Wednesday, 29 July 2020
Department of Health
Medicines which have a high potential to be misused are subject to stricter controls under the Misuse of Drugs Acts 1977 to 2016 and the Misuse of Drugs Regulations and Orders 2017. The legislation imposes restrictions on the possession, production, supply, importation and exportation of controlled drugs.
In 2017, the Misuse of Drugs Regulations were updated and additional controls on benzodiazepines and so-called 'z-drug' sedatives were introduced, including import and export controls, stricter prescribing and dispensing controls, as well as an offence of possession, thereby assisting Customs and An Garda Síochána in protecting public health and local communities.
The amendments to the Regulations also afforded practitioners an opportunity to review patients receiving such medications and allow them to make brief interventions with these patients. Brief interventions have been shown to be of value in reducing prescription usage of these potent medicines.
In October 2017 the Medical Council of Ireland and the Pharmaceutical Society of Ireland launched joint guidance on the Safe Prescribing and Dispensing of Controlled drugs. The aim of this resource was to facilitate safer prescribing and dispensing of controlled drugs. It should be used by all prescribers and pharmacists in the collaborative, safe and effective care of patients.
In further support of the legislative changes, in February 2018, the HSE Medicines Management Programme (MMP) published “Guidance on appropriate prescribing of benzodiazepines and z-drugs (BZRA) in the treatment of anxiety and insomnia”. It contains information on initiation and review of BZRA, highlighting the potential dangers associated with long-term use and provides examples of resource materials which may support prescribers and pharmacists to manage the withdrawal of patients from these medicines.
More recently, officials in the Department of Health have been working with stakeholders, including prescribers, pharmacists and the HSE, facilitated by the Medical Council, to further examine the issue of the prescribing of benzodiazepines and other controlled drugs and to build on the changes introduced in 2017. This is providing a platform for key stakeholders to work together to develop initiatives, led by the respective stakeholders, to better address the difficulties associated with the prescribing of controlled drugs.
This group, via the HSE MMP, has prepared support materials, including posters for GP waiting rooms and community pharmacies, and patient guides to better inform both prescribers and patients of the potential risks associated with the prescribing of controlled drugs.
Officials from the Department of Health are continuing to engage with and support the work of this group as it considers potential solutions to ensure greater visibility and governance around the prescribing and dispensing of controlled drugs in order to ensure the safe, appropriate and efficacious use of these important but potent medicines.