As a vet, you must follow legal requirements when working with controlled drugs in veterinary medicine.
The Misuse of Drugs Regulations (MDR) 2001 and the Misuse of Drugs Regulations (Northern Ireland) (MDR(NI)) 2002 define what substances are controlled drugs (CDs).
The Veterinary Medicines Regulations (VMR) set out the requirements on using veterinary medicines including those that contain CDs.
The destruction and disposal of CDs are subject to the Waste Management Licensing Regulations 1994.
View the relevant exemptions:
Recording use and wastage of multi-dose preparations containing Schedule 2 CDs
Drugs listed under Schedule 2 of the MDR are subject to strict controls on prescribing, storing, destroying and record keeping.
You must avoid having discrepancies between the amounts recorded as used, the volume of product left in the vial and the total stated volume.
The filling volume of a product is set and checked to ensure that it is as stated on the label on the vial. There is minimal variation in fill volume of the product.
Once the product is in use, there will be some wastage within the needle and hub of the syringe each time the product is withdrawn. If numerous doses are withdrawn, there will be considerably more product lost to this ‘dead space’ than if fewer doses are given. It is not possible to quantify exactly how much product might be wasted in the syringe hub and needle. There are international manufacturing standards which specify the maximum amount of ‘dead space’ that is permitted in needles and syringes of different sizes and gauges. You can obtain this information from manufacturers or wholesalers. In general, the smaller the gauge of needle or size of syringe, the less wastage that will occur.
Some vets use insulin syringes to minimise wastage. This is acceptable although it is important to ensure that the syringe allows accurate measurement of the dose in millilitres.
Other potential factors that may increase wastage are:
- the use of a separate, larger bore needle to withdraw the product from the vial before changing to a smaller needle to administer the product
- the process of expelling air from the syringe prior to injection
Minimise wastage and record it
You must carefully select the injection equipment and use good technique to reduce wastage due to dead space in syringes. You must record the volume (dose) withdrawn on each occasion and write off the vial as unusable (destroyed) in the register once there is no useable volume remaining.
View theto check the procedure for recording use of CDs.
Compliance with legislation
The Home Office and the VMD or Royal College of Veterinary Surgeons Practice Standards Inspectors who inspect veterinary premises are aware that some wastage will be unavoidable even after all steps are taken to minimise this. The recording of small discrepancies that can be explained by wastage due to dead space is not considered a breach of the legislation provided that Inspectors are satisfied appropriate measures are in place to comply with the requirements of the misuse of drugs regulations.
Controlled drug liaison officers (CDLOs)
All police forces in England, Wales and Scotland have CDLOs who offer advice on safe storage, auditing, destruction, suspicious activity, internal thefts, forged or stolen prescriptions, as well as ‘current crime trends’. Contact details for officers in your area can be obtained from the Association of Police Controlled Drugs Liaison Officers.