Diarmophine Drug in the United Kingdom - Essay Example

Introduction: The drug under analysis is diamorphine. The main reason of analyzing this drug, is because it is a very important drug used for purposes of treating pain, as well as it is a drug that is under heavy regulation by the government. This paper analysis how diamorphine is ordered, received, stored and disposed off. This paper also analysis the principles of supply and administration of diamorphine through the patient group direction. Furthermore, it explains the ethical and legal framework underpinning its safe and effective administration and management. This paper also explains the advantages and disadvantages of working with partners in the administration and management of diamorphine, and these partners include patients, clients, as well as carers. The setting of this paper is based on an hospital ward. Diamorphine can also be referred to as diacetylmorphine, and it is a drug prescribed as a very strong analgesic substance in the United Kingdom. Diamorphine is always administered through intramuscular, intrathecal, subcutaneous as well as intravenous routes, and it is used for purposes of treating and minimizing acute pain, such as severe myocardial infarction, physical trauma, chronic pain, post surgical pain, end-stage cancer, as well as most of the terminal diseases (Meikle, 2010). In other European as well as American countries, drugs such as morphine, as well as strong opiods are always used for purposes of treating and preventing acute pain. In the management of this drug, the United Kingdom department of health, through the institute of clinical excellence as well as health published a body of guidance that is responsible for outlining measures and methods in which the caesarian section of health should be managed. These guidelines and measures strongly recommended the use of epidural or even intrathecal diamorphine for purposes of relieving pain after the caesarian operation. Medical practioners also use diamorphine in palliative care, and they usually administer this drug through the subcutaneous route, and by the use of a syringe driver (Gov.uk, 2014). This is in case the patients under consideration are unable to swallow the oral morphine solution. Meikle (2010) denotes that diarmophine has more advantages than other chronic pain killers such as opiods and morphine. This is because the drug is soluble in fat, and on this basis, it is possible to administer the drug through an injection. The medical use of diamorphine is strongly regulated by the government of the United Kingdom, and this is through the 1971 Misuse of Drugs Act. This drug, is a controlled drug under class A, and on this basis, it is subjected to a variety of guidelines that surround its administration, storage, as well as destruction. It is important to explain that possessing diarmophine without that prescription from a medical doctor is an offence that is arrestable in the United Kingdom. Theoretical Framework: The 2001 misuse of drugs regulations act is able to divide controlled drugs into five major schedules. This division is based on the therapeutic usefulness of the drug under consideration, and the potential of misusing the same drug. Karpin (2008) is able to explain that a number of changes have been made in regard to the prescription, storage, record keeping, as well as destruction of controlled drugs, and this is because of amendments that occurred in the 2001 misuse of drugs regulations act. In 2006, the government was able to introduce the controlled drug regulations act, which was able to be implemented in the 1st of January 2007. The 2001 misuse of drugs regulation places Diarmophine under schedule 2 of the controlled drugs. Other controlled drugs that are categorized under schedule 2 are, secobarbital, pethidine, remifentanil, glutethimide, cocaine, amphetamine, as well as morphine ((Meikle, 2010). These drugs are always subjected to the principles of safe custody requirements, and on this basis, the law requires that these drugs must always be kept in a receptacle that is locked, and on most occasions, in a controlled drug cabinet that is appropriate, and approved by health care officials that the cabinet where the drugs are kept, is safe, and no one can tamper with it. Furthermore, the law requires that the cabinet where these drugs are stored can only be accessed by an individual who is authorized by law to be able to possess the drugs, or even administer the drugs. Spence (2010) further denotes that the 2001 misuse of drugs regulations act makes it mandatory for anybody importing or exporting diarmophine to acquire a license that authorizes them to do so. On this note, importing and exporting the drug is a criminal offence that is prosecutable by the state. The drug regulations act of 2006 identifies the individuals who can administer the drugs, particularly diamorphine. Medical practitioners who can administer the drug include doctors, as well as dentists. This act further allows other medical practioners to administer diamorphine only if they are acting under the direction of a dentist or a doctor. The 2001 misuse of drugs regulations act makes it mandatory for medical practitioners to keep a register for the use of diamorphine, and this register must comply with relevant statutes, as well as laws guiding the use of diamorphine (SalisburyNHS, 2014). Furthermore, when destroying Diarmophine, the destruction must be authorized by the government, as well as witnessed by an individual who is authorized to witness the destruction. It is important to understand that these strong regulations are put in place to regulate the use of diarmophine because of its potential dangers when the drug is not professionally used. For instance, the street name for diarmophine is heroine, and this drug has very adverse effects, which includes constipation, addictability, physical dependency, decreased kidney functioning, poisoning that emanates from contaminants, risks of acquiring sclerosis, as well as other bacterial infections. Furthermore, an over use of diarmophine can result to the death of the patient or an individual using the drug, and based on this fact, Diarmophine is a highly controlled drug, that should not fall in the hands of an individual who is not trained to use the diarmophine. Beynon, Bellis, Church and Neely (2007) denotes that in regulating the use of this drug, the 2006 health act makes it mandatory for an health care organization to conduct an appointment of an officer who is accountable and responsible for effective and safe use of diamorphine and other controlled drugs in the health care organization under consideration (Bank, 2014). The 2006 health care act also introduces the standard operating procedures regarding the administration and management of diarmophine and other controlled drugs. The government requires that all health care institutions operating in the United Kingdom have to develop a standard operating procedure for the management and administration of diarmophine. Karpin (2008) defines a standard operating procedure as a process that is put in place for purposes of describing the responsibilities as well as the procedures necessary for managing controlled drugs in an efficient and accountable manner. This includes drugs such as diarmophine, as well as cocaine. The 2006 health care act makes it mandatory for the following to be included under the standard operating procedures that regulates the management and regulation of diarmophine, Receipt and ordering of the drug. Assigning of the responsibilities to people who should handle the drug. Areas where the drug should be kept band stored. The people who have an access to the drug under consideration. The methods an organization will use to transport, as well as store the drugs. Methods of destroying and disposing off the drug under consideration. In case of the complications regarding the use of the drug, a health care individual who should be contacted. Maintaining a register on the use of the drugs under consideration, including drugs that have been returned by patients. Identification of the responsibilities of various professionals who handle the drugs, their qualifications, and experience in the medical field. Furthermore, in the administration, as well as management of this drug, the drugs regulation act of 2006 requires that it is only a pharmacist, a dentist, or even a doctor who should compound and supply diarmophine (NHS, 2014). This law requires them to supply diamorphine to a patient who has been legally allowed to use the drugs, and possess them. Currently, paramedics are allowed to administer and manage diarmophine to administer and manage the drugs. Other regulatory measures contained in the act includes, prohibiting medical practitioners from using patient specific diarmophine prescriptions for purposes of replacing as well as topping up the practitioners medical stock (Patient.co.uk, 2014). Furthermore, the law requires that a written requisition be made for purposes of a medical practitioner acquiring diarmophine from pharmaceutical organizations, as well as wholesalers. This requisition form must be duly signed by the prescriber, stating their address, name, occupation and profession. Furthermore, Nash (2011) explains that this requisition form should specify the quantity of diarmophine ordered, and the main reason as to why the drug under consideration is ordered and purchased. Furthermore, the 2006 drug regulations act requires that the supplier should store and record the requisition form, for a minimum number of two years. However, in an emergency situation, a medical practitioner who is unable to produce a signed order may request the supply of diarmophine by citing emergency conditions (Lancashire Health Economy, 2014). On this basis, the drug wholesaler, or the pharmacist may supply diarmophine to the practitioner, on conditions that the medical practitioner will provide a signed order or requisition within a period of 24 hours. Failing to produce this signed order will amount to a criminal offence, punishable by law, on the side of the medical practitioner (Meikle, 2010). Furthermore, the doctor, as well as the pharmacist is responsible for ensuring that the correct drug, that is diarmophine is received and all appropriate entries are recorded in the register of controlled drugs regarding the supply of this drug. This entry should happen on the same day when diarmophine is supplied, or on the next day of its supply, failure to which, it is a criminal offence (BBC, 2009). An individual collecting diarmophine must prove on whether he or she is a patient, a representative of the patient, or a professional health care official as a representative of a patient, based on his or her professional capability. Brazier, Gillon and Harris (2012) provides an explanation that in case the person collecting the drug is a representative of the patient, such as a neighbor or even a friend, then the person dispensing diarmophine has the right to refuse issuing the drug under consideration. This is in the case of a situation whereby the dispenser is not satisfied with the identity of the individual under consideration. The same also applies to the patient whom the doctor or a dentist has prescribed the use of diarmophine. This patient has to produce a document of identification that clearly identifies him or her to the satisfaction of the dispenser. However, Campbell (2009) denotes that it is easier for a health care professional to collect diarmophine on behalf of a patient, as opposed to the use of representatives. All that a professional has to do is to produce his or her identification, in case they are not acquainted to the dispenser. The professional must also produce his or her address and name. However, the 2006 drug regulations act allows the dispenser of the drug not to ask for the proof of identity if the production of the proof under consideration may compromise the confidentiality of the patient, or even prevent the patient from using diarmophine in the manner in which it is prescribed by the doctors of dentists (Midwifery and Nursing Council, 2014). This legal provision is aimed at protecting the confidentiality of the patient, based on medical procedures and requirements, of protecting any medical information that emanates from the patient (Research UK, 2014). Furthermore, the law is specific on the manner in which the diarmophine is stored. This drug must be kept in a locked receptacle, or a locked cabinet on a secured wall. These receptacles or cabinets must only be opened by an individual authorized to access and use the drugs. Furthermore, the law requires that any medical practitioner that uses diarmophine must keep a register on the quantity of these drugs under his or her possession, and the reasons as to why the practitioner under consideration is using the drugs (PSNC, 2014). Furthermore, the 2006 drugs regulations act requires that all medical individuals keeping a record of the use of diarmophine are responsible for this record, and it must be up-to date, and accurate. This register must be bound, and the top of its page must contain a notification of the drug under consideration, in this case diarmophine, its usage, and all relevant entries concerning the acquisition, storage, as well as disposal of the drug. Furthermore, the law requires that the medical practitioner should write this record using ink, or in a manner that health auditors can have the capability of auditing the records. Boyd, Anderson and Rieckmann (2011) denotes that these regulations and rules of procedure regarding the supply, use, acquisition, as well as the storage of diarmophine emanate from the provisions contained in the patient group directions. These directions were proposed in 1998, and various legislations regarding its implementations were enacted from the periods of the year’s 2000s. The patient group directives, (PGD) requires that a written instruction be provided regarding the administration, as well as supply of medicine to a group of patients, whom it is difficult to identify before they are treated. The 2012 human medicines regulations act is a new law that identifies the procedures of administering controlled drugs, as well as other drugs administered in the United Kingdom (Shaxson, 2012). This law further identifies information that must be contained in a PGD, and these information are similar to the requirements of accessing and supplying controlled drugs as established by the 2006 drugs regulations act. In the prescription of medicine, the PGD has outlined a set of directives that medical practioners should follow. This includes, the description of the medicine under consideration, the class and qualification of a health care professional who is responsible for administering the drug, the kind of medical condition that the patient under consideration suffers from, the dosage administered and its details, as well as the follow up measures that a medical practitioner has put in place, for purposes of ensuring that the patient adheres to the correct prescription (GOV, 2014). For instance, in the prescription of diarmophine, the dentist or even the doctor has to sign with his own handwriting on the prescription of the drug. Other details concerning the ailment, as well as the dosages can be computer generated. Furthermore, the prescription for diarmophine is valid for a period of 28 days, and the start date of the validity period begins from the day in which the medical practitioner signed the prescription, unless it is stated in the prescription form on the starting date of the medication. Furthermore, for a prescription that is characterized by installment dispensing, the first supply of diarmophine must occur within the first 28 days, after which the remaining installments must occur in accordance with the directions of the prescription. Furthermore, the law prohibits a medical practitioner to repeatedly prescribe diarmophine. This is because the regulations require that medical practioners can only use this drug for a period of 30 days of treatment (Chinthapalli, 2013). Furthermore, the law requires that in prescribing the use of this drug, it is essential for the medical practitioner to write down the dosage, strength of the dosage, form of the drug, as well as the total quantity of diarmophine that is administered to the patient. These are the guidelines established by the PGD directive, and a medical practitioner who breaches these directives in the administration of diarmophine is guilty of a criminal offence (PGD, 2014). In as much as diarmophine is a restricted drug, an individual can acquire privately from a dispenser by filling form FP10PCD. This form is pink in nature, and it contains the dosage required, and the reasons for purchasing the drug. However, the 2006 drug regulations act requires that any individual, who in his private capacity purchases the drug, must send it to NHS prescription services for purposes of analyzing the drug, and monitoring the use of the drug under consideration. Furthermore, any individual who want to self-administer the drug, must obtain a six digit identification number, from the NHS agency (NICE, 2014). This is after satisfying all the requirements needed for an individual to be able to use the drug under consideration. Furthermore, the 2007 provisions on miscellaneous regulations requires that a pharmaceutical body should present all FP10PCD forms for an audit, and follow up on the patients who purchased the drugs for self-administration. It is important to explain that the NHS always seeks to work with patients in the self-administration of this drug, mainly because it seeks to regulate the manner in which these drugs are used, for purposes of preventing their abuse. Furthermore, the NHS would also transfer knowledge and skills to carers in regard to how to administer and manage these highly sensitive drugs (Haynes, 2012). However, the main disadvantage of working with these groups is that they are not professional medical practitioners, and on this basis, they could mishandle or mismanage the drug. Conclusion: In conclusion, diarmophine is a highly regulated and controlled drug in the United Kingdom. This drug is established as class A controlled drugs, as per the 1971 misuse of drugs act, which identified sensitive drugs, which the government had to enact control measures. However, diarmophine is usually prescribed for purposes of treating and preventing acute pains that may emanate from caesarian deliveries, as well as from other chronic illnesses and diseases. There are a variety of legislations that are put in place for purposes of regulating and controlling its use. These legislations include, the health care act of 2006, the 2001 misuse of drugs act, as well as the 2006 drugs regulations act. 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Controlled drugs: licences, fees and returns. Retrieved May 15, 2014, from https://www.gov.uk/controlled-drugs- licences-fees-and- returns Read More