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The Directorate of Health

Guidelines on physicians' good practices when prescribing addictive drugs

24th June 2024

In June 2023, the Directorate of Health published updated Guidelines on good practice for physicians when prescribing addictive drugs. The guidelines are now being republished, with a slightly changed introduction. The Directorate of Health reminds physicians once again of these guidelines, which were first published in 2017.

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It is important to reaffirm the importance of physicians always using the Prescription Medicines Register and the Central Medicine Card when prescribing and reviewing patients’ medications. Prescriptions that have not been dispensed must be reviewed and voided if applicable. This applies to all medicines, but especially addictive drugs. See the Regulation on prescriptions and the supply of medicines, No. 740/2020 (Icelandic). If there is a valid prescription in the prescription portal for addictive drugs, it is not permitted to prepare another prescription, unless:

  • A different strength of the drug, a different pharmaceutical form, or a drug with a different active ingredient is prescribed.

  • The existing prescription is invalidated

The prescribing physician in each case is responsible for ensuring that this is done.

The physician decides which drug is used and gives instructions about its use. The physician critically assesses, based on the best knowledge, which drugs an individual needs and in what doses and regularly reviews medication use. A physician is, therefore, obliged to refuse prescriptions that they consider to conflict with good medical practice.

Prescriptions of high-risk medicinal products should be in the hands of the treating physician or in consultation with the physician. Particularly in the case of addictive drugs, where a patient has received higher doses than stipulated - or drugs that should not be used concurrently.

Medical students with temporary licenses are not authorised to prescribe drugs subject to control. They may not prescribe addictive drugs unless in consultation with a physician, provided that the physician has a valid medical license. Doctors responsible for medical students with temporary licenses must enforce these rules.

Further information
Kjartan Hreinn Njálsson, assistant to the Medical Director of Health
kjartan.h.njalsson@landlaeknir.is