Controlled Drugs and Sedative Prescription policy (Patient Information)

What Are Controlled Drugs?

Controlled drugs are medications that are carefully regulated by the government because they can be
addictive or misused. These include medicines such as opioids (e.g. morphine, codeine),
benzodiazepines (e.g. diazepam, temazepam), Z-drugs (e.g. zopiclone, zolpidem), and certain
stimulants or sedatives.
You can view a full list of controlled drugs here:
List of most commonly encountered drugs currently controlled under the misuse of drugs legislation – GOV.UK

Some patients need these medicines to manage genuine medical conditions. However, because of the risks of dependence and side effects, our practice follows strict prescribing policies.

Our Practice Policy

We aim to provide safe, effective care while protecting patients from the risks of addiction or misuse.

This policy explains how Ealing Park Health Centre manages prescriptions for controlled or potentially addictive drugs.

New Patients

If you are new to our practice and have previously been prescribed benzodiazepines or Z-drugs:

  • We may not issue repeat prescriptions immediately until we receive your medical records and understand your full clinical history.
  • The GP may decide not to continue a previous prescription if it is not considered clinically appropriate.
  • If prescribed, medication will be at the lowest dose for the shortest time necessary, and may differ from your previous prescription.

General Prescribing Standards

  • Your GP will discuss the benefits, risks, and goals of treatment before prescribing any drug of dependence.
  • You may be asked to sign a treatment or withdrawal agreement, outlining what you and the practice will do to ensure safe use of the medication.
  • You nmay also be referred for specialist care if your needs are complex.
  • Abuse or aggressive behaviour towards staff will not be tolerated.

Sedatives for Fear of Flying

We understand that fear of flying can be distressing. However, our practice does not prescribe sedative medications (such as diazepam, chlordiazepoxide, or zopiclone) for this purpose.

This decision is supported by all our GP partners and national medical guidance.

 

Reasons include:

  • Sedatives slow reaction time and alertness, making it dangerous in an emergency on a flight.
  • They increase the risk of Deep Vein Thrombosis (DVT) during long flights.
  • Importing such medicines is illegal in some countries.
  • National guidance advises against using medication for mild or situational anxiety or phobias.
  • Sedatives raise the risk of falls, confusion, and accidents.

We recommend trying recognised fear of flying courses, relaxation techniques, or therapy, which are safer and more effective long term.

If You Are Prescribed a Benzodiazepine or Z-Drug

Your doctor will explain:

  • The medicine is for short-term use only and should be used alongside self-care or therapy.
  • Possible side effects include drowsiness, unsteadiness, poor memory, dependence, and withdrawal symptoms when stopping.
  • Long-term use (more than 4 weeks) can lead to:
  • Tolerance (needing higher doses to get the same effect)
  • Dependence (finding it hard to stop or needing the medication daily)
  • Increased risk of falls, confusion, memory problems, depression, and overdose
  • Mixing with alcohol or other sedatives is dangerous.
  • You must not drive if your alertness is affected.

Older adults are particularly vulnerable to these effects, and in many cases, long-term use can mimic or worsen memory problems.

Issuing and Reviewing Prescriptions

  • New prescriptions for benzodiazepines or Z-drugs will be issued as short-term (acute) prescriptions only.
  • We will aim to keep you under the care of one GP for consistency.
  • We will only continue prescriptions started by another provider after written confirmation and review.
  • Hospital discharges including these drugs will be reviewed by your GP before any further issue.
  • All new prescriptions will be reviewed within 2–4 weeks, and ongoing prescriptions reviewed every 6 months.
  • Maximum issue length is 1 month per prescription.
  • All prescriptions will include clear instructions – no “as needed” (PRN) or vague directions.

 

Lost or Stolen Controlled Drug Prescriptions

If your prescription is lost or stolen:

  1. It must be recorded in your medical notes.
  2. You (or the practice) must report it to the police and obtain a crime number.
  3. The incident will be reported to the Controlled Drug Accountable Officer at cdreporting.co.uk.
  4. The GP will review your record before deciding whether to issue a replacement.
  5. Frequent reports of lost prescriptions may trigger a safeguarding or misuse review.
  6. You may be given a small supply only until a full review takes place.

 

Existing Patients on Long-Term Benzodiazepines or Z-Drugs

If you are already taking these medicines:

  • You will be invited for a review with a GP or pharmacist.
  • We may create a gradual reduction plan to help you stop safely.
  • Prescriptions will continue only as part of this plan, with regular reviews every 6 months.
  • If you repeatedly decline to engage in a review without medical reason, your GP may stop prescribing after consulting a specialist.

 

Key National Guidance

Our policy follows NICE and NHS recommendations:

  • Benzodiazepines and Z-drugs should be used only for short-term severe insomnia or anxiety, for no more than 2–4 weeks.
  • These medications should be avoided for long-term anxiety, depression, or phobias.
  • Alternative treatments such as CBT (Cognitive Behavioural Therapy), sleep hygiene advice, and lifestyle approaches are preferred.
  • Use the lowest effective dose for the shortest time possible.

 

If You Need Support

If you are struggling to stop or reduce medication, we can help. Please ask about:

  • A personalised tapering plan
  • Referral to addiction or mental health support services
  • Advice on non-medication treatments for anxiety or sleep problems

 

Sedation for MRI and CT Scanning

We do not prescribe sedatives (e.g. diazepam) for patients undergoing radiological procedures such as CT or MRI scans.

Rationale

  1. Safety – Sedation must only be provided by trained hospital teams with proper monitoring, resuscitation equipment, and reversal agents.
  2. Risk – Unmonitored sedation has led to serious incidents, including respiratory arrest.
  3. Effectiveness – Low-dose sedatives prescribed in primary care are often ineffective or unpredictable.
  4. Training – GPs are not trained or appraised in providing procedural sedation.
  5. Responsibility – The hospital consultant requesting or performing the scan is best placed to assess and prescribe sedation if required.

Guideline Reference

This approach aligns with Royal College of Radiologists guidance, which states that sedation should be administered only by appropriately trained and equipped teams.

Practice Process

If a patient may need additional support for imaging, this can be noted on the referral form so the radiology team can assess and manage it appropriately.

In Summary

  • Controlled drugs carry risks of addiction and misuse.
  • Our goal is to keep you safe while managing your condition appropriately.
  • Prescriptions will be short-term, regularly reviewed, and only continued when clinically justified.
  • We will work with you to reduce dependence and support your health in the long term.

 

APPENDIX 1

Patient Agreement for Benzodiazepines and Related Medications

 

This agreement explains the risks of taking benzodiazepines and similar medicines, and the responsibilities shared between you (the patient) and your doctor.

Understanding Your Medication

  • I understand that I am being prescribed a controlled drug.
  • My doctor has explained the benefits and risks of this medicine, including:
    • Risk of dependence or addiction
    • Risk of drowsiness and confusion, which may lead to falls, injuries, or road accidents
    • Risk of low mood or depression
    • Risk of breathing problems at night, especially if I have a lung condition such as asthma or COPD

 

How My Prescription Will Be Managed

  • My doctor will only prescribe this medication for a limited time and will always aim for the lowest effective dose for the shortest duration possible.
  • I understand that I will need regular reviews with my doctor before any repeat prescription is issued.
  • I understand that it can be difficult to reduce or stop this medication after long-term use.
    • If needed, I may be referred to a specialist service (such as the local community drug team) for help with reducing or stopping the medication safely.

 

My Responsibilities as a Patient

I agree to the following:

  1. Safe Storage and Security
    • I will keep my medication safe and secure, away from children and vulnerable people.
    • If my medication is lost, damaged, or stolen, I understand that a replacement will not be issued early.
  2. Use as Prescribed
    • I will take my medication exactly as prescribed.
    • I will not request early repeats or additional prescriptions unless advised by my doctor.
    • I will not obtain similar medication (such as other benzodiazepines or sedatives) from any other doctor or service while being prescribed this medication by my GP.
  3. Driving and Safety
    • I understand that this medication can affect my ability to drive safely.
    • I will not drive if I feel sleepy, unsteady, or otherwise impaired.
    • I understand that I may need to inform the DVLA that I am taking this medication.

 

Agreement

By signing below, I confirm that I have read and understood this agreement.
I agree to follow the conditions outlined above and understand that failure to do so may affect future prescribing decisions.

 

Signed………………………………………Print Name………………………………………………………………………Date…………………………

 

References

NHS Choices – Insomnia Treatment

http://www.nhs.uk/conditions/insomnia/pages/treatment.aspx

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Royal College Of Psychiatrists Website – Health Advice – Benzodiazepines

http://www.rcpsych.ac.uk/healthadvice/treatmentswellbeing/benzodiazepines.aspx