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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

a key in lock imageJanuary 18 2018

Pharmacists are being urged to express their views on the impact of UK-wide proposals to reschedule pregabalin and gabapentin as controlled drugs.

Community Pharmacy Scotland is asking pharmacists to get involved with the consultation, as it could mean many pharmacies would have to install a second Controlled Drugs cabinet due to the volume of stock needed to dispense against high prescribing levels of pregabalin and gabapentin.

A consultation issued in November by the Home Office and Northern Ireland’s Department of Health is proposing the drugs should be restricted in one of three ways:

  1. by making them Class C Drugs under the Misuse of Drugs Act 1971 and placing them both in Schedule 3 to the 2001 Regulations, with safe custody requirements;
  2. by making them Class C Drugs in Schedule 3 but with an exemption from the safe custody requirements;
  3. by making them Class C Drugs but placing them in Part 1 of Schedule 4 to the 2001 Regulations.

A ‘do nothing’ option would mean that any illicit supply of the drugs would have to be dealt with under the Psychoactive Substances Act 2016.

In its response to the Consultation, CPS says it has selected option 2, from the choice given, “but must make it clear that none of the options would be the preferred choice for community pharmacy. We would strongly recommend the adoption of option 2, but with the ability to include the two drugs in PGDs [patient group directions] and emergency supply arrangement.”

While there would be benefits from option 3 (with reduced prescribing requirements), CPS says it has opted for option 2 as it recognises “there is a growing problem with online private prescribing of substances liable to abuse by EEA/Swiss-based prescribers” so Schedule 3 offers better protection.

In its message to pharmacist, CPS has said: “Whilst we agree something must be done, we are of the strong view that, given the volume of dispensing, it would not be feasible to keep these items in CD cabinets in community pharmacy. Additional cabinets would almost certainly have to be purchased, and we are aware of a number of premises where the space for installing any further safes is simply not available.”

The consultation was launched after the Advisory Council on the Misuse of Drugs (ACMD) proposed that both drugs should be controlled as Class C drugs under the Misuse of Drugs Act 1971 (‘the 1971 Act’) and placed in Schedule 3 to the Misuse of Drugs Regulations 2001.

The ACMD had noted that “both pregabalin and gabapentin present a risk of addiction, potential illegal diversion and medicinal misuse.” It had reported that “the harms of these substances are equivalent to those of other drugs controlled under the 1971 Act, including tramadol, which was controlled as a Class C drug in 2014,” says the consultation, which closes on January 22.

Links:
CPS statement   
CPS response to consultation      
Home Office Consultation ‘Pregabalin and gabapentin: proposal to schedule under the Misuse of Drugs Regulations 2001’                  

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