Combinations should also be changed whenever there are grounds to suspect that they may have become known to an unauthorised person; Cannabis-based products for medicinal use (CBPMs) are controlled drugs. This means they can only be prescribed by a specialist doctor. They must have specialist knowledge and expertise and they must be on the specialist register of the General Medical Council.

Records of administration must be made – they are an inherent part of the records. It is accepted that the reality of ‘in the field’ administration cannot immediately be recorded in the CD register. Please ensure you do so as soon as possible, but when in the field, radio in details of administration, if it is possible to do so, and record on the incident log.

Refrigerating controlled drugs

Only team members that may, for operational reasons, need access should have a key or know the code to open the safe. Keeping a record of key holders or intermittently changing codes would be appropriate. Some vets use insulin syringes to minimise wastage. This is acceptable although it is important to ensure that the syringe allows accurate measurement of the dose in millilitres. The medical director must be informed of any changes to locations where drugs are being stored immediately, and ideally before the planned change. CDs in Schedules 3, 4, and 5 do not need to be recorded in the CDR but invoices and usage records must be retained for 5 years.

Fentanyl is a Schedule 2 CD. It is therefore subject to safe custody requirements and must be recorded in the CDR. There is only one veterinary authorised fentanyl product, which is a POM-V Schedule 2 CD. It is an injectable solution authorised for use in dogs, for the control of significant post-operative pain and intra-operative analgesia. Please help them fulfil this role by understanding your responsibilities and the context for the licences held, whether you personally handle CDs within the team or not. Providers should be certain they comply with the legislation. Find out how to apply for a Home Office licence (GOV.UK). Failure to comply has consequences e.g., administrative sanctions or contraventions can be applied to a licence which may mean more frequent licence visits, or shorter licence validity. Ultimately, where it is proportionate to do so, a licence can be revoked, or if there are concerns limited to a specific team, that team removed from the licence annex. This would severely curtail M/CRTs ability to deliver pain relief to casualties. Furthermore, if a weakness in process or poor execution of a sound process led to a drug being misappropriated the implications could be serious. Potentially the drug may be abused by an individual or, in extreme circumstances, lead to an individual’s death within your community. This would have a reputational impact on the organisation concerned and the regulatory authorities. Single prescriptions with multiple dispenses (i.e., repeat prescriptions) are not allowed for CDs in Schedules 2 and 3, however an instalment prescription can be used if required (see below).

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If people bring in food grade cannabis products for their own (or a relative's) use, the service must do its own risk assessment. Supply of medicines for end of life care People’s own individually labelled controlled drugs (Schedules 2, 3 and 4 (Part I)) must be denatured before handing to the waste disposal company. The Environment Agency classes this as processing waste. Care homes with nursing will need to apply for a T28 waste exemption. This is free of charge. Make a record in the controlled drugs register. This should be signed by the person making the entry and another suitably trained person as a witness. Care homes without nursing