Tighter legal controls on drug prescribing are not the answer

Rising drug related deaths alarm treatment providers, legislators, and society. The recent report from the Advisory Council on the Misuse of Drugs, Reducing Drug Related Deaths, suggests that lax prescribing is responsible for a significant proportion.1 It supports recent national guidelines on managing drug misuse, emphasising the supervised consumption of controlled drugs.2 On the same theme, the UK Home Office proposes extending the licensing system for addiction prescribing to cover all controlled drugs except NHS prescriptions for methadone mixture.3 Yet an expansion in the licensing system is likely to reduce accessibility of treatment and so increase drug related deaths. We believe that a clinical governance based solution would more successfully enhance treatment quality, safety, and accessibility.

Currently Home Office licences cover only heroin, cocaine, and dipipanone, and about 100 doctors (mainly specialist psychiatrists) have licences. The licences encompass prescriptions for about 500 patients, most of whom receive heroin. Monitoring is indirect and low key, aimed at detecting negligently aberrant prescribing and self …