Ir Med J. 2012 Jun;105(6):187-8
Sir,


We report an observational study involving an anonymous postal questionnaire that asked all general practitioners in the HSE West region (n=216) to self-report their habits with regards to their storage of schedule 2 controlled drugs and keeping of a controlled drug register. Possession of schedule 2 controlled drugs is permitted in the Irish general practice setting in accordance with the Misuse of Drugs Acts^1-3, provided they are kept in a locked store and a controlled drug register is maintained. There was a response rate of 55.1% (n=119). Results from respondents showed that 70.6% kept controlled drugs on their premises. Of those who kept controlled drugs, 28.6% kept a controlled drug register, 67.9% kept their controlled drugs in a locked store and 27.4% kept their controlled drugs in a locked store and also kept a controlled drug register.

Morphine was the commonest controlled drug for doctors have stored in their surgery (80%), followed by oxycodone (17%) and then pethidine (9%). Unsurprisingly, doctors were most likely to store controlled drugs in their surgery if they were in a rural setting (86.5%). This probably reflects the perceived increased need for availability of opioids when there is a further distance from a hospital setting. However, rural practices were no more likely than urban or mixed practices to keep their drugs in a locked store. Whether a doctor was single handed or a group practitioner did not appear to influence the decision to store controlled drugs in the surgery or not, though single handed practices were more likely to keep their drugs in a locked store. An unexpected finding was that less than a third of those who keep controlled drugs had a register to account for these drugs.  Female doctors were nearly twice as likely to keep a register than male doctors (43% v's 23%). 34% of rural, 32% of urban and 18% of mixed practices kept a controlled drug register. 32% of single-handed practitioners and 26% of group practitioners kept a controlled drug register.

According to the Primary Care Unit for the HSE West the study population appears to be typical of the actual HSE West general practitioner population. There were significantly more men (n=84) involved in the study than women (n=35). This reflects the current manpower situation in the HSE West. A balanced return of questionnaires came from rural, urban and mixed practices and this should reduce location of the surgery as a confounding factor in the rates of possession of controlled drugs. The study population also appears to be representative of the nationwide general practitioner population according to 2011 figures from the ICGP library and a study performed on demographics of general practitioners in Ireland in 2005⁴. Our study was anonymous to encourage truth telling by participants. However, it was a self-reporting questionnaire which limits its credibility. In conclusion, our study suggests that, 72.6% of the study population is non-compliant with the legislation despite the risk of fine or imprisonment.
M Carroll¹, R O’Connor^2
1The Surgery, Cooleevin, Dublin Rd, Roscrea, Co Tipperary
²Mid-Western GP Training Scheme, University of Limerick, Limerick
Acknowledgements
Ms Tina Carroll, Administrator Mid-Western GP Scheme, for printing and postage of questionnaires 
References 
1. Office of the Attorney General, Ireland. Misuse of Drugs Act 1977. Cited 16/05/2011. Available from: http://www.irishstatutebook.ie/1977/en/act/pub/0012/index.html
2. Office of the Attorney General, Ireland. Misuse of Drugs Act 1984. Cited 16/05/2011. Available from: http://www.irishstatutebook.ie/1984/en/act/pub/0018/index.html
3. Office of the Attorney General, Ireland. Misuse of Drugs Regulations 1988. Cited 16/05/2011. Available from: http://www.irishstatutebook.ie/1988/en/si/0328.html
4. O’Dowd T. Kelly M. O’Kelly F. Structure of General Practice in Ireland 1982-2005. Cited 18/05/2011. Available from: http://www.medicine.tcd.ie/public_health_primary_care/assets/pdf/reports/GP_Structure.p