Misuse of Drugs Act 1971 Quiz
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Questions and Answers

What does CD stand for?

Controlled Drug

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?

  • Tramadol
  • Cannabis
  • Codeine
  • Cocaine (correct)

What is the primary reason for classifying some drugs as controlled?

<p>To prevent misuse and protect public health.</p> Signup and view all the answers

Which of the following substances is included in Schedule 2?

<p>Heroin (D)</p> Signup and view all the answers

The Misuse of Drugs Act 1971 was enacted to control _____ drugs.

<p>dangerous</p> Signup and view all the answers

What significant event influenced changes in CD legislation?

<p>The Shipman murders</p> Signup and view all the answers

What role does the Advisory Council on Misuse of Drugs have?

<p>Advise on controlled drugs (A)</p> Signup and view all the answers

Schedule 1 controlled drugs include _____ and MDMA.

<p>cannabis</p> Signup and view all the answers

What are the penalties for possession of Class B drugs?

<p>Up to 5 years in prison or an unlimited fine.</p> Signup and view all the answers

Which of the following drugs are classified as Schedule 2 CDs? (Select all that apply)

<p>Methadone (B), Alfentanil (C), Dronabinol (D)</p> Signup and view all the answers

All Schedule 3 CDs should be written up in the CD register.

<p>False (B)</p> Signup and view all the answers

Dronabinol is classified as Schedule 2 CD.

<p>True (A)</p> Signup and view all the answers

Which statement is true regarding Schedule 4 CDs?

<p>Schedule 4 part I includes most benzodiazepines. (B), Schedule 4 prescriptions are valid for 28 days. (C)</p> Signup and view all the answers

What is the classification of Sativex?

<p>Schedule 4 part 1</p> Signup and view all the answers

All Schedule 5 CDs have restrictions on possession.

<p>False (B)</p> Signup and view all the answers

Dihydrocodeine for parenteral use is classified as a CD ___ ______.

<p>POM</p> Signup and view all the answers

Which of these cannabinoids is not controlled under the Misuse of Drugs Act?

<p>Cannabidiol (CBD) (B)</p> Signup and view all the answers

What is the maximum prescription validity for Schedule 3 CDs?

<p>28 days (D)</p> Signup and view all the answers

What type of medical conditions is Nabilone used for?

<p>Nausea and vomiting caused by chemotherapy</p> Signup and view all the answers

Raw cannabis is classified as a Schedule 2 CD.

<p>False (B)</p> Signup and view all the answers

Controlled drugs in the UK are classified into ___ schedules and classes.

<p>False (B)</p> Signup and view all the answers

The legal requirements for controlled drugs become more stringent as the level of control increases.

<p>True (A)</p> Signup and view all the answers

Cannabis is completely unrestricted under UK drug legislation.

<p>False (B)</p> Signup and view all the answers

Dronabinol is considered a Schedule 3 controlled drug in the UK.

<p>False (B)</p> Signup and view all the answers

The Shipman murders had no impact on drug control legislation in the UK.

<p>False (B)</p> Signup and view all the answers

Following the Shipman case, the duration of validity for a controlled drug prescription was increased to 28 days.

<p>False (B)</p> Signup and view all the answers

Controlled Drug Accountable Officers (CDAOs) were introduced as part of the changes in legislation post-Shipman.

<p>True (A)</p> Signup and view all the answers

The introduction of running balances in controlled drug registers is a legal requirement.

<p>False (B)</p> Signup and view all the answers

Mrs. Brant was found guilty of failing to observe an unusual pattern of prescribing.

<p>False (B)</p> Signup and view all the answers

Private prescriptions for controlled drugs are no longer required to be written on a standardized form.

<p>False (B)</p> Signup and view all the answers

Dr Harold F Shipman was known for using morphine to treat his patients.

<p>False (B)</p> Signup and view all the answers

The Misuse of Drugs Act 1971 initially included controls on both opiates and cocaine.

<p>True (A)</p> Signup and view all the answers

Diamorphine is classified as a non-controlled substance under current drug regulations.

<p>False (B)</p> Signup and view all the answers

The addition of tramadol to drug regulations occurred before 2019.

<p>False (B)</p> Signup and view all the answers

Benzodiazepines were part of the regulations established prior to the Misuse of Drugs Act 1971.

<p>False (B)</p> Signup and view all the answers

Dr Shipman was highly regarded by his patients and healthcare professionals.

<p>True (A)</p> Signup and view all the answers

Gabapentin and pregabalin were classified as controlled drugs in 2020.

<p>False (B)</p> Signup and view all the answers

The Misuse of Drugs Act 1971 has remained unchanged since its enactment.

<p>False (B)</p> Signup and view all the answers

Possessing a Schedule 1 controlled drug can result in a penalty of up to 5 years in prison.

<p>False (B)</p> Signup and view all the answers

A pharmacist can take possession of a Schedule 1 controlled drug without any special exemptions.

<p>False (B)</p> Signup and view all the answers

Drugs classified as Schedule 1 have significant medical value and are strictly controlled.

<p>False (B)</p> Signup and view all the answers

Dealing with Schedule 1 controlled drugs can lead to a penalty of up to 14 years in prison.

<p>True (A)</p> Signup and view all the answers

Researching the medical use of controlled substances does not require a license from the Home Secretary.

<p>False (B)</p> Signup and view all the answers

A CDAO is responsible for prescribing controlled drugs as part of their regular duties.

<p>False (B)</p> Signup and view all the answers

Class A drugs include substances like cocaine and LSD.

<p>True (A)</p> Signup and view all the answers

Penalties for possession of Class C drugs can include up to 5 years in prison.

<p>False (B)</p> Signup and view all the answers

The Advisory Council on Misuse of Drugs consists of representatives from multiple fields such as medicine and dentistry.

<p>True (A)</p> Signup and view all the answers

Keithamine is classified as a Class B drug.

<p>False (B)</p> Signup and view all the answers

Class B drugs include oral amfetamines and barbiturates.

<p>True (A)</p> Signup and view all the answers

Community pharmacies must appoint a CDAO.

<p>False (B)</p> Signup and view all the answers

Penalties for dealing Class A drugs can include life imprisonment.

<p>True (A)</p> Signup and view all the answers

Tramadol is classified as a Class C drug.

<p>True (A)</p> Signup and view all the answers

The penalties for dealing Class B drugs include a maximum of 10 years in prison.

<p>False (B)</p> Signup and view all the answers

Cannabidiol (CBD) is classified as a Schedule 1 controlled drug under the Misuse of Drugs Act.

<p>False (B)</p> Signup and view all the answers

Dihydrocodeine injections are classified as a CD Inv POM.

<p>False (B)</p> Signup and view all the answers

The maximum strength for non-parenteral dihydrocodeine tablets to be classified as CD Inv POM is 150mg.

<p>False (B)</p> Signup and view all the answers

Schedule 4 Part II controlled drugs have no restrictions on possession when contained in a medicinal product.

<p>True (A)</p> Signup and view all the answers

All Schedule 3 controlled drugs have a valid prescription period of 60 days.

<p>False (B)</p> Signup and view all the answers

Methadone is listed as a Schedule 2 controlled drug.

<p>True (A)</p> Signup and view all the answers

Cannabis-based products for medicinal use are classified as Schedule 3 controlled drugs.

<p>False (B)</p> Signup and view all the answers

Prescription requirements for Schedule 5 CDs stipulate that invoices must be retained for 12 months.

<p>False (B)</p> Signup and view all the answers

Buprenorphine is an example of a Schedule 4 controlled drug.

<p>False (B)</p> Signup and view all the answers

Dronabinol is an example of a Schedule 2 controlled drug.

<p>True (A)</p> Signup and view all the answers

For Schedule 4 controlled drugs, there are no safe custody requirements.

<p>True (A)</p> Signup and view all the answers

Schedule 1 controlled drugs include synthetic cannabinoids.

<p>False (B)</p> Signup and view all the answers

Phenobarbital is classified as a Class B drug.

<p>True (A)</p> Signup and view all the answers

Alprozolam is an example of a Schedule 4 Part 2 controlled drug.

<p>False (B)</p> Signup and view all the answers

Controlled drugs in the UK are classified into three schedules and classes.

<p>False (B)</p> Signup and view all the answers

The validity period for a controlled drug prescription was decreased following the Shipman murders.

<p>False (B)</p> Signup and view all the answers

Diamorphine is considered a controlled substance under current drug regulations.

<p>True (A)</p> Signup and view all the answers

Researching the medical use of controlled substances is permitted without any licensing requirements.

<p>False (B)</p> Signup and view all the answers

Drugs classified as Schedule 1 have significant medical value and are subject to strict control.

<p>False (B)</p> Signup and view all the answers

The maximum quantity of controlled drugs on a prescription is a legal requirement under current legislation.

<p>False (B)</p> Signup and view all the answers

Following the Shipman case, the duration of validity for a controlled drug prescription was reduced to 28 days.

<p>True (A)</p> Signup and view all the answers

Recording running balances in controlled drug registers is mandated by law after the Shipman case.

<p>False (B)</p> Signup and view all the answers

Controlled Drug Accountable Officers (CDAOs) were introduced as a measure to enhance oversight in organizations handling controlled drugs.

<p>True (A)</p> Signup and view all the answers

Mrs. Brant was subject to disciplinary actions due to her failure in recognizing the unusual prescribing pattern.

<p>False (B)</p> Signup and view all the answers

Possessing a Schedule 1 controlled drug can result in a penalty of up to 2 years in prison.

<p>False (B)</p> Signup and view all the answers

A pharmacist may take possession of a Schedule 1 controlled drug for research purposes without special exemptions.

<p>False (B)</p> Signup and view all the answers

Penalties for dealing Schedule 1 drugs include a maximum prison sentence of 14 years.

<p>True (A)</p> Signup and view all the answers

LSD is classified as a Class B controlled drug.

<p>False (B)</p> Signup and view all the answers

The production, possession, and supply of Schedule 1 drugs are limited only to medical purposes.

<p>False (B)</p> Signup and view all the answers

Mrs. Brant thought that Dr. Shipman was using 30mg of diamorphine for treating patients with suspected ____ pain.

<p>True (A)</p> Signup and view all the answers

Dr. Shipman was sentenced to 10 life sentences for his crimes.

<p>False (B)</p> Signup and view all the answers

Every line recorded in the CD register for Dr. Shipman's 30mg ampoules was associated with the same patient.

<p>False (B)</p> Signup and view all the answers

Mrs. Brant thought Shipman's prescription requests were unusual and raised concerns about them.

<p>False (B)</p> Signup and view all the answers

The BNF recommends a slow IV injection of 5mg of diamorphine followed by further doses if necessary for myocardial infarction.

<p>True (A)</p> Signup and view all the answers

Mrs. Brant was interviewed by the police only after Shipman's trial concluded.

<p>False (B)</p> Signup and view all the answers

The requests made by Dr. Shipman for diamorphine were consistent with standard medical practices for treating heart attacks.

<p>False (B)</p> Signup and view all the answers

The police investigation into Dr. Shipman led to concerns about the management of controlled substances.

<p>True (A)</p> Signup and view all the answers

The FSA website can be used to check if a CBD product has been authorised for sale.

<p>True (A)</p> Signup and view all the answers

Sativex is classified as a Schedule 4 part 1 controlled drug and requires specific prescription requirements.

<p>False (B)</p> Signup and view all the answers

Doctors on the Specialist Register of the General Medical Council are required to prescribe unlicensed cannabis medicines.

<p>True (A)</p> Signup and view all the answers

THC is permitted in CBD products if it is below 0.3% concentration.

<p>False (B)</p> Signup and view all the answers

Unlicensed medicinal products must have clear published evidence of benefit before they can be prescribed.

<p>True (A)</p> Signup and view all the answers

NICE guidance recommends the use of cannabis-based products to treat chronic pain.

<p>False (B)</p> Signup and view all the answers

All cannabis-based products are classified as licensed medicines under UK regulations.

<p>False (B)</p> Signup and view all the answers

Pharmacists are required to maintain records of Sativex despite it being a Schedule 4 CD.

<p>True (A)</p> Signup and view all the answers

Dihydrocodeine is classified as a Schedule 5 controlled drug due to its high strength.

<p>False (B)</p> Signup and view all the answers

Cannabidiol (CBD) is a psychoactive compound that is controlled under the Misuse of Drugs Act.

<p>False (B)</p> Signup and view all the answers

All controlled drugs within Schedule 3 are considered to be more likely to be misused than those in Schedule 2.

<p>False (B)</p> Signup and view all the answers

Flunitrazepam and diazepam are both classified as Schedule 4 controlled drugs.

<p>False (B)</p> Signup and view all the answers

The prescription validity for Schedule 4 CD drugs is 28 days.

<p>True (A)</p> Signup and view all the answers

Alfentanil is an example of a Schedule 3 controlled drug.

<p>False (B)</p> Signup and view all the answers

The MHRA states that CBD products marketed for medical purposes should be regulated as medicines.

<p>True (A)</p> Signup and view all the answers

The law requires all Schedule 4 Part II controlled drugs to be kept under safe custody.

<p>False (B)</p> Signup and view all the answers

Morphine is an example of a drug listed under Schedule 1 controlled drugs.

<p>False (B)</p> Signup and view all the answers

Possession of Schedule 5 controlled drugs has no restrictions on import, export, or administration.

<p>True (A)</p> Signup and view all the answers

A cannabis-based product used for medicinal purposes is classified as a Schedule 1 controlled drug.

<p>False (B)</p> Signup and view all the answers

Buprenorphine is an example of a controlled drug that is classified under Schedule 4.

<p>False (B)</p> Signup and view all the answers

Nandrolone is classified as a Schedule 4 Part II controlled drug.

<p>True (A)</p> Signup and view all the answers

Prescription validity for Schedule 5 controlled drugs is valid for 6 months.

<p>True (A)</p> Signup and view all the answers

What are controlled drugs (CDs)?

<p>Drugs that are subject to restrictions due to their potential for misuse and harm.</p> Signup and view all the answers

What led to changes in CD legislation following the Shipman murders?

<p>Introduction of Controlled Drug Accountable Officers (B)</p> Signup and view all the answers

Give two examples of drugs classified as Class A.

<p>Cocaine and diamorphine.</p> Signup and view all the answers

What are the legal requirements for Schedule 2 controlled drugs?

<p>Must be prescribed by an authorized prescriber, kept in safe custody, and all transactions must be recorded.</p> Signup and view all the answers

Other regulations exist on the safe custody of controlled drugs.

<p>True (A)</p> Signup and view all the answers

The ______ introduced maximum quantities for controlled drugs on prescriptions.

<p>CD legislation post-Shipman</p> Signup and view all the answers

What does CDAO stand for?

<p>Controlled Drug Accountable Officer.</p> Signup and view all the answers

Which drug is considered a Class B controlled substance?

<p>Cannabis (C)</p> Signup and view all the answers

What role does the Advisory Council on Misuse of Drugs play?

<p>It advises the government on matters relating to controlled drugs and their misuse.</p> Signup and view all the answers

Describe one consequence of Dr. Harold Shipman's actions.

<p>Increased scrutiny and reform of controlled drug legislation in the UK.</p> Signup and view all the answers

What schedule does cannabis (non-medicinal use) fall under?

<p>Schedule 1 (C)</p> Signup and view all the answers

Which of these are examples of Schedule 2 controlled drugs (CDs)? (Select all that apply)

<p>Alfentanil (C), Fentanyl (D)</p> Signup and view all the answers

All Schedule 2 controlled drugs must be kept in the CD cupboard.

<p>True (A)</p> Signup and view all the answers

Schedule 3 controlled drugs must be recorded in the CD register.

<p>False (B)</p> Signup and view all the answers

Schedule 4 Part I includes most benzodiazepines, such as nitrazepam.

<p>True (A)</p> Signup and view all the answers

Class A controlled drugs are also classified as Schedule 2 CDs.

<p>True (A)</p> Signup and view all the answers

Codeine phosphate tablets 30mg are classified as CD Inv POM.

<p>True (A)</p> Signup and view all the answers

Co-codamol tablets 30/500 are classified as CD Inv POM.

<p>False (B)</p> Signup and view all the answers

Co-codamol tablets 8/500 can be classified as CD Inv P.

<p>True (A)</p> Signup and view all the answers

Temazepam elixir 10mg/5ml which has been returned by a patient should be stored in the CD cabinet.

<p>True (A)</p> Signup and view all the answers

MST tablets which have been dispensed but are waiting for collection by the patient should be stored in the CD cabinet.

<p>True (A)</p> Signup and view all the answers

What does Schedule 5 contain?

<p>Preparations of some controlled drugs exempt from full control due to presence in medicinal products at a low strength.</p> Signup and view all the answers

What is one drug classified as a Schedule 3 controlled drug?

<p>Buprenorphine.</p> Signup and view all the answers

What is the classification of Sativex?

<p>Schedule 4 Part 1.</p> Signup and view all the answers

Which cannabinoid gives cannabis its psychoactive effect?

<p>Tetrahydrocannabinol (THC).</p> Signup and view all the answers

Flashcards

Controlled Drugs (CDs)

Drugs subject to strict controls due to potential harm, abuse, or misuse.

Misuse of Drugs Act 1971

Legislation controlling dangerous or harmful drugs in the UK.

Shipman Murders

A series of murders committed by Dr. Shipman with misuse of diamorphine.

Controlled Drugs Schedules

Classifications of CDs based on the level of control, based on medicinal use.

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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

Most harmful drugs with severe penalties for possession or dealing.

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Class B CDs

Controlled drugs with penalties less severe than Class A.

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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)

A senior person responsible for managing controlled drugs within an organisation.

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Medicinal use of CDs

Legitimate use of controlled drugs as medicines, by permitted practitioners.

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CD Prescription Validity

Prescriptions for controlled drugs are valid for 28 days.

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CD safe custody

Strict regulations on storing and securing controlled drugs.

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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

A record of all transactions involving controlled drugs.

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CD Invoices

Records of CD purchases.

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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

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

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

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

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

Products derived from cannabis, intended for medicinal use, and classified as Schedule 2 CDs.

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Cannabidiol (CBD)

A non-psychoactive cannabinoid, not controlled under the Misuse of Drugs Act, available as oils and tinctures.

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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

Synthetic cannabinoid, used for chemotherapy-induced nausea and vomiting, classified as Schedule 2.

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Dronabinol

Synthetic cannabinoid, THC version, also for chemotherapy-induced nausea and vomiting.

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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

A record keeping system for controlled drugs.

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Safe Custody

Storing controlled drugs according to regulations to prevent theft and misuse.

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Inv POM

Controlled drug products exempt from full control due to a low strength in medicinal products.

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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)

Drugs with special controls due to potential harm or abuse.

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CD Legislation Changes

Changes in laws governing controlled drugs, often after serious events.

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CD Schedules

Classifying controlled drugs based on their level of control (safety).

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Why Control Drugs?

Controlled drugs are controlled to mitigate harm and misuse.

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Legal Requirements (CDs)

Legal rules changing with decreasing control level, affecting storage, records, etc.

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CDAO Responsibilities

Senior person managing controlled drugs within an organization, ensuring compliance with regulations.

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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

Controlled drug prescriptions are now valid for 28 days.

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Private CD Prescription Forms

Private prescriptions for controlled drugs must use a specific standardized form.

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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

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

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

Substances subject to strict controls due to their potential harm, abuse or misuse.

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Shipman Murders

A series of murders committed by Harold Shipman, who used diamorphine prescriptions illicitly to kill his patients.

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Diamorphine

A potent opiate used by Dr. Shipman to commit murders, as it was controlled, yet frequently misused.

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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

A controlled drug added to the Misuse of Drugs Act 1971, reflecting changing patterns of misuse.

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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

A designated person responsible for safe and effective controlled drug (CD) management in an organization.

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Class A CDs

Most harmful drugs; severe penalties for possession or dealing.

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Class B CDs

Harmful drugs with penalties less severe than Class A.

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Class C CDs

Drugs with less severe penalties.

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CD Schedules

Classifies controlled drugs by their level of control regarding permissible medicinal use.

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Advisory Council on Misuse of Drugs

Advises the government on matters related to drug misuse.

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Controlled Drugs

Drugs with strict controls due to potential harm, abuse, or misuse.

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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?

Controlled drugs are controlled to minimize harm and misuse.

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CD Local Intelligence Network

A network dedicated to sharing information about controlled drugs.

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Schedule 1 Drugs

Drugs with the strictest controls; limited medical use, high misuse potential.

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Schedule 1 Pharmacist Restrictions

Pharmacists can only possess Schedule 1 drugs for destruction or transfer to police.

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Schedule 1 Penalties

Severe consequences for possession or dealing, up to 14 years in prison.

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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)

Up to 14 years in prison, unlimited fine, or both for dealing with nitrous oxide.

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Schedule 2 CDs

Highly addictive drugs with high misuse potential, requiring strict controls.

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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)

Primarily benzodiazepines and 'z' hypnotics, with some import/export and possession restrictions

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Schedule 4 CDs (Part 2)

Anabolic and androgenic steroids; import/export/possession with fewer restrictions

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Schedule 5 CDs

Low strength drugs in medicinal products; minimal controls, including no safe custody.

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Cannabis medicinal products

Cannabis-derived products for medicinal use, classified as Schedule 2.

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Cannabidiol (CBD)

Non-psychoactive cannabinoid used in oils and tinctures, not controlled.

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Prescription validity (Schedule 2-5)

Prescription durations vary for different Schedules: 28 days common.

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Controlled Drugs Register

Record-keeping system for controlled drug transactions.

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Safe Custody

Strict regulations to prevent theft and misuse of controlled drugs.

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Inv POM

Controlled drug products (low strength) in medicines, exempt from full control.

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CD Invoices

Records of controlled drug purchases kept for a set period.

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Sch 2 Examples

Alfentanil, Morphine are some Schedule 2 drugs.

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Sch 3 Examples

Buprenorphine, Phenobarbital and Temazepam are examples

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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

Modifications to the laws governing controlled drugs, often due to events highlighting problematic misuse or safety concerns.

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Controlled Drugs Schedules

Classifications of drugs based on their potential for misuse and the level of control needed.

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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)

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

Dr. Shipman murdered patients by overprescribing diamorphine, potentially exceeding clinical need.

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Pharmacist's role

Mrs. Brant dispensed most of Shipman's diamorphine prescriptions.

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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 believed Shipman's actions were justifiable and thought to be for patients with chest pain/heart trouble.

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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

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

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?

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 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 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 CDs have little to no medical value but can cause significant social issues when misused.

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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 can lead to penalties of up to 14 years imprisonment.

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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)

A senior person responsible for managing controlled drugs within an organization, ensuring compliance with regulations.

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Prescription Validity (CDs)

Prescriptions for controlled drugs (CDs) are now valid for 28 days.

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Private CD Prescription Forms

Private prescriptions for controlled drugs must use a standardized form (FP10PCD).

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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 must not contain THC (a controlled substance) and require pre-market authorization (risk assessment) by the FSA.

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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, a cannabis-based mouth spray, is a Schedule 4 part 1 controlled drug used to treat spasticity.

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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

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

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 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

NICE guidelines do not currently recommend cannabis-based medicine use for chronic pain treatment.

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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

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)

Primarily benzodiazepines and 'z' hypnotics, with some import/export and possession restrictions.

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Schedule 4 CDs (Part 2)

Anabolic and androgenic steroids; import/export/possession with fewer restrictions.

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Schedule 5 CDs

Low strength drugs in medicinal products; minimal controls, including no safe custody.

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Cannabis-based medicinal products

Cannabis-derived products for medicinal use, classified as Schedule 2 CDs.

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Cannabidiol (CBD)

Non-psychoactive cannabinoid used in oils and tinctures, not controlled.

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CD Prescription Validity

Prescriptions for controlled drugs are valid for 28 days.

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CD Safe Custody

Strict regulations on storing and securing controlled drugs to prevent theft or misuse.

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Inv POM

Controlled drug products (low strength) in medicines, exempt from full control.

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CD Invoices

Records of controlled drug purchases kept for a set period.

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Schedule 2 Examples

Alfentanil, Morphine are Schedule 2 drugs.

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Schedule 3 Examples

Buprenorphine, Phenobarbital and Temazepam are examples.

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Controlled Drugs (CDs)

Drugs with strict controls due to potential harm, abuse, or misuse.

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Misuse of Drugs Act 1971

UK law controlling dangerous drugs, used to prevent misuse.

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Shipman Murders

Murders committed by Dr. Shipman using controlled drugs inappropriately.

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CD Schedules

Classifications of controlled drugs based on level of control in medicinal use.

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Schedules 1-5

Categorization of CDs with Schedule 1 having the strictest control and decreasing to 5.

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Class A CDs

Most harmful drugs; severe penalties for possession or dealing.

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Controlled Drugs Accountable Officer (CDAO)

Senior person responsible for managing controlled drugs in an organization.

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Prescription Validity (CDs)

Prescriptions for controlled drugs are valid for 28 days

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CD Register

Record of all controlled drug transactions, including in/out movement.

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Safe Custody (CDs)

Regulation of handling and storing controlled drugs to prevent theft or misuse.

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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

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

Primarily benzodiazepines and 'z' hypnotics, with some import/export and possession restrictions.

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Schedule 4 Part 2 CDs

Anabolic and androgenic steroids; import/export/possession with fewer restrictions.

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Schedule 5 CDs

Low strength drugs in medicinal products; minimal controls, including no safe custody.

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Cannabis-based medicinal products

Cannabis-derived products for medicinal use, classified as Schedule 2.

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Cannabidiol (CBD)

Non-psychoactive cannabinoid; not controlled, available as oils and tinctures.

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Sativex

Cannabis-based oromucosal spray for spasticity treatment, Schedule 4 Part 1; fridge storage, no lock required.

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Nabilone

Synthetic cannabinoid for chemotherapy-induced nausea and vomiting, Schedule 2.

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Dronabinol

Synthetic cannabinoid, THC version, also for chemotherapy-induced nausea and vomiting, Schedule 2.

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Study Notes

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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Test your knowledge on the Misuse of Drugs Act 1971 and its classifications. This quiz includes questions about controlled drugs, schedules, and the roles of the Advisory Council. See how well you understand drug classification and regulations.

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