THE USE OF ‘CONTROLLED DRUGS’ IN GENERAL PRACTICE

Abstract

A survey on the use of ‘Controlled Drugs’ (CD) was carried out, for the first time, in three socio-economic areas in Liverpool. These areas included the city centre, an affluent area and a poorer area. The purpose of this survey was to find out if there were any differences and trends in the use of CD in general practice and to suggest possible explanations for these findings. The average number of dose units of CD dispensed per pharmacy per year was determined by collecting and analysing the records in the CD registers which are kept in randomly selected pharmacies in each area. Over the 6-year period (1971-76) pharmacies in the city centre dispensed two to three times more narcotic analgesics (57,410 doses per pharmacy) than those in the poorer area (22,429 doses per pharmacy) and the affluent area (19,372 doses per pharmacy); Methadone (26,586 doses per pharmacy), diamorphine (5,504 doses per pharmacy) and pethidine (4,754 doses per pharmacy) were the most popular drugs used respectively in these areas. From 1973 to 1976 inclusive, the amounts of central nervous system (CNS) stimulant and hypnotic CD dispensed in pharmacies in the city centre, the affluent area and the poorer area were 28,836, 12,983 and 9,076 doses per pharmacy respectively. In the city centre amphetamine, was dispensed most, followed by methaqualone, phenmetrazine and methylphenidate. However, the rank order for both the affluent and poorer areas was methaqualone, amphetamine, phenmetrazine and methylphenidate. Cocaine, a CNS stimulant, was not dispensed as such because it was used as an ingredient in preparations containing diamorphine or morphine for relieving severe pain. Factors such as drug regulations, prescribing habit of doctors, presence of treatment centres for addicts, socio-economic influence were considered to affect the legal use of CD in the City of Liverpool. The present study may also give, indirectly, valuable information to identify the type of addictive drugs involved in poisoning and suicidal cases. More surveys of this type in big cities should be encouraged.