NICE guidance on controlled drugs urges 30-day supply limit

GPs should ensure they prescribe supplies of controlled drugs to meet needs for no more than 30 days and use lockable bags when transporting them, according to guidance on safe use from NICE.

The NICE guidance on safe use of controlled drugs brings together legislation and existing advice on the best ways of ensuring drugs such as morphine, methadone and diazepam are used safely and responsibly.

It calls on practices to develop a controlled drug policy and standard operating procedures for storing, transporting, destroying and disposing of controlled drugs.

When prescribing, GPs should take into account the benefits of the controlled treatment and the risks of prescribing the treatment – including possible dependency and overdose.

GP prescribing

The regimen should be clearly documented in the person’s care record. Patients should be monitored and have their dose adjusted to achieve good balance between benefits and harms.

GPs should prescribe enough of a controlled drug to meet a person’s clinical needs for no more than 30 days. If larger quantities are prescribed in exceptional circumstances, this should be recorded in the patient’s care record, the advice says.

When storing controlled drugs, practices must make sure that they are doing so in line with the Misuse of Drugs (Safe Custody) Regulations 1973.

This includes providing appropriate security settings for the drugs in question and taking into account additional storage needs for controlled drugs of different strengths with similar or ‘lookalike’ packaging.

Controlled drugs

Regular stock checks – preferably carried out by two people – should be taken to ensure stocks match registers.

Clinicians should use lockable bags when transporting controlled drugs off the premises.

GP Dr Tessa Lewis, who chaired the guideline development group, said: ‘A great deal of work has been done recently to help ensure the safe use and management of controlled drugs at a local and national level.

‘However, ongoing activity and vigilance is required to sustain the positive developments that have been achieved since the changes to the structure of the NHS took effect in 2012.

‘In considering changes to legislation and to the NHS structure as well as relevant patient safety incidents, this guidance provides further clarity and good practice recommendations across most NHS settings and people’s own homes.

‘Our aim with this guideline is to support organisations and individuals to minimise the potential harms associated with these medicines by having robust systems and processes in place for their use.’

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