Special responsibilities are placed upon pharmaceutical wholesalers, pharmacies and doctors in the stocking, distribution, issuing of prescriptions, supply and disposal of items listed under the first three of the schedules. The regulations have been further tightened since Dr Harold Shipman used diamorphine to murder hundreds of his patients during the late 20th century.
Drugs which are not used medically, and thus their possession and supply is prohibited; e.g. DMT and LSD except when licensed by the Home Office to carry out research.
Schedule 2 - CD
Substances subject to the full controlled drug requirements; e.g. Cannabis, diamorphine, pethidine, cocaine, methadone, methylphenidate, dextroamphetamine, fentanyl and oxycodone. Under the Act, a prescription for these drugs need to show full details including the form and strength of the preparation, with the total quantity written out in both words and figures. It is an offence for a doctor to issue an incomplete prescription or for a pharmacist to dispense a controlled drug unless all the required details are given. It is the prescriber's responsibility to minimize the risk of dependence or misuse by ensuring that such drugs are not started for a particular patient without good cause, that the dose is not increased to the point where dependency is more likely, and to avoid being an unwitting source of supply for addicts. The quantities of controlled drugs prescribed should match the likely needs of the patients until the next clinical review and prescription forms should be secured against theft. Requirements for safe custody in pharmacies apply to all Sch 2 Controlled Drugs except quinalbarbitone. The safe custody requirements ensures that pharmacists and doctors holding stock of controlled drugs must store them in securely fixed double-locked steel safety cabinets and maintain a written register, which must be bound and contain separate entries for each drug and must be written in ink with no use of correction fluid. Disposal of expired stock must be witnessed by a designated inspector. Until 2005 prescriptions for most schedule 2 & 3 drugs required certain details to be handwritten by the prescriber, unless he or she held a handwriting exemption certificate. The Shipman Inquiry however, found that this was one of the weaknesses in the audit system. Whereas computer generated prescriptions automatically left an audit trail which was easy to follow, handwritten prescriptions did not, even though all filed prescriptions are eventually sent to a central UK depositary. Therefore, good practice now calls for these prescriptions to be computer generated.
Include drugs subject to the same prescription requirements as Schedule 2 drugs, but without the requirement to maintain registers. With the exception of phenobarbitone or related drugs for treatment of epilepsy, no Sch 3 drug can be given as an emergency supply. Safe custody is currently only required for Tenuate Dospan, buprenorphine products, temazepam and flunitrazepam. Neither phenobarbitone nor midazolam require safe custody. Other Sch 3 drugs can be stored in the general dispensary.
Schedule 4
Controlled drug prescription requirements and safe custody requirements do not apply. Included drugs are Benzodiazepines, other than temazepam, flunitrazepam or midazolam, and androgenic and anabolic steroids. However CD Benz products- which also include mild stimulants such as mesocarb and femcamfamine, formerly prescribed as anorectics- are illegal to supply or possess without prescription and all Sch 4 drugs cannot be legally supplied without medical authority. As of April 2014 "Sativex", the Cannabis derived medicine prescribed for spasticity due to Multiple Sclerosis, is listed as a Schedule 4 Part 1 drug, whereas before that date it was a Schedule 1 drug requiring reporting and recording protocols.
