B

AH1 Prescribe controlled drugs for substance users

Overview

This standard is about prescribing controlled drugs – e.g. methadone, other opiates or other controlled drugs – to substance users as part of their treatment plan. It covers both reduction and maintenance prescribing.

Users of this standard will need to ensure that practice reflects up to date information and policies.

Version No 1

Knowledge and Understanding

You will need to know and understand:

  1. how to make a clinical assessment and carry out tests to establish the individual’s dependence
  2. the importance of regular liaison with other services involved, and appropriate ways of maintaining this liaison
  3. national guidelines and local protocols for the prescription of controlled drugs
  4. types, properties, functions, effects, indications and contra-indications of controlled drugs that can be used in the treatment of drug dependency
  5. methods of drug administration
  6. how to calculate the correct dose of the drug and frequency of administration
  7. how to relate the prescription to the individual’s condition and treatment plan
  8. when a licence is required for prescribing a controlled drug and how to obtain one
  9. the correct form to be used when prescribing controlled drugs and the information required
  10. the importance of keeping prescription forms in a safe place
  11. the importance of supervising the consumption of controlled drugs
  12. the importance of regular liaison with the dispensing pharmacist
  13. how to record prescriptions clearly and accurately on appropriate documentation
  14. how to review your prescribing practice in view of new guidelines and/or evidence
  15. the importance of keeping full, legible and accurate records in date order, and how to do so
  16. the principle of confidentiality under data protection legislation: what information may be given to whom
  17. the importance of carrying out regular clinical reviews of the individual’s progress, and how to do so
  18. the importance of carrying out regular reviews of your own prescribing practice, and how to do so
  19. organisational requirements and policies relevant to the functions being carried out
  20. an appropriate clinical supervisor to consult when you are unsure about the medication to be prescribed or your level of competence in prescribing it
  21. the range of different substances and their effects
  22. the importance of only prescribing controlled drugs to substance users as part of a wider treatment plan and how the use of controlled drugs complements other psychological, social and medical interventions

Performance Criteria

You must be able to do the following:

  1. keep prescription forms in a safe place and maintain an audit trail of prescriptions for all controlled drugs
  2. check that dependency has been confirmed using a combination of clinical assessment and testing
  3. liaise with other services and check the individual’s medical history and that no other clinician is prescribing controlled drugs for the individual
  4. only prescribe controlled drugs (e.g. methadone, other opiates or other controlled drugs) to substance users as part of a wider treatment plan with specific goals and as an enhancement to other psychological, social and medical interventions
  5. prescribe controlled drugs in line with the individual’s treatment plan and condition (e.g. drug dependency, co-morbidity, other medication taken by the individual)
  6. follow guidelines and protocols, where available, in selecting the type of drug, induction regime, dosage, frequency of dispensing and frequency of administration
  7. consult an appropriate clinical supervisor, if you are unsure about the drug to be prescribed or your level of competence in prescribing it
  8. where required, you obtain a licence for prescribing the controlled drug
  9. state, on the correct form for prescribing controlled drugs:
    1. the individual’s name and address
    2. the name of the controlled drug
    3. the form and the strength of the preparation
    4. the total quantity of the preparation (the number of dose units) in both words and figures
    5. the dose
    6. the route of administration
    7. the number and frequency of instalments, if the controlled drug is to be dispensed by instalments
    8. any requirement for the consumption of the drug to be supervised
  10. write the prescription in your own handwriting, in ink, unless you have a specific handwriting exemption from the Home Office
  11. ensure there is no blank space on the form in which the individual could add further items
  12. sign and date the prescription
  13. agree the dispensing regime with the pharmacist and liaise regularly about the specific individual and the prescribing regime
  14. make yourself available to take emergency telephone calls from the pharmacist in cases of a prescription error
  15. record the prescription for controlled drugs on the appropriate monitoring record
  16. ensure that records of the individual’s treatment are available only to those authorised to see them
  17. take part in regular clinical reviews of the individual’s progress including compliance with the prescribing regime
  18. review your prescribing practice in view of new guidelines and/or evidence

Additional Information

This National Occupational Standard was developed by Skills for Health.

This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004):

Dimension: HWB7 Interventions and Treatments
AH1 Prescribe controlled drugs for substance users
Final version approved June 2010 © copyright Skills For Health
For competence management tools visit tools.skillsforhealth.org.uk
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