Gabapentin and Pregabalin become Controlled Drugs on 1st April 2019 - what are the implications for care homes and nursing homes?
Gabapentin (trade name – Neurontin) and Pregabalin (Trade name – Lyrica / Alzain) are drugs which are used to treat nerve pain, epilepsy and anxiety. They can bring an elevated mood in users and have serious side effects.
There has been concern over the illegal use of these drugs leading to increased addiction and rising number of fatalities. This is the reason why these drugs have been rescheduled to become Class C of the Misuse of Drugs Act 1971 – making them Controlled Drugs (CDs) and placed under Schedule 3 of the Misuse of Drugs Regulations 2001 – which specifies the extra controls and requirements for the use of these drugs. It means that they are still available on prescription for legitimate use but there are more controls which ensure accountability and prevent the drugs falling in to the wrong hands and being stockpiled by patients.
The main changes relate to doctors and pharmacists. Doctors now need to physically sign prescriptions and the quantity prescribed must be written in words and figures. Pharmacists must dispense the drugs within 28 days of the prescription being written.
How does this reclassification affect the use and handling of these drugs in Care Home and Nursing Homes?
The storage of Gabapentin and Pregabalin has not changed and they can be kept in the same way as any other drug that is not a CD.
If they are not to be kept in the CD cupboard, then there is also no need to keep records in the CD register.
Legally there is no requirement for a witness signature on administration of these drugs. However, good practice guidelines make a recommendation to have a witness check the administration is correct. For this reason, ATLAS eMAR prompts for a check and provides an option to have a witness signature.
The only thing that you may notice is that prescriptions will look slightly different in the way that they are written as the quantity is required in both words and figures.
These drugs will also not be available on the national repeat dispensing (Batch) prescriptions.
The drugs can only be prescribed for a treatment period of 30 days.
The prescriptions are only valid for 28 days from the time they are written and cannot be issued by the pharmacy after this time.
Disposal of unwanted Gabapentin and Pregabalin
Residential Homes without nursing – Drugs should be returned to the pharmacy for destruction in the same way as any other drug is returned. The pharmacy may require you to sign for these and will denature these drugs on your behalf.
Nursing Homes – These drugs should be denatured by a registered nurse before being handed to the waste disposal company. Legally written records and witness signatures are not required but some Nursing Homes may choose to do this as good practice.