What is a Controlled Substance?

In the UK there are certain drugs that require additional monitoring and control from professional medical prescribers. This is because they carry a higher risk of being misused and causing harm. The Office for National Statistics found that in the UK there were 4,561 deaths related to drug poisoning in 2020, which is a continual increase year on year.

Two thirds of the number of these drug-related deaths were a result of drug misuse, with a particularly high proportion being linked to opiates. Methadone is one form of opiate that is classed as a controlled drug in the UK that has been linked to some of these deaths. This is why restrictions are in place that manage how people obtain and use controlled substances. You can find out more about controlled drugs in the UK below.

What is a controlled substance?

A controlled substance is often referred to as a controlled drug. This is because it is a term used to describe chemicals that are turned into drugs. In the UK, the Government controls and regulates the manufacturing, prescription and possession of these drugs to ensure that they do not get into the hands of the wrong people or get abused.

Controlled substances require more advanced looking after than other drugs. The strict controls placed on the substances are for the protection of the end user. This is because they can cause serious harm, or even death, if used incorrectly. As well as this, controlled substances require greater care and attention to their storage, transfer and administering. This is because of the chemical compounds in the drugs.

Many controlled substances must be stored at a certain temperature to enable the drug to work effectively as it should. Not doing so may interrupt the function of the chemicals once consumed by a person, which could cause harm.

Furthermore, many controlled substances cannot be taken home by patients due to the storage issues above. As well as this, another reason people are unable to take controlled substances home is due to how they need to be taken. Prescription medication always has administration guidance included on the packet that is individual to each patient. This also includes the negative side effects that could happen if the medication is taken incorrectly, or if the medication reacts differently in your body.

Due to controlled drugs having a larger impact on the body than regular prescription medication, professionals also take control of the administration process of the drug. This means that, often, people do not get to take the medication home with them to take, and instead must visit a health professional to take their medication.

This can even be the case if people have to take their medication daily. A person will go and visit a health professional every day to take this, rather than be given a longer supply of the controlled drug to take at home.

What are controlled substances used for?

Controlled substances that are legal have a medical use, and the people that control the substance are professionally trained in the medical field. As well as being trained, they must also hold a Government licence that confirms they are able to manage the controlled substances.

The National Institute of Medicine states that the most difficult challenge for any prescriber of a controlled substance is distinguishing between the legitimate prescription of controlled substances versus the prescription potentially used for illegitimate purposes. It is extremely difficult to determine a person’s intended use for controlled substances. Prescribers have the job of identifying the signs, symptoms and treatment of acute and chronic pain, and the signs and symptoms of patients misusing controlled substances.

Doing so assists professional teams by helping develop an awareness of the appropriate dosage to prescribe to patients, and how to control the substance; recognising that patients may be abusing these drugs for non-legitimate purposes.

Different controlled substances are used to treat different medical conditions that a person may be suffering from. Each controlled drug has a different classification which determines what type of health issue it can be used for. This is often classified using the strength of the drug. You can find out more about the classification of controlled substances below.

What is classed as a controlled substance?

Controlled substances include drugs that have a certain chemical compound that makes them too strong to be used without additional control. There are many controlled drugs listed in the UK (which include a mixture of legal and illegal drugs). However, the misuse of any of them can be extremely dangerous as well as against the law.

Some of the more common drugs that you may have heard of are listed below:

• Amphetamines.
• Anabolic steroids.
• Benzodiazepines.
• Cannabis.
• Cocaine.
• Codeine.
• DMT.
• Ecstasy.
• Heroin.
• Methadone.
• Methylene.
• Morphine.
• Opium.
• Tramadol.

You may notice that the list above contains both legal and illegal drugs. We will go into further detail about the legality of controlled substances later.

Are controlled substances addictive?

Controlled substances can be addictive with continued use, which is the reason why they are controlled by the Government. Addiction to a controlled drug begins when you are no longer taking the medication as directed, and are no longer taking the medication to treat the health issue that you initially set out to target.

Abusing controlled drugs leads to negative side effects on the body that can be physical and mental. As well as this, addiction to controlled substances can ruin other areas of your life such as your career, relationships and finances. Despite this, it can be difficult for people with addiction to stop taking the substance because their brain is addicted to how the drug alters its chemicals and functioning.

People can become addicted to a controlled substance when they least expect it. It can develop for a number of reasons that are often linked to lifestyle, trauma or grief. However, whenever you notice that a problem has developed, you should seek support straight away.

The higher the tolerance for a controlled drug and the longer that it is used for, the larger the addiction and the more severe the damage is to the brain. There is always support available for addiction in places such as rehab, that treat any form of addiction no matter what stage this is. Addiction can be a difficult illness to treat, but with the right support, hospital discharge and aftercare in place, regaining control of your life is possible for everybody.

Are controlled substances illegal?

It is illegal to be in possession or supply a controlled drug. This means that doing so without a prescription or a licence is breaching drug laws which would make you liable for sentencing for imprisonment.

Controlled drugs include a mixture of legal and illegal drugs. The legal drugs are what are often referred to as prescription drugs. These are the types of drugs that are used to relieve pain or treat a medical condition. However, they are only classified as a legal drug if you have obtained and used them in accordance with a medical professional.

Sourcing legal drugs yourself off the black market means that you are carrying these drugs illegally, which could lead you to a prison sentence for unauthorised production, supply or possession. Not all prescription drugs are classified as controlled drugs. It is only the prescription drugs that cause greater changes to your body, as these are the greater risk of harm to you.

We have included an example of different classifications of pain relief drugs below:

1. Paracetamol – This is not a controlled drug which means that you can buy it in shops and pharmacies in the UK (as long as you are over 18 years of age). This can often be referred to as an ‘over the counter’ drug.

2. Tramadol – Whilst this is also a form of painkiller, it cannot be bought ‘over the counter’ because it is a lot stronger than paracetamol and has a greater effect on the body. Due to this, it is a controlled drug and can only be obtained with a prescription from a medical professional who will also explain the dosage rules to follow when using the medication. Buying Tramadol from other sources instead of obtaining a prescription for proper use of this drug is illegal.

Illegal drugs are all included in the Home Office’s list of controlled substances in the UK. These drugs are often known as ‘street drugs’, and are banned from being used or supplied in the UK. This means that there is no legal reason to ever be in possession, supplying or using these drugs in the UK.

Some common examples of illegal controlled drugs include ecstasy, cocaine, methamphetamine and cannabis. These drugs are also included in the controlled drugs list for the UK because the Government have control over them to not be used or circulated.

In the UK, controlled drugs are classified under the following guidelines:

• Class A – Possession of a class A drug carries a maximum prison sentence of seven years and an unlimited fine.
• Class B – Possession of a class B drug carries a maximum prison sentence of five years and an unlimited fine.
• Class C – Possession of a class C drug carries a maximum prison sentence of two years and an unlimited fine.

What legislation is there on controlled substances?

Misuse of Drugs Act 1971

In the UK, the Misuse of Drugs Act 1971 includes the full list of controlled drugs under Schedule 2. The purpose of the Act is to list prohibited drugs in the UK, as well as establish the Home Secretary in the drug licensing system.

The drug licensing system in the UK is what enables some controlled drugs to be prescribed by medical professionals under a prescription, and what medicines can be produced by licensed professionals for industrial and medical purposes. More information about the licensing and production of these drugs is included in the Misuse of Drug Regulations 2001.

Controlled Substances Act

The Controlled Substances Act is an American piece of legislation that provides the legal framework for the regulation of certain drugs that pose a risk of being abused. This includes having control over how these drugs are imported and manufactured, along with the possession, distribution and use of the drugs. The Act is broken down into schedules to cover the drugs’ medical use, potential for abuse, and safety or dependence risk.

What are the risk factors of controlled substances?

Although many prescribed controlled medicines are highly effective in treating health conditions, such as anxiety, attention disorders, severe pain, sleeping disorders and obesity, they can also lead to serious health complications. All medication has side effects, but controlled substances usually carry more severe side effects than over-the-counter medicines.

Some risk factors of controlled substances include:

• Heart attack.
• Stroke.
• Hormonal imbalance.
• Memory loss.
• Anxiety.
• Depression and suicidal thoughts.
• Mental health issues such as paranoia and hallucinations.
• Drowsiness.
• Breathing difficulties.
• Behaviour changes.

The side effects listed above can be risk factors for controlled medications even when they are taken as directed by a doctor. The risks increase further when controlled substances are not taken as directed, such as taking them with alcohol or other drugs.

Controlled drugs should not be mixed with other substances because of the high performing chemicals that are included in the drugs. If they are mixed with different chemicals from other drugs or alcohol, it can change how the chemical in the drugs reacts with your body, causing more severe side effects or even death.

It is important that controlled medicines are used safely under the strict instruction of a medical professional. There are many risks associated with controlled drugs, but the drugs also serve a special purpose of treating a medical problem, which professionals argue outweighs the risks when taking the medication.

With proper use, they are extremely helpful drugs that can transform a person’s life by reducing pain, settling mental health symptoms, supporting the weaning off of illicit drugs, and minimising sleep problems. When the control measures are properly followed, serious problems like addiction and drug abuse can be minimised, and the controlled drugs can be used safely to help people in need.