UK hospital medication rules

[Opiatehell85]

Hi all,

im going for a big operation on Monday, I've already picked up my weekly subs yesterday and was given an early script today from rehab for the week after to save me worrying about getting to the pharmacy post op, so I have two weeks worth with me. My consultant told me that I must bring in my own subs as I don't intend to use morphine or other opiates after my op for pain (I don't wanna ruin my detox) as it was pain medication I was originally addicted to.

My key worker told me today to not hand over more than three days worth to staff as if I give them a whole weeks worth, and I'm only in a few days, they will not give me the remainder of my tablets. Apparently this has happened in all but one cases.

Does anyone have experience of this or shall I just not hand any over altogether? I'm a little worried that I'm going to become without my medication, I'm more worried about this than the operation itself.

Thanks in advance

 

[Keif' Richards]

It's going to be hard for anyone to give you a concrete answer. Who you need to be communicating with, is the hospital/medical team that you're going to be working with throughout your surgery and recovery. I don't see why they couldn't just give you a black and white answer, bring this much or don't.

I'm gonna leave this open on the off-chance that someone has experienced the same thing and might be able to help you out, but I'm not counting on it.

 

[T. Calderone]

I'm hoping somebody in EADD may have some experience with this so I'm moving it there. Good luck with your surgery!

 

[StoneHappyMonday]

I would have thought your prescription is your prescription and cannot, under any circumstances, be taken from you. Take your repeat script (the piece of paper) to show you have rights to them. I may be missing something but I have never heard of a hospital interfering in this way. Can't you just keep them in your personal belongings anyway instead of handing them all over?

 

[ClemFandango]

You're not "in recovery" if you're still taking strong opioids to get off the other opioids you were addicted to.

Subs and methadone is for people too weak to live a clean life.

Similar to a vodka addict thinking they're staying sober by drinking wine. Ridiculous.

Every sub and meth patient is still a junkie... until you have the balls to cluck and get 'really' clean.

Sorry if that makes me sound like a prick, but it's the truth.


All the best with the surgery. X

 

[StoneHappyMonday]

^

Fuck off with your tough love eh Clem, you just come across as a prick. Whether you're genuinely sorry about coming across that way or not.

To the OP. Ive been in touch with someone who knows about this and the position is they will take your controlled drugs off you but are LEGALLY OBLIGED to return them to you when you leave, which is basically what I thought.

 

[ClemFandango]

^

Fuck off with your tough love eh Clem, you just come across as a prick. Whether you're genuinely sorry about coming across that way or not.

To the OP. Ive been in touch with someone who knows about this and the position is they will take your controlled drugs off you but are LEGALLY OBLIGED to return them to you when you leave, which is basically what I thought.

You've always come across as a belligerent Manc twat who likes to stick poor quality mephedrone up your back passage.

I like you, though. Rolling around SE Asia paying for gash.

And meth and sub 'users' will always be junkies until they abstain completely.

You ain't sober while you're on potent opioids...

 

[steewith2ees]

I haven't worked a shift since Decemebr 2006 but I worked as RMN for 8 years beforehand.

One of the major sources of money wastage in hospitals across the board was that upon admission to hospital - patients were always asked to bring in all of the medication they were currently taking, so that the doctor on duty could use the information label on the packaging of any prescription medicines in order to transfer them verbatim onto the hospital 'treatment sheets'. The sheets acted not only as charts for us to record and sign for medicines if they were administered (and to record instances when they were not i.e. a refusal), but were in themselves legal prescriptions for current inpatients.

This was always seen as the most efficient way of transferring everything over as accurately as possible, as the patients may not have any other information regarding this such as photocopies of current outpatient scripts or recent GP letters with the entire treatment regime as of course many unplanned admissions occur out of hours and in these instances it could be up to 72 hours before we could confirm any of this with the GP directly (even if your subs scripts are issued by a specialist addiction service your GP should still have an accurate and current record of the drug and dosage to be taken).

After the patient was admitted, they were (and of course still are) not permitted to free access to any medicines they take so that everything that someone is administered during an inpatient stay is recorded as described above, as all responsibility for this is part of a nurses standard duty of care, making them legally accountable for anything that is or isn't taken, prescribed or unprescribed.

Once the doctor had finished their part of the admission process and re - prescribed any medicines that were to continue during their stay, we would basically remove them, throw them in the bin (of course, the 'bin' being a secure storage box for their collection and destruction by pharmacy staff) and we would then use our own ward and pharmacy stock from the drug trolley.

With the amount of unused medicines being dispensed and then thrown away being a major source of financial waste for the NHS top to bottom (a distance that decreases of course as more and more statuary services are sent out to tender) one small area that they could stop this was by changing the process above and introducing personal locked drug cupboards for individual patients so that they could use up there own supply before the hospital pharmacies had to dispense more drugs for continuing treatment.

In many hospitals now, the cupboard is usually located next to an individuals bed so although they may not have access to it they can at least monitor there own supplies as they are dished out, and from a legal perspective, even if your prescription medicine is not accessible to you under these circumstances they are still your own property and anything that has not been used should be returned upon discharge if still needed and prescribed.

Of course, cock ups do happen but if you can get it sorted at this late stage - any anxieties you may have about you original concern can be alleviated by having a responsible adult (preferably a direct relative such as a parent, sibling or spouse) hang on to you subs and only give the ward nurses a couple of days supply at a time, but as but as buprenorphine is a class C, schedule 3 drug it is very important that you have this arrangement firmly in place before you are admitted, as otherwise they could be liable to prosecution for being in possession of the drugs or even liable for their supply.

I hope that this is of some help but it is important to try and ensure that you have made contact with the ward staff prior to your admission as local policies and procedures covering this area can vary greatly between different inpatient settings.

 

[tightlywound]

You've always come across as a belligerent Manc twat who likes to stick poor quality mephedrone up your back passage.

I like you, though. Rolling around SE Asia paying for gash.

And meth and sub 'users' will always be junkies until they abstain completely.

You ain't sober while you're on potent opioids...

that begs the question -- are people legitimately prescribed and not abusing ADD meds "clean?" what about antipsychotics? antidepressants? where do you draw the line?
IMO if I'm not getting high on anything, I'm sober. in fact I think that's the definition.

 

[steewith2ees]

You ain't sober while you're on potent opioids...

I'm neither 'clean' or 'in recovery' Clem as I am currently on a methadone reduction, but as I have not had any other intoxicants since my last spliff on Sunday night, due to my tolerance I feel perfectly 'sober'.

I will be correcting that over the weekend of course.

 

[ClemFandango]

that begs the question -- are people legitimately prescribed and not abusing ADD meds "clean?" what about antipsychotics? antidepressants? where do you draw the line?
IMO if I'm not getting high on anything, I'm sober. in fact I think that's the definition.

U.S. Ritalin prescriptions are a worldwide joke. Just like the nasty heroin epidemic your beautiful country is suffering from is mainly down to your doctors' liberal opioid prescriptions for pulling out a wisdom tooth.

 

[ClemFandango]

I'm neither 'clean' or 'in recovery' Clem as I am currently on a methadone reduction, but as I have not had any other intoxicants since my last spliff on Sunday night, due to my tolerance I feel perfectly 'sober'.

I will be correcting that over the weekend of course.

I wish you all the best, mate, but while you're on this methadone programme, you're still a smackhead.

Your situation is unique. To be able to hand over heroin to your Father to be stashed and used later is not normal.

 

[tightlywound]

U.S. Ritalin prescriptions are a worldwide joke. Just like the nasty heroin epidemic your beautiful country is suffering from is mainly down to your doctors' liberal opioid prescriptions for pulling out a wisdom tooth.

okay so IYO, ritalin = not okay. anything else we should know about that you've officially declared constitutes making one a "junkie?"

 

[steewith2ees]

U.S. Ritalin prescriptions are a worldwide joke. Just like the nasty heroin epidemic your beautiful country is suffering from is mainly down to your doctors' liberal opioid prescriptions for pulling out a wisdom tooth.

I'll always be a smackhead Clem even if I remain abstinent for the rest of my life following my detox and rehab.

I'm the one who has to live with it mate I don't need telling by a 3rd party.

 

[thecamelduluxe]

Hi,

My experience is slightly different from yours but I'll share it anyway just incase you glean any useful info from it, mainly to do with staff attitudes.

I was admitted to hospital with agonising chest pains a few months ago, and after an x-ray the doctors suspected TB (which actually "just" turned out to be Pneumonia), which meant that I had to go into isolation due to it being rather contagious.

I was on 10mg of Subutex a day, and at that point was on daily pick up. I made this clear to the doctors when I went in, and I left a voicemail with my keyworker telling him about my situation. He rang the hospital and made sure that I got my medication and the nurses were completely cool about it, even if I had to press them for urgency as I was getting sick on the first day although I know they are really busy (I was in for two days). I even had a really sound doctor give me 90mg of DCH on the first night as I was starting to get sick which really surprised me.

I don't know why the doctors wouldn't give you your medication back - it's prescribed to you after all. That said, I doubt they'll search your bags and a few subs wouldn't be the hardest thing to hide in your possessions.

I also think I might be missing something here - what do you stand to gain by handing over your whole weeks worth of medication to them?

I'll finish by saying that I wish you the best of luck with your operation and I hope it runs as smoothly as possible

 

[steewith2ees]

a few subs wouldn't be the hardest thing to hide in your possessions.

I appreciate the reply camel as you have first hand inpatient experience of this, but this part of the post is really bad advice - they take deliberate concealment of ANY medicines very seriously (as any unknown contra - indicated medicines that may be taken by a patient could in the worst case scenario kill them) but if they catch you farting around trying to conceal a drug scheduled under The Medicines act and controlled by the Misuse of Drugs Act would probably get you discharged from both the hospital and any drug treatment services and render you liable for prosecution.

I hoped that would have been made clear when I explained that ward nurses are legally accountable for any drugs taken by a patient under their care.

 

[ordinary mind]

I also think I might be missing something here - what do you stand to gain by handing over your whole weeks worth of medication to them?

This. If you're worried about getting kept in longer than expected, then is there maybe someone you could arrange to drop them off if needed?

Also Clem you clearly know what the purpose of maintenance is, the rest is just semantics.

 

[steewith2ees]

I haven't worked a shift since Decemebr 2006 but I worked as RMN for 8 years beforehand.

One of the major sources of money wastage in hospitals across the board was that upon admission to hospital - patients were always asked to bring in all of the medication they were currently taking, so that the doctor on duty could use the information label on the packaging of any prescription medicines in order to transfer them verbatim onto the hospital 'treatment sheets'. The sheets acted not only as charts for us to record and sign for medicines if they were administered (and to record instances when they were not i.e. a refusal), but were in themselves legal prescriptions for current inpatients.

This was always seen as the most efficient way of transferring everything over as accurately as possible, as the patients may not have any other information regarding this such as photocopies of current outpatient scripts or recent GP letters with the entire treatment regime as of course many unplanned admissions occur out of hours and in these instances it could be up to 72 hours before we could confirm any of this with the GP directly (even if your subs scripts are issued by a specialist addiction service your GP should still have an accurate and current record of the drug and dosage to be taken).

After the patient was admitted, they were (and of course still are) not permitted to free access to any medicines they take so that everything that someone is administered during an inpatient stay is recorded as described above, as all responsibility for this is part of a nurses standard duty of care, making them legally accountable for anything that is or isn't taken, prescribed or unprescribed.

Once the doctor had finished their part of the admission process and re - prescribed any medicines that were to continue during their stay, we would basically remove them, throw them in the bin (of course, the 'bin' being a secure storage box for their collection and destruction by pharmacy staff) and we would then use our own ward and pharmacy stock from the drug trolley.

With the amount of unused medicines being dispensed and then thrown away being a major source of financial waste for the NHS top to bottom (a distance that decreases of course as more and more statuary services are sent out to tender) one small area that they could stop this was by changing the process above and introducing personal locked drug cupboards for individual patients so that they could use up there own supply before the hospital pharmacies had to dispense more drugs for continuing treatment.

In many hospitals now, the cupboard is usually located next to an individuals bed so although they may not have access to it they can at least monitor there own supplies as they are dished out, and from a legal perspective, even if your prescription medicine is not accessible to you under these circumstances they are still your own property and anything that has not been used should be returned upon discharge if still needed and prescribed.

Of course, cock ups do happen but if you can get it sorted at this late stage - any anxieties you may have about you original concern can be alleviated by having a responsible adult (preferably a direct relative such as a parent, sibling or spouse) hang on to you subs and only give the ward nurses a couple of days supply at a time, but as but as buprenorphine is a class C, schedule 3 drug it is very important that you have this arrangement firmly in place before you are admitted, as otherwise they could be liable to prosecution for being in possession of the drugs or even liable for their supply.

I hope that this is of some help but it is important to try and ensure that you have made contact with the ward staff prior to your admission as local policies and procedures covering this area can vary greatly between different inpatient settings.

I know most of my posts are boring as fuck but it's not a bad idea for anyone contributing towards this thread to actually read it.

 

[ClemFandango]

I'll always be a smackhead Clem even if I remain abstinent for the rest of my life following my detox and rehab.

I'm the one who has to live with it mate I don't need telling by a 3rd party.

Me, too. High five. o/

You really are a bitch to your own self. If that blonde fella really is you in that pic, with the disc jockey, then you're a good looking, incredibly intelligent entity.

 

[thecamelduluxe]

I appreciate the reply camel as you have first hand inpatient experience of this, but this part of the post is really bad advice - they take deliberate concealment of ANY medicines very seriously (as any unknown contra - indicated medicines that may be taken by a patient could in the worst case scenario kill them) but if they catch you farting around trying to conceal a drug scheduled under The Medicines act and controlled by the Misuse of Drugs Act would probably get you discharged from both the hospital and any drug treatment services and render you liable for prosecution.

I hoped that would have been made clear when I explained that ward nurses are legally accountable for any drugs taken by a patient under their care.

Ah ok you're absolutely right, truth be told I didn't read your whole post as it was quite long (EDIT: not boring, stop being pejorative about your posts!) and I'm pretty sleepy.

Should really have done that seeing as you have direct experience working in the field but at least your advice may have stopped someone doing something fucking stupid on my account - nice one fella!