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NICE guidance to support safer use of controlled drugs

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Nurses should provide advice and information to patients prescribed medications about how to store and dispose of them safely, under latest guidance on controlled drugs.

The National Institute for Health and Care Excellence has published guidance on the best ways of ensuring drugs like morphine, methadone and diazepam are used “safely and responsibly”.

“This guidance provides further clarity and good practice recommendations across most NHS settings and people’s own homes”

Tessa Lewis

NICE said it covered changes to legislation, the different ways hospitals and primary care manage the drugs, restrictions on which staff can prescribe them and considerations when reviewing repeat prescriptions.

It said its new guidance would help health and social care professionals “negotiate complex legislation and regulations” to ensure they were doing all they could to care for patients being treated with controlled drugs.

The guidance may also be relevant to people who work in prisons, the police and the armed forces, said the institute.

Its recommendations include that health professionals should provide advice and information to people prescribed medications about how to “store and dispose of them safely”.

This should cover discussing lockable or non-lockable storage boxes, whether drugs will be accessible to others and whether the chosen storage method increases the risk of a drug-related incident.

In addition, health organisations should keep a record log for the supply, administration, transfer and disposal of controlled drugs.

Clinicians should also prescribe enough of a controlled drug to meet a patient’s clinical needs for up to, but no more than, 30 days. If a larger quantity is prescribed, the reason should be documented.

Dr Tessa Lewis, chair of the NICE 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,” she said.

“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,” said Dr Lewis.

She added that the guidance aimed to support clinicians in minimising the potential harms associated with controlled drugs by having “robust systems and processes in place for their use”.

A seven-year review of 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, especially from overdose.


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