Controlled Drugs (CDs) were the topic of a dedicated NICE document (NG46), much of which is relevant to pharmacy:

• All organisations should have a CD policy and standard operating procedures for CD storage, transport, destruction and disposal, which should be regularly reviewed and updated

• All CDs that require safe custody storage should be subject to stock checks – usually weekly – carried out by two people in line with a designated standard operating procedure (SOP)

• Governance arrangements and processes should be in place for delivery or transport services that involve supplies of or prescriptions for CDs

• CD registers and requisitions should be retained for two years, with invoices held for six years and records of the destruction of a patient’s own CDs for seven years

• No more than 30 days of a CD should be prescribed, unless there are exceptional circumstances

• CDs supplied to patients or carers should be documented and information provided about what the drug is for, how long it will take to work and how long it is likely to be needed, as well as how it may affect driving ability and any issues around concurrent prescribing of immediate- and sustained-release products

• Reasonable steps must be taken to confirm an individual’s identity before supplying CDs to a patient or their representative. If the person taking the medication is in police custody, you should check before making a supply that custody staff have adequate arrangements and handling facilities for CDs

• Advice on safe storage of CDs should be provided, with discussions taking into account the person’s preference for a lockable or non-lockable storage box, who will access to the CDs and whether the storage method could increase the risk of incidents

• If a full quantity of a Schedule 2, 3 or 4 CD cannot be supplied, you should make sure the patient knows to collect within 28 days of the date on the prescription. Only the quantity supplied should be recorded in the CD register, with a further entry made when the balance is issued

• Health professionals must use a mandatory form when requisitioning a CD for use in the community

• Records should be kept so that an audit trail exists for the supply, administration and disposal of CDs and their movement between locations

• An authorised person must be present to witness the destruction of stock Schedule 2 CDs, and records must include the name, strength, form and quantity of the drug, the date of destruction and the signature of the witness. It is good practice to take the same measures for Schedule 3 and 4 CDs and patient returns, in which case the record should also state the date the CD was received by the pharmacy

• When disposing of a stock bottle that contains an irretrievable amount of a liquid CD, consider rinsing the bottle and disposing of the liquid into a pharmaceutical waste bin, and removing or obliterating labels before disposing of the clean empty container via recycling waste. This does not need to be recorded.