All jurisdictions regulate psychoactive substances. Such control is for public health reasons but the evidenced based interaction between public health and social control of controlled drug use can be uncomfortable territory for politicians who set drug policy. This can lead to significantly different implications for patients who travel, but are prescribed a controlled drug in one jurisdiction to which different rules apply in another. Doctors who have a right to practice in more than one jurisdiction will also risk falling foul of the relevant law inadvertently. As doctors are more likely to have access to controlled drugs legally the issue of abuse of such by doctors is likely to be covered by specific regulation and sanction.
International context as relevant to UK
In the UK several drugs and classes of drugs are defined by the medicines acts as controlled drugs. The equivalent legislation in the USA is the Controlled Substances Act. Prescriptions and their BNF entries are marked with CD and varyingly greater control is applied to their use, supply and recording than the general run of prescription only medicines (POM). The most controlled are some of the useful opiates and opioids, and various drugs almost entirely of abuse. Controls are exercised - at least in theory - at national and supranational borders on the passage of such drugs, which in the UK are partly dependent on quantity. Currently patients travelling with small quantities of prescribed controlled drugs need a letter from their doctor about it, and with quantities greater than 28 days worth require a form obtainable from the Home Office for import or export.
In some countries certain drugs are simply forbidden, and even the attempt to import them can be potentially lethal and practically will at least leave the patient without presumed urgently required medicine or a patient/doctor detained at that countries convenience. Information on this is available to travellers from embassies and theoretically travel agents. While it is not the responsibility of any doctor not working in a travel clinic to provide relevant advice, it may be possible to be helpful. Further doctors need to be aware of the issues to avoid such situations, which can arise at an international border from just forgetting to remove to safe CD storage an emergency supply of a CD used in clinical practice.
New psychoactive substances
In most jurisdictions there are attempts to pre-classify new substances that may need to be classified by the relevant legislation. This may help deal with the issue common to all jurisdictions that there is a delay in determining a new substances status while that status is assessed formally. In practice this does not work very well.
CD classification schemes
This can be important for a prescriber to understand.
- ↑ Csete J, Kamarulzaman A, Kazatchkine M, Altice F, Balicki M, Buxton J, Cepeda J, Comfort M, Goosby E, Goulão J, Hart C, Kerr T, Lajous AM, Lewis S, Martin N, Mejía D, Camacho A, Mathieson D, Obot I, Ogunrombi A, Sherman S, Stone J, Vallath N, Vickerman P, Zábranský T, Beyrer C. Public health and international drug policy. Lancet (London, England). 2016 Mar 23.(Epub ahead of print) (Link to article – subscription may be required.)
- ↑ http://www.law.cornell.edu/uscode/html/uscode21/usc_sec_21_00000812----000-.html
- ↑ http://www.justice.gov/dea/pubs/scheduling.html
- ↑ http://www.deadiversion.usdoj.gov/schedules/index.html