Which drug could be next for the CD cabinet?

listen to ‘Tramadol recommendations’ on Audioboo

BBC News has reported that the Advisory Council on the Misuse of Drugs' chairman, Professor Les Iversen, has recently recommended that the pain relief drug, Tramadol, should be re-classified as a class C drug.

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The drug is often prescribed for moderate to severe pain and acts on the central nervous system. It normally comes in the dosage form as capsules, but can come in tablets and in an effervescent form. In the UK, however, they are normally dispensed as capsules. Its side effects can include an increased heart rate, causing extra pressure on the cardiovascular system, fever and hallucinations.

A potential re-classification could potentially impact on the way pharmacists dispense the drug in future. The ACMD's report on the consideration of tramadol has also suggested that tramadol should fall under schedule III of the Misuse of Drugs Act, meaning that any potential change in the regulations could see pharmacists being legally required to keep the more commonly prescribed synthetic opioid in the CD cabinet. Other drugs that fall under schedule III of the regulations include buprenorphine, phenobarbital and temazepam.

If such a change takes place then that will mark a significant change in the way tramadol is dispensed and pharmacy will witness one of the most radical changes in drug/medicine legislation in many years. It will mean regular trips to the CD cabinet just to dispense the drug in accordance with a prescription because it is being prescribed more and more often. In fact,  But there is evidence to suggest why such a change may take place.

Between 1998 and 2009, the number of deaths caused by use of tramadol rose from just 2 fatalities to 111 - a dramatic rise of 5,550%, over a period of a decade. As terrifying that percentage figure may be, it just goes to illustrate how major this issue has become. It could be linked to the increasing number of times the medicine is prescribed, but this is unclear.

And with major concerns building up constantly about whether the drug is being used appropriately, technically nobody from ACMD can be blamed for suggesting such a legislative move. But in reality, it'll increase the workload and responsibilities of pharmacists and any re-classification of tramadol may open the way for other drugs to be covered by further regulation in the future.