An occasional feature, prepared in the Royal Pharmaceutical Society's Professional Standards Directorate, to highlight problems and inquiries currently being handled
Under the Misuse of Drugs Regulations 1985, as amended, there are specific
regulations dictating who may supply and possess a drug specified in Schedule
2. Any person may have in his possession a Schedule 2 drug that has been supplied
by or on the prescription of a practitioner for the treatment of that person.
Therefore, whereas a pharmacist may supply methadone to the patient for whom
it is prescribed, any person whom the patient then supplies may be in unlawful
possession.
A pharmacist may suspect that a patient intends to supply methadone to someone
else who would not lawfully be able to have it in his or her possession. If
so, the pharmacist must use his or her professional judgment to evaluate the
appropriateness of making a supply and consider the consequences of making or
not making a supply. The pharmacist must be able to justify his or her decision.
Confidential information acquired in the course of a pharmacist’s professional
duties may be disclosed without the patient’s consent only in very limited
circumstances. One such circumstance is where disclosure is necessary to prevent
serious injury or damage to the health of the patient or a third party or serious
risk to public health. This could include the passing on of a supply of methadone
to a person other than the patient.
If it is apparent to the pharmacist that unlawful dealing is taking place, then
the matter should be raised with the prescribing doctor. If the situation appears
to continue, it may be necessary to raise the matter with the local drug squad
officer, who may provide useful support.
Particular vigilance must be exercised when a third party collects a Schedule
2 medicine for a patient being treated for addiction. Only in exceptional circumstances
may the pharmacist supply a prescribed Controlled Drug to a third party. A letter
of authority from the patient should be obtained on every occasion a representative
collects the prescription on the patient’s behalf and such letters should
be kept in the CD register. If the patient continually sends in a representative
to collect the prescription, it may be necessary for the pharmacist to notify
the clinic or prescriber.
Legislation made under the Medicines Act 1968 allows a pharmacist to make an
emergency supply of a prescription-only medicine at the request of a medical
practitioner in certain defined circumstances. The pharmacist has to be satisfied
that the sale or supply has been requested by a doctor who, by reason of some
emergency, is unable to furnish a prescription immediately.
Pharmacists are reminded of the importance of checking the identity of the doctor
before making any supply of a prescription only medicine, particularly when
a doctor from the deputising doctor services make requests and the doctor is
unknown to the pharmacist. The General Medical Council has an out-of-hours,
automated service (tel 020 7915 3630) through which one may check a doctor’s
registration if one has the doctor’s GMC registration number.