UK legislation introducing a number of changes to the professional use of controlled drugs by pharmacists and nurses from April 23 will improve patient care, according to nursing leaders.
Key changes included in the legislation – The Misuse of Drugs (Amendment 2) (England, Wales and Scotland) Regulations 2012 – are that, from April 23, independent pharmacist prescribers and independent nurse prescribers will be enabled to prescribe, administer and give directions for the administration of Schedule 2, 3, 4 and 5 controlled drugs. Neither independent pharmacist or nurse prescribers will be able to prescribe diamorphine, dipanone or cocaine for treating addition but they will be able to prescribe them for the treatment organic disease or injury.
All registered pharmacists and nurses will be able to supply diamorphine (heroin) or morphine under a patient group direction (PGD) for the immediate, necessary treatment of sick or injured persons.
The changes will also mean that any person acting in accordance with the written directions of a pharmacist independent prescriber, nurse independent prescribers, doctor, dentist or supplementary prescriber (working in accordance with a clinical management plan), will be able to compound Schedule 2, 3, 4 or 5 controlled drugs.
The Royal Pharmaceutical Society (RPS) has welcomed the changes, which it says have been “eagerly awaited” by the pharmacy profession for many years, while the Royal College of Nursing (RCN) said the move means that more than 20,000 nurse independent prescribers in the UK will now “receive the recognition they have long deserved.”
“Until now, the formal process of supplementary prescribing of controlled drugs has, in some instances, led to delays in patients receiving medicines which could have led to extended periods of pain,” said Dr Peter Carter, the RCN’s chief executive and general secretary.
“The RCN has worked hard for many years to ensure that specially qualified nurses should, as independent practitioners, be able to prescribe from the same list as doctors, and our members have lobbied hard in favour of this change,” he added.
– Schedule 2 controlled drugs include diamorphine, morphine, remifentanil, pethidine, secobarbital, glutethimide, amphetamine and cocaine. Schedule 3 lists a small number of minor stimulants and other drugs which are less likely to be misused than those covered by Schedule 2, including the barbiturates (apart from secobarbital, which is Schedule 2). buprenorphine, diethylpropion, mazindol, meprobamate, midazolam, pentazocine, phentermine and temazepam.
Part 1 of Schedule 4 includes most benzodiazepines (except temazepam and midazolam), zolpidem and other substances including femcamfamin and mesocarb, while Part 2 consists of androgenic and anabolic steroids, clenbuterol, human chorionic gonadotropin (hCG), non-human chorionic gonadotropin, somatotropin, somatrem and somatropin.
Schedule 5 lists preparations of certain controlled drugs such as codeine, pholcodine and morphine, which are exempt from full control when present in medicinal products of low strength, as their risk of misuse is reduced.
