NICE guidance to minimise risk in prescribing controlled drugs

NEW guidance on prescribing controlled drugs has been issued by NICE, drawing together up-to-date legislation and existing advice.

The new guidance takes account of changes to the NHS and relevant legislation as well as the different ways hospitals, pharmacies and GPs manage drugs such as morphine, methadone and diazepam, staff restrictions on prescribing and considerations when reviewing repeat prescriptions.

Among the recommendations, health professionals are urged to provide advice and information to patients about how to store and dispose of controlled drugs safely – including advice on lockable or non-lockable storage boxes – to minimise the risk of a drug-related incident.

Health organisations should also keep a record log for the supply, administration, transfer and disposal of controlled drugs and prescribe enough of a controlled drug to meet a patient’s clinical needs for up to but no more than 30 days. Should it be necessary under exceptional circumstances to prescribe a larger quantity, the reasons for this should be documented in the care record.

A seven year review of medicines-related safety incidents concerning controlled drugs in England and Wales (reported to the National Reporting and Learning System) found the risk of death was far greater than with other medications. Five commonly used controlled drugs were responsible for 113 incidents (88.4 per cent) leading to serious harm (death and severe harm) with overdose accounting for 89 (69.5 per cent) of the 128 incidents of serious harm.