Controlled drugs

Controlled drugs are prescription medicines which have stricter legal controls applied to them. This is to prevent them:

• being misused
• being obtained illegally
• causing harm

Common examples include:

• morphine
• fentanyl
• methadone

Legal controls govern how these medicines may be:

• stored
• produced
• supplied
• prescribed

Controlled drugs may be supplied in the following ways for staff:

• In patches that are applied to the skin
• In liquid form
• In tablet form

Controlled drugs in a home care setting

Once in a service user's own home, controlled drugs can be treated in the same way as all other medication. As with any drug, it is important to refer to the storage, administration and disposal instructions which should accompany the drug. Additional storage, recording and witnessing requirements which apply in care homes and hospitals do not apply in a service user's own home.

Collection of controlled drugs

Providers must not routinely order medication, including controlled drugs on behalf of a service user. These tasks will not be included as part of a service users schedule (SUS.) Therefore, the provider will not be paid for carrying out these tasks unless under special circumstances agreed by an Authorised Officer of the Council. Refer to Ordering medications for further guidance.

If it is ever agreed as part of a Kirklees Service User Specification (SUS) for the provider to collect controlled drugs for a service user, whoever collects the prescription will need to know they are legally required to show the pharmacist proof of identity which can be in the form of their identity badge.

Controlled drugs can be more difficult to obtain outside normal chemist opening times. It is important to note that many controlled drugs are used for pain relief and therefore it is particularly essential to ensure the service user always has a supply of these drugs.

Due to the pharmacy storage requirements of controlled drugs, pharmacies do not keep large volumes of controlled drugs in stock, and often need to order them from the wholesaler on receipt of a prescription. It is therefore essential for the person ordering the prescription to ensure it is ordered at least one week before the service user is due to run out.

Ordering

It is NOT recommended that providers order prescriptions on behalf of Service Users. Providers need to refer to Ordering medications and Managing medicines for adults receiving social care in the community | Guidance | NICE

Disposal of controlled drugs

Any UNUSED controlled drugs should be collected by or returned to, the pharmacist in the same way as any other unused medication and NOT disposed of in household waste bins, or down sewage systems via sinks or toilets etc.

Patches

Particular care is required when disposing of USED controlled drug patches (e.g., Fentanyl patches). USED patches must be folded in half, sticky side together, then placed in a bag, or ideally, replaced in the original packet, before being placed in the bin. Disposable gloves must always be worn when handling any controlled drugs, including waste patches.

Refer to Patches for further guidance.

Any unused patches must be disposed of in the same way as any other unused medication.

Controlled drugs prescribed on a PRN basis (as required)

Please refer to the Kirklees Medication Guidance for PRN medication.

Further guidance

Managing medicines for adults receiving social care in the community | Guidance | NICE

Medicines information for adult social care services | Care Quality Commission (cqc.org.uk)