Clinical Skills: Prescribing Controlled Drugs

Controlled drugs are medications which are prone to causing addiction and being abused. For this reason they are securely locked away within the hospital inpatient setting, and the prescription of these drugs for use on discharge from hospital is bound by certain additional restrictions.

• Schedule 1 drugs: illegal recreational drugs (no recognised medicinal use)
• Schedule 2 drugs: opiates, morphine, methadone, amphetamines, cocaine
• Schedule 3 drugs: buprenorphine, temazepam, barbiturates
• Schedule 4 drugs: - two parts - Part 1 includes benzodiazepines and ketamine, and Part 2 includes anabolic steroids
• Schedule 5 drugs: codiene, pholcodine (minimal control measures)

• All prescriptions for controlled drugs should be written in indelible black ink
• Controlled drug TTAs are required to include:
  • The prescribers name and address
  • The patient's name and address
  • The drug name, dose, route to be taken, frequency of administration
  • The form and strength of the medication where appropriate (e.g. liquid, 10mg/5mls)
  • The amount to be supplied, either as: the total quantity (in words and figures) of the preparation, or the number (in words and figures) of dosage units
  • A handwritten signature and a date (even if the TTA is completed electronically)
• Good practice requires that you include all standard information on the TTA prescription - e.g. full patient details, consultant, allergy status, admission/discharge date, and request for any action from the General Practitioner

If in doubt about what to prescribe or how to prescribe it, then the best course of action is to ask a senior or a pharmacist. This is even more important when controlled drugs are concerned, as there are medical and legal consequences if you get it wrong!

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