Gabapentin and pregabalin to be reclassified as controlled drugs

Gabapentin and pregabalin will be reclassified from 1 April 2019, as Schedule 3 controlled drugs. Independent prescribers must review their practices before that date to ensure legal compliance.

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Joint statement agreed by NHS England, the Health & Care Professions Council, the Chartered Society of Physiotherapy, the College of Podiatry and the Institute of Chiropodists and Podiatrists:

CSP professional adviser Pip White said: 'It is important that all independent prescribers ensure they review their practice before 1 April.

'The CSP first highlighted this issue to members in November 2018

'Whilst acknowledging the frustration, and disruption to patient pathways this may cause to some prescribers and patients, independent prescribers must ensure they prescribe legally
and that their governance processes reflect the law change.

'The HCPC has made it clear they may investigate concerns of inappropriate prescribing, if it is raised with them.'

From 1 April 2019, gabapentin and pregabalin will be reclassified as Schedule 3 controlled drugs, under the Misuse of Drugs Regulations (2001), and Class C of the Misuse of Drugs Act (1971), as is already the case with Tramadol.

Their reclassification follows a Government consultation and recommendations from the Advisory Council on the Misuse of Drugs that additional safeguards be put in place as a result of concerns around the misuse of these drugs.

Until 1st April 2019, physiotherapist and podiatrist independent prescribers registered with the Health and Care Professions Council may continue to prescribe gabapentin and pregabalin.

After this date, they will no longer be able to independently prescribe these medicines and must use supplementary prescribing for new or existing patients. This must be in partnership with an independent prescriber who can prescribe pregabalin and gabapentin (a doctor or dentist). Where supplementary prescribing is not possible, patients in need of these medicines should be referred to an appropriate independent prescriber.

Independent prescribers are reminded that they must work within the law and comply with the HCPC Standards for Prescribing at all times. The HCPC may investigate concerns about inappropriate prescribing practice.

NHS England, together with the professional bodies representing physiotherapists and podiatrists, has identified additional controlled drugs that physiotherapist and podiatrist independent prescribers may require to prescribe in practice, where there is demonstrable evidence of need.   Both pregabalin and gabapentin will be considered for both physiotherapist and podiatrist independent prescribing. Work is underway to progress the proposal to public consultation in the near future.

What has the CSP done?

  • contributed to the original Home Office consultation in November 2017 highlighting the impact such a change would have on both patients and physiotherapist independent prescribers
  • the government response acknowledged impact on patients legitimately prescribed the drugs, but the change was to address the bigger problem of illegal misuse and diversion of prescriptions of these medicines
  • in anticipation of these changes, the CSP secured the inclusion of these medicines within the project to update the list of controlled drugs that independent physiotherapist prescribers can use
  • work to progress to a public consultation on changes to the controlled drugs list has stopped due to Brexit pressures on government time in recent months. This is beyond the CSP's control and we will inform members as soon as there is any update

Should gabapentin and pregabalin become approved additions to the existing list of controlled drugs available to physiotherapist and/or podiatrist independent prescribers, then such prescribers will again be able to prescribe them. NHS England and the professional bodies will update the professions if these changes are agreed.

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by Frontline

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