Misuse of Drugs (Miscellaneous Amendments) (Jersey) Law 1978: Law Drafting Instructions

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A decision made on 25 August 2020

Decision Reference: MD-HSS-2020-0061
Decision Summary Title :	Misuse of Drugs (Jersey) Law 1978 – Miscellaneous Amendments: Law Drafting Instructions		Date of Decision Summary:	13 August 2020
Decision Summary Author:	Chief Pharmacist		Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:
Written Report Title :	Misuse of Drugs (Jersey) Law 1978 – Miscellaneous Amendments: Law Drafting Instructions		Date of Written Report:	13 August 2020
Written Report Author:	Chief Pharmacist		Written Report : Public or Exempt? (State clauses from Code of Practice booklet)	Public
Subject: Misuse of Drugs (Jersey) Law 1978 - Miscellaneous amendments
Decision(s): The Minister endorsed the recommendations of the Misuse of Drugs Advisory Council and accordingly determined that amendments to the Misuse of Drugs (Jersey) Law 1978 should be prepared.
Reason(s) for Decision: The Misuse of Drugs Advisory Council has recommended a number of changes to the Misuse of Drugs (Jersey) Law 1978.
Resource Implications: None
Action required: The Principal Legislative Drafter to be requested to prepare the necessary amendments on the basis of a drafting brief to be provided by the Chief Pharmacist.
Signature:		Position:
Date Signed:		Date of Decision (If different from Date Signed):

Misuse of Drugs (Miscellaneous Amendments) (Jersey) Law 1978: Law Drafting Instructions

GOVERNMENT OF JERSEY

HEALTH AND COMMUNITY SERVICES DEPRTMENT

Misuse of Drugs (Jersey) Law 1978 – Miscellaneous Amendments: Law Drafting Instructions

Issue

The Minster is requested to consider a number of recommendations from the Misuse of Drugs advisory Council (MDAC) for amendments to the Misuse of Drugs (Jersey) Law 1978

Introduction

The Misuse of Drugs Advisory Council (MDAC) is established in accordance with Article 2 of the Misuse of Drugs (Jersey) Law 1978 and has a duty to advise the Minister on measures, which in its opinion, should be taken to prevent the misuse of drugs and/or to deal with the social problems connected with drug abuse.

Removal of Cannabis and related substances from the Misuse of Drugs (Designation) (Jersey) Order 1989

3.1. Cannabis and Cannabis Resin are controlled as Class B Controlled Drugs under the provisions of the Misuse of Drugs (Jersey) Law 1978 with cannabinol and cannabinol derivatives controlled as Class A substances. All these substances are further controlled under the provisions of the Misuse of Drugs (Designation) (Jersey) Order 1989 (the 1989 Order) and as Schedule 1 substances under the provisions of the Misuse of Drugs (General Provisions) (Jersey) Order 2009 (the 2009 Order).

3.2. Substances placed under the control of the 1989 Order, the highest level of control, are substances for which there is generally accepted to be no therapeutic use and for which it is in the public interest that any use should only be for the purposes of research or other special purposes. Any such limited activity in relation to substances controlled by the 1989 Order must be under the authority of a licence issued by the Minister for Health and Social Services.

3.3. Any activity in relation the Schedule 1 substances must again only be under the authority of a licence issued by the Health Minister, but such licenses are not necessarily restricted to research or other special purposes unless the substance is also controlled under the 1989 Order.

3.4. Limited exemptions from these levels of control were introduced in order to enable doctors to prescribe cannabis-based products for medicinal use (CBPM) on 1st January 2019. Since then interest in the use of cannabis-based products for medicinal use has increased with emerging evidence of therapeutic benefits in some conditions.

3.5. At a recent meeting the MDAC concluded that keeping cannabis and related substances under the control of the 1989 Order was no longer consistent with the increasing evidence for use for medical purposes. The MDAC further concluded that these substances should remain Schedule 1 substances under the provisions of the 2009 Order such that any activity in relation to these substances must be authorised by licence issued by the Health Minister.

Amendment to the definition of cannabis-based product for medicinal use

4.1. The current definition for a cannabis-based product for medicinal use (CBPM), which placed these products in Schedule 2 to the 2009 Order, differs slightly to that used in the UK.

4.2. The MDAC concluded that it would be reasonable to adopt the UK definition of a CBPM in order to provide consistency between jurisdictions and recommended that the UK definition be adopted

4.3. Adopting the UK definition does not alter any other provisions in relation to CBPMs such as who may lawfully prescribe these products.

4.4. The proposed definition to be adopted is:

“cannabis-based product for medicinal use in humans” means a preparation or other product which –

(a) is or contains cannabis, cannabis resin, cannabinol or a cannabinol derivative (not being dronabinol or its stereoisomers);

(b) is produced for medicinal use in humans; and –

a medicinal product, or
a substance or preparation for use as an ingredient of, or in the production of an ingredient of, a medicinal product

“medicinal product” has the same meaning as in Article 2 of the Medicines (Jersey) Law 1995 and which is manufactured in compliance with the principles and guidelines of good manufacturing practice laid down by Commission Directive 2003/94/EC of 8 October 2003 laying down the principles and guidelines of good manufacturing practice in respect of medicinal products for human use and investigational medicinal products for human use (OJ L 262, 14.10.2003, p. 22) as amended from time to time

Non-Medical prescribing of controlled drugs

5.1. The concept of non-medical prescribing is now widely accepted and is one which has evolved in Jersey over the last few years. While recent amendments to the Medicines (Jersey) Law 1995 provide for independent prescribing of prescription only medicines by additional healthcare professionals, the current provisions of the Misuse of Drugs Law would maintain the prohibition on the prescribing of controlled drugs

5.2. The prescribing of controlled drugs is currently restricted to doctors, dentists, veterinary surgeons or nurse independent prescribers under the provisions of the Misuse of Drugs (General Provisions) (Jersey) Order 2009 (the 2009 Order).

5.3. The Medicines (Prescription Only) (Jersey) Order 1997 (the 1997 Order) was amended on 15th October 2019 by the Medicines (Prescription Only) (Amendment No. 9) (Jersey) Order 2019 to provide for non-medical prescribing by additional healthcare professionals. These amendments bring Jersey legislation regarding prescribing of medicines into line with that of the UK where non-medical prescribing by a range of healthcare professionals has been in existence for several years

5.4. The amendment to the 1997 Order restricted the range of prescription only medicines which are also classified controlled drugs that could be prescribed by certain professions.

5.5. Corresponding amendments are now required to the 2009 Order to lawfully enable the new non-medical prescribing professions to prescribe the specified controlled drugs

5.6. The amendments which are now required to the 2009 Order can be summarised as

5.6.1. Pharmacist Independent Prescribers should be able to prescribe all controlled drugs listed in Schedules 2 to 5 of the 2009 Order

5.6.2. Paramedic Independent Prescribers should be able to prescribe the following controlled drugs only – codeine, fentanyl, midazolam and morphine

5.6.3. Physiotherapist Independent Prescribers should only be able to prescribe the following controlled drugs – dihydrocodeine, fentanyl, morphine, oxycodone and temazepam

5.6.4. Podiatrist Independent Prescribers should lonely be able to prescribe dihydrocodeine and temazepam

5.6.5. Therapeutic Radiographer Independent Prescribers should be able to prescribe codeine, fentanyl, midazolam, morphine, oxycodone, temazepam and tramadol

5.6.6. Article 5 of the 2009 Order will also need to be amended to enable the administration of controlled drugs prescribed by, or in accordance with the directions of, these healthcare professionals.

5.6.7. Article 6(2A) and (2B) the 2009 Order will need to be amended to enable these prescribers to compound the relevant controlled drugs for the purposes of administration or for others do so when acting in accordance with the written directions of such a prescriber

5.7. The MDAC recommended that the above amendments should be made.

Provisions as to supply on prescription

6.1. Article 17(2)(b) of the 2009 Order requires that the address of the person issuing a prescription for a controlled drug must be an address in Jersey

6.2. This prevents pharmacies in Jersey dispensing controlled drug prescriptions for Jersey residents issued by UK clinics following a consultation with the UK clinic.

6.3. The MDAC was of the view that it should be possible for Jersey pharmacies to dispense such prescriptions

6.4. The MDAC therefore recommend that Article 17(2)(b) be amended such that either the address of the person issuing the prescription, or the address of the patient is an address in Jersey

Recommendation

The Minister is requested to approve the above recommendations of the Misuse of Drugs Advisory Council and direct the Chief Pharmacist to prepare a brief for consideration by the Principal Legislative Drafter.