The Family Health Services Authority often circulate information to prac-tices and pharmacies if forged prescriptions have been identified.
C o n t r o l l e d D r u g s What process should a pharmacist follow if they suspect a F a c t s h e e t N o . 4 prescription is a forgery?
attempt to contact the prescriber to determine if it is genuine or not—this
may not always help as there have been instances locally where prescrip-
tions have been copied and both the original and the copy are presented at different pharmacies
Controlled Drug Prescribing
The PCT Accountable Officer for Controlled Drugs is required to
If the prescriber is unknown to you the telephone number should be obtained from the tele-
monitor the use and management of controlled drugs including re-
phone directory or directory inquiries, not from the prescription, as forgers may use false ad-
The type of data that is being reviewed includes:
If you are unable to contact the prescriber you may choose to ask the patient to return at a later
Quantity of controlled drugs prescribed on individual prescrip-
time giving you more time to verify the authenticity of the prescription.
tions – with emphasis on large quantities on individual pre-
If the patient insists on leaving with the prescription it is good practice to make brief notes of the
Volume of controlled drugs prescribed compared to PCT average
details it contains, a brief description of the patient and preferably a photocopy of the prescription
Choice of drug – with particular emphasis on a list of drugs that are not recommended for
routine prescribing in primary care (drugs currently under review include oral pethidine,
pentazocine, Diconal, dexamfetamine and barbiturates)
At NO time should the safety of the pharmacist or staff be compromised Forging of prescriptions is a criminal offence
Although most patients take prescription medications responsibly, there are concerns about the
The following organisations should be notified immediately after you have confirmed with the GP
abuse of some prescription drugs in particular
Practice that the prescription is a forgery.
Local police – who will come to investigate and take a statement
Stimulants—such as those used to treat narcolepsy and attention deficit hyperactivity dis-
Family Health Services Agency – who will circulate the information in case of similar
Patients who need medication for their clinical condition should not be deprived of appropriate
Prescription Pricing Division (PPD) – as you will be eligible for a reward
treatment because of the potential for these medications to be misused. However, long term
use can lead to physical dependence and addiction.
Routine monitoring of local e-PACT prescribing data has highlighted there are large quantities
of these types of medicines prescribed. We would encourage prescribers to regularly review
their patients that are prescribed controlled drugs to ensure that these medicines are prescribed
PCTs have a statutory duty to appoint an Accountable Officer (AO) – responsible for a range of
appropriately. There is some evidence that some patients have become dependent on their
measures relating to the monitoring of the safe and effective use and management of controlled
medication and may need review by either pain clinics or in some circumstances substance
drugs in the organisation and within local organisations subject to the PCT’s oversight. The Ac-
countable Officer is directly accountable to the Medical Director and also works as part of the
Governance structure within NHS South of Tyne and Wear.
The police have advised us that some of the
Catherine Baldridge (pharmacist) is the Accountable Officer for NHS South of Tyne and Wear. Morphine/codeine analogues,
commonly prescribed drugs sell on the street for
Her role is to co-ordinate the measures outlined above and to take action where necessary. She
quite high prices and we thought it was worth
2. Barbiturates and benzodiazepines, e.g.
carries out visits to GP practices to monitor procedures around controlled drugs, look at storage
sharing this information with you—see the table
temazepam, nitrazepam, diazepam
facilities and record keeping. As part of her role, Catherine chairs a ‘Local Intelligence Network’
3. Miscellaneous, e.g. clomethiazole, zopi-
to allow healthcare organisations, police services, inspection bodies (RPSGB, HC, CSCI) and
regulatory bodies to work together to share intelligence on controlled drugs issues.
Drug diversion is an issue both locally and
4. Controlled Drugs in general eg dipi-
Catherine is available to support practices in controlled drugs issues and should feel free to
nationally and one prescribers should be aware
of. Police have reported instances where medi-
5. Steroids, e.g. nandrolone (also used in
cation labelled for patients has been found in
These fact sheets should be used as a quick reference guide
other people’s homes following a police raid.
For further advice contact: Catherine Baldridge, Accountable Officer for Controlled Drugs,
Pharmacists have been recently reminded of the potential for misuse of the medicines in
figure 1, by the Royal Pharmaceutical Society
Tel: 01912831345 or e-mail: [email protected]Prescribing of Buprenorphine UK PHARMACEUTICAL AND STEROID STREET PRICES
There are concerns that large quantities of low strength buprenorphine are being prescribed in
South of Tyne and Wear. It has abuse potential and may itself cause dependence. It is widely
prescribed as substitute medication in substance misuse patients but this is most commonly
prescribed as 2 and 8mg tablets. The graph below shows the prescribing of buprenorphine
200microg tablets in 1 local PCT in 2007-2008. Prescribing rates are similar in all 3 PCTs in
South of Tyne and Wear. The 200microg tablets are not licensed for substance misuse pa-tients. As shown in the table on page 2, buprenorphine has a street value and we would urge
prescribers to review all patients prescribed buprenorphine and establish if their treatment is
Prescribing of buprenorphine 200microgram tablets 2007-08 Practice CD requisition form—FP10 CDF
Just a reminder to all GPs and pharmacists—the new CD requisition form for signed orders is
available from the Ambulance Service and not from the PCT. This form is to be used for
requisitions for controlled drugs for practices, doctors bags and for transferring controlled drugs between pharmacies.
Anyone having concerns around any issues relating to controlled drugs should
contact the Accountable Officer in complete confidence. Appropriate investigations
All staff working with controlled drugs should be aware of this. Catherine Baldridge, Accountable Officer can be contacted on 0191 2831345 or by e-mail: catherine.baldrid[email protected] with any queries relating to controlled drugs.
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