, but they have the least restrictions on import, export, and administration.
- The legal requirements for controlled drugs increase as the level of control increases.
- Class A drugs include cocaine, LSD and heroin.
- Class A drugs have the highest potential for harm and addiction.
- Penalties for possession of Class A drugs include a maximum penalty of 7 years in prison.
- Penalties for dealing Class A drugs can include life imprisonment.
- Class B drugs include amphetamine, barbiturates, and cannabis.
- Penalties for possession of Class B drugs can include a maximum penalty of 5 years in prison.
- Penalties for dealing Class B drugs include a maximum of 10 years in prison.
- Class C drugs include anabolic steroids, some benzodiazepines and ketamine.
- Penalties for possession of Class C drugs can include a maximum of 2 years in prison.
- Dronabinol is a Schedule 2 controlled drug.
- Sativex is a Schedule 4 part 1 controlled drug.
- Dihydrocodeine injections are classified as a CD Inv POM.
- The maximum strength for non-parenteral dihydrocodeine tablets to be classified as CD Inv POM is 150mg.
- Cannabidiol (CBD) is not a controlled substance under the Misuse of Drugs Act 1971, as long as it is below 0.3% concentration.
- THC is a psychoactive compound that is controlled under the Misuse of Drugs Act, but there are exceptions for THC in CBD products.
- Cannabis-based products for medicinal use are classified as Schedule 2 controlled drugs.
- Medicinal cannabis products are not licensed but can be used for medicinal purposes.
- Schedule 4 part 2 controlled drugs have no restrictions on possession when contained in a medicinal product.
- Flunitrazepam and diazepam are both classified as Schedule 4 controlled drugs.
- Alfentanil is an example of a Schedule 3 controlled drug.
- The MHRA states that CBD products marketed for medical purposes should be regulated as medicines.
Dr Harold Shipman
- Dr.Harold F Shipman was a medical doctor who was convicted of murdering 15 patients.
- Mrs.Brant was a nurse who worked with Dr.Shipman and noticed an unusual pattern of prescribing.
- Mrs.Brant suspected Shipman was using 30mg of diamorphine for treating patients with suspected myocardial infarction (heart attack) pain.
- Dr.Shipman was sentenced to 10 life sentences for his crimes.
- The police investigation into Dr.Shipman led to concerns about the management of controlled substances.
Controlled Drugs Legalities
- Following the Shipman case, the duration of validity for a controlled drug prescription was reduced to 28 days.
- The maximum validity period for Schedule 3 CDs is 28 days.
- Controlled Drug Accountable Officers (CDAOs) were introduced as part of the changes in legislation post-Shipman.
- The introduction of running balances in controlled drug registers is a legal requirement.
- Private prescriptions for controlled drugs are no longer required to be written on a standardized form
- The BNF recommends a slow IV injection of 5mg of diamorphine followed by further doses if necessary for myocardial infarction
- Gabapentin and pregabalin were classified as controlled drugs in 2020.
- The Misuse of Drugs Act 1971 has remained unchanged since its enactment.
- Community pharmacies must appoint a CDAO.
- The FSA website can be used to check if a CBD product has been authorized for sale.
- Sativex is classified as a Schedule 4 part 1 controlled drug.
- Doctors on the Specialist Register of the General Medical Council are required to prescribe unlicensed cannabis medicines.
- Unlicensed medicinal products must have clear published evidence of benefit before they can be prescribed.
- NICE guidance recommends the use of cannabis-based products to treat chronic pain.
- Pharmacists are required to maintain records of Sativex despite it being a Schedule 4 CD.
- All Schedule 3 controlled drugs have a valid prescription period of 28 days.
- Methadone is listed as a Schedule 2 controlled drug.
- Prescription requirements for Schedule 5 CDs stipulate that invoices must be retained for 12 months.
- Buprenorphine is an example of a Schedule 4 controlled drug.
- Diamorphine is considered a controlled substance under current drug regulations.
- Researching the medical use of controlled substances is permitted without any licensing requirements.
- Drugs classified as Schedule 1 have significant medical value and are subject to strict control.
- The maximum quantity of controlled drugs on a prescription is not a legal requirement under current legislation.
- Controlled Drug Accountable Officers (CDAOs) were introduced to enhance oversight in organizations handling controlled drugs.
- Mrs.Brant was subject to disciplinary actions due to her failure in recognizing the unusual prescribing pattern.
- Possessing a Schedule 1 controlled drug can result in a penalty of up to 2 years in prison.
- A pharmacist may take possession of a Schedule 1 controlled drug for research purposes without special exemptions.
- Penalties for dealing Schedule 1 drugs include a maximum prison sentence of 14 years.
- LSD is classified as a Class A controlled drug.
- The production, possession, and supply of Schedule 1 drugs are limited only to medical purposes.
- Tramadol is classified as a Class C drug.
- The penalties for dealing Class C drugs can include a maximum of 14 years in prison.
- The Advisory Council on Misuse of Drugs consists of representatives from multiple fields such as medicine and dentistry.
- Keithamine is classified as a Class B drug.
- The Misuse of Drugs Act 1971 initially included controls on both opiates and cocaine.
- Diamorphine is classified as a Schedule 2 controlled substance under current drug regulations.
- The addition of tramadol to drug regulations occurred before 2019.
- Benzodiazepines were part of the regulations established prior to the Misuse of Drugs Act 1971.
- Dr.Shipman was highly regarded by his patients and healthcare professionals.
- All Schedule 4 controlled drugs require safe custody.
- Morphine is an example of a drug listed under Schedule 2 controlled drugs.
- Possession of Schedule 5 controlled drugs has no restrictions on import, export, or administration.
- A cannabis-based product used for medicinal purposes is classified as a Schedule 2 controlled drug.
- Buprenorphine is an example of a controlled drug that is classified under Schedule 4.
- Nandrolone is classified as a Schedule 4 Part II controlled drug.
- Prescription validity for Schedule 5 controlled drugs is valid for 6 months.
- All controlled drugs within Schedule 3 are considered to be more likely to be misused than those in Schedule 2.
- The law requires all Schedule 4 Part II controlled drugs to be kept under safe custody.
- Phenobarbital is classified as a Class B drug.
- Alprozolam is an example of a Schedule 4 Part 2 controlled drug.
- Controlled drugs in the UK are classified into five schedules and three classes.
- The validity period for a controlled drug prescription was decreased following the Shipman murders.
- The Shipman case had no impact on drug control legislation in the UK.
- The duration of validity for a controlled drug prescription was increased to 28 days following the Shipman case.
- Recording running balances in controlled drug registers is mandated by law after the Shipman case.
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