The Home Office last week set out its intentions to introduce emergency measures that would allow pharmacists to supply medicines in schedule 2, 3 and part 1 of schedule 4 under the Misuse of Drugs Regulations 2001 to patients without a prescription.

The legislative change, suggested in the wake of the COVID-19 pandemic, would apply in cases where the patient is “receiving [the drugs] as part of ongoing treatment”, home secretary Priti Patel stated in a letter to the Advisory Council on the Misuse of Drugs (ACMD) last week (April 1)

The measures will “rely on the professional judgement of pharmacists, who will be working outside of the scope of their usual practice,” ACMD chair Professor Owen Bowden-Jones and Professor Roger Knaggs, chair of ACMD’s technical committee said in a joint letter replying to Ms Patel yesterday (April 7).

There is also a risk that enabling pharmacists to supply controlled drugs to patients without a prescription  could “increase the risk of the misuse and diversion of controlled drugs”, the ACMD warned.

“Patients with substance misuse issues might attempt to place pressure on a pharmacist to dispense in accordance with this measure”.

Alternatively, someone might “visit a range of pharmacists in an attempt to locate and exploit weaknesses…in order to be supplied with medicines against best practice”, the ACMD added.

ACMD “generally supportive”

However, the ACMD said it is “generally supportive” of the proposal to enable pharmacies to supply controlled drugs without a prescription during a pandemic, “where there is a risk of discontinuity of supply of repeat prescriptions”.

It recommended that national guidance is produced in consultation with the “relevant medical Royal Colleges and professional bodies”, but added that pharmacists will still “require additional support and guidance” when implementing this measure.

The ACMD is also “generally supportive” of the measure to allow the supply of these controlled drugs under a serious shortage protocol (SSP), but advised that this should be a “last resort”, it said.

However, the advisory body recommended that amendments are made to the final measure proposed, which would allow pharmacists without prescribing rights to “change the frequency of instalments on instalment prescriptions without the immediate need for a new prescription from a prescriber”.

It recommended that this should be changed so that pharmacists can “only vary the frequency of dispensing where they have consulted with the prescriber”.