The Pharmaceutical Journal
Vol 277 No 7407 p25
1 July 2006

Society summary

Who may currently prescribe, supply and administer Controlled Drugs?

Currently doctors, dentists and veterinary practitioners may prescribe all CDs in Schedules 2 to 5. Doctors are only able to prescribe diamorphine, dipipanone and cocaine to substance misusers for the treatment of addiction if they hold a licence issued by the Home Office. All doctors may prescribe such drugs for patients, including substance misusers, for relief of pain due to organic disease or injury without a specific licence.

Independent non-medical prescribers Independent nurse prescribers (formerly extended formulary nurse prescribers) may prescribe, supply or administer, or direct other nurses to administer, the following:

· Diamorphine, morphine and oxycodone for use in palliative care

· Diazepam, midazolam and lorazepam for use in palliative care or treatment of tonic-clonic seizures

· Buprenorphine and fentanyl for transdermal use in palliative care

· Diamorphine and morphine for pain relief of suspected myocardial infarction or for relief of acute or severe pain after trauma, including in either case post-operative pain relief

· Chlordiazepoxide hydrochloride and diazepam for the treatment of initial or acute alcohol withdrawal symptoms

· Codeine phosphate, dihydrocodeine tartrate and co-phenotrope (no restrictions)

Independent pharmacist prescribers may not currently prescribe any Controlled Drugs.

Patient group directions The following CDs may be supplied or administered under patient group directions (PGDs):

· Diamorphine, but only for the treatment of cardiac pain by nurses working in coronary care units or hospital accident and emergency departments.

· All drugs listed in Schedule 4 of the Regulations except anabolic steroids and injectable formulations for the purpose of treating a person who is addicted to a drug

· All drugs listed in Schedule 5 of the Regulations

Occupational therapists, orthotists and prosthetists will be able to supply or administer CDs in Schedules 4 and 5 (except anabolic steroids) under PGDs from 7 July 2006.

Supplementary non-medical prescribers Supplementary nurse and pharmacist prescribers may prescribe and administer any CD as long as it is within the clinical management plan specific to that patient and agreed between the independent prescriber, the supplementary prescriber and the patient.

During 2005 chiropodists, podiatrists, physiotherapists, radiographers and optometrist who are supplementary prescribers have also been able to prescribe CDs, in partnership with a doctor and according to a patient’s clinical management plan.

Administration Any person may administer any CD in accordance with the directions of a supplementary prescriber acting under and in accordance with the terms of a clinical management plan.

Any person may administer to another any drug in Schedule 5. Any person, other than a doctor or dentist, may administer to a patient in accordance with the directions of a doctor or dentist, any drug in Schedules 2, 3 or 4.

Midwives Midwives may possess, supply and administer diamorphine, morphine, pethidine and pentazocine, provided it is in the course of their professional midwifery practice.