What is a Controlled Drug (CD)?
Controlled drugs (CDs) are prescribed drugs used to treat severe pain, induce anaesthesia or treat drug dependence, and they have additional safety precautions and requirements.
Examples of CDs are:
Morphine
Fentanyl
Methylphenidate.
You can find a full list of controlled drugs here.
When do I administer a Controlled Drug?
Any need for medication support, including support taking controlled drugs is identified at the care assessment stage by the care management team and recorded in the care recipient's care plan. The care plan will clearly describe whether controlled drugs are required and the desired outcome(s).
What is a CD protocol?
A personalised CD Protocol is a detailed account of when CD medication should be administered for a particular recipient. It is needed for all CD medications. The plan should include appropriate alternative support and interventions to use before medicines are prescribed. If a CD protocol is not in place for a CD medication, please contact the office on 020 3970 9900.
How do I collect Controlled drugs?
CDs are prescribed and dispensed for individual named people, in the same way as other medicines. If the care recipient does not arrange the supply and collection of controlled drugs but relies on you to do so, there should be clear records including:
• Receipt from the pharmacy;
• Supply to the person;
• Any subsequent disposal of unwanted controlled drugs.
Please note, if identified at the assessment stage that you will be responsible for helping with ordering prescription or for collecting medicines from the community pharmacy or dispensing GP practice, the arrangements will be fully documented in the care plan.
When collecting controlled drugs prescriptions from the pharmacy or dispensing practice you should be prepared to provide personal identification if requested to do so. They should carry the drugs in a bag which disguises it and not stop anywhere else enroute to ensure the medication is not stolen or misplaced.
How do I store Controlled drugs?
Once a controlled drug is in the care recipient’s home, it should be stored safely like any other medication. Please find further details on receiving and storing medication here.
How do I administer Controlled drugs?
When there is an identified need for you to actually administer a CD, the consent of the care recipient must be documented. If the care recipient is unable to communicate informed consent, the prescriber must indicate formally that the treatment is in the best interest of the individual and comply with the requirements of the Mental Capacity Act.
Before administering, Carers should refer to the Digital Care Plan / Medication Administration Record (MAR) for times, frequency and route of dosage and storage of medication. It will set out clearly the roles and responsibilities of all parties involved. They must also read the instructions carefully.
If a risk is identified during the care assessment, then systems will be put in place to ensure that controlled drugs are managed safely. This may include locking controlled drugs away, either with the consent of the service user or with a best interests decision.
Safe administration of controlled drug medication:
Wash hands
Explain the procedure to the client
The care recipient must provide their consent to medication before administering.
Check expiry dates of medication
Know the therapeutic use of the medication administered, its normal dose, side effects, precautions and contra-indications of its use.
Give medication via the appropriate route e.g oral
Wash hands again
Record medication taken on the Medication Administration Record (MAR) and Controlled Drug (CD) Chart
N.B.There is no need to keep a record when the client is wholly independent (i.e. responsible for requesting a prescription and collecting the controlled drugs from the pharmacy).
Please report any suspected tampering with blister packs to the office immediately, as these medications could have been exposed to air and administering them could risk your care recipients' health and safety. Do not administer medication unless you dispensed it yourself.
CD chart
How do I monitor Controlled drugs?
You should always be aware of the nature of the medication being taken by care recipient and should report any change in condition that might be due to the medication or its side effects. Reports should be made immediately to their care coordinator and escalated to management if required.
How do I dispose of Controlled drugs?
When a care recipient’s CDs are no longer required they should be disposed of safely to the pharmacist or dispensing doctor who supplied them at the earliest opportunity for safe denaturing and disposal. When CDs are returned for disposal a record of returns should be kept of who returned them, the quantity and the date on the CD chart.
For further information on medication management please review NICE Medication Management Guidelines