Methamphetamine: link to cold remedies and reclassification
Methamphetamine (metamfetamine) is a highly addictive, powerful stimulant
that has potentially harmful effects on the central nervous system.
The drug is produced in powder, tablet or crystal form and can be snorted,
smoked, swallowed or injected. Typically users experience a brief rush
followed by a longer period of euphoria which lasts for a number of
days.
Methamphetamine is one of the easier synthetic drugs to make, and can
be produced in a few hours using everyday equipment and commonly available
ingredients, including over-the-counter cold remedies. The manufacturing
of methamphetamine presents a substantial risk of injury and even death
from contamination, toxic gases, fire or explosion.
Use of this drug (whose street names include crystal meth, crystal, ice,
burn, pure, p, crank, yaba and meth) is already extensive in North America,
Australia and South East Asia. From 18 January 2007, methamphetamine
has been reclassified as a Class A drug in the UK. This reflects the
true harms of the drug when misused, and concerns that it is gaining
a foothold in the UK illicit drugs market which could cause serious social
problems.
Methamphetamine can be synthesised relatively easily from over-the-counter
products containing ephedrine or pseudoephedrine. In other countries,
bulk sales of certain cold remedies are closely monitored because of
this risk.
Pharmacists in the UK are therefore asked to be alert to unusual requests
for any items or products containing ephedrine or pseudoephedrine. In
particular, requests for inappropriately large quantities of such products
should be treated with caution.
Pharmacists may only supply methamphetamine to a patient on the authority
of a prescription issued by an appropriate practitioner, although it
is recognised that pharmacists will rarely be presented with such an
authorisation. However, should any pharmacists receive such a prescription
they should be aware that methamphetamine remains a Schedule 2 Controlled
Drug. The product may be manufactured by a licence holder, practitioner,
pharmacist or a person lawfully conducting a retail pharmacy business
who is acting in their capacity as such. Requirements as to safe custody
continue to apply, destruction of methamphetamine stocks must be in the
presence of an authorised witness and marking of containers and the keeping
of records must also be observed.
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Missed doses or collections of methadone
When providing services to drug misusers it is important to remember
that several missed doses of methadone may cause a reduction in tolerance.
In the event that a patient fails to collect several consecutive days’ supplies
of methadone, pharmacists must consider the patient’s best interests and
whether tolerance levels may be affected and if there is a need to inform the
prescriber.
In the event that a patient has not provided prior consent for their prescriber
to be informed of situations where they miss one or more doses, pharmacists should
explain to the patient why there is a need to inform their prescriber and attempt
to seek their consent to do so. Where a patient refuses to provide consent for
disclosure, pharmacists must weigh up their duty of confidentiality to the patient
with the need to act in their best interests, and be prepared to justify their
decision.
Pharmacists should consider the benefits of a written agreement between themselves,
the patient and the prescriber or drug worker for the service to be provided,
which should include the protocol to be followed when a patient does not collect
their daily dose or misses a number of doses of methadone.
The Royal College of General Practitioners has issued guidance regarding supplies
of methadone and the need for reassessment and re-titration if a patient consecutively
misses doses (PDF 500K). |
The
Pharmaceutical Journal