BtM prescription for strictly monitored drugs
Germany
In addition to normal health insurance prescriptions and private prescriptions, a doctor can also issue a narcotic prescription – or BtM prescription for short. It is intended for the prescription of so-called narcotics.
These are mainly drugs that are addictive or can be misused. These are often active ingredients with particularly strong addictive or mind-altering effects.
These include, for example, strong painkillers from the opioid group (such as morphine, fentanyl), which are administered for tumor pain or severe acute or chronic non-tumor pain. Benzodiazepines (sleeping pills), amphetamines (stimulants), hallucinogens (e.g. LSD) and medicinal drugs (such as coca leaves, cath and opium) are also classified as narcotics.
Not all narcotics listed in the Narcotics Act (BtM Act) can be prescribed. The law distinguishes between substances that can and cannot be prescribed.
Physicians may only prescribe narcotics if their use on humans is justified and the intended purpose cannot be achieved in any other way, for example by means of medicines that are not subject to the Narcotic Drugs Act (BtM Act).
Austria
In Austria, the dispensing of potentially addictive drugs works in a similar way. However, the term “addictive poisons” is used for narcotics – the corresponding prescription is therefore the Suchtgift prescription and the underlying law is the Narcotic Substances Act (SMG).
In Austria, prescriptions for narcotic drugs can be identified by the so-called “Suchtgiftvignette” (narcotic drug vignette), which is requested by doctors from the district authorities in the provinces and from a central office in Vienna. Physicians must adhere to certain regulations for the information on the prescription.
Switzerland
In Switzerland, the prescription and marketing of narcotics is also strictly regulated by the Swiss Narcotics Law (BetmG). BtM prescriptions in Switzerland are requested by physicians on a person-by-person basis via the cantonal health authorities.
What is written on the BtM prescription?
Germany
In Germany, the BtM prescription is an official form in three parts, consisting of a yellow cover sheet and two carbon copies. Part III remains with the physician for archiving, Part II is sent by the pharmacy to the health insurance company for billing or, in the case of a private patient, is handed back with a receipt. Part I remains in the pharmacy for documentation.
Instructions for use (individual and daily dose) are also mandatory, or the note “According to written instructions” if the doctor gives the patient a separate slip of paper with instructions for use.
In addition, special markings such as “S” for substitution drugs can be found on the BtM prescription. This would include methadone as a drug substitute for opiate-dependent patients (for example, heroin addicts).
In addition, the name, address (including telephone number) and signature of the physician must appear on the narcotic prescription.
New BtM prescriptions have been available since March 2013. In contrast to old prescriptions, they bear a consecutive, nine-digit prescription number that allows them to be clearly assigned to the prescribing physician.
Austria
The narcotic prescription in Austria is basically a conventional cash prescription that becomes a narcotic prescription when the narcotic vignette is affixed. The physician must note both the quantity and the strength of the drug in writing and specify precise instructions for use (e.g., “twice daily at intervals of twelve hours” and not “if pain” or “as needed”).
Switzerland
Prescription forms for the prescription of narcotics were adapted in Switzerland in 2017. The new form is now trilingual (German, French, Italian) and includes several features such as a barcode next to the prescription number (for easier verification) and a security mark as copy protection.
Furthermore, only two narcotic-containing drugs can now be prescribed on the same form.
Redeeming a BtM prescription
In Germany, Austria and Switzerland, there is no difference between filling a BtM or narcotic prescription and filling a normal prescription. The patient presents the prescription at the pharmacy and receives the drug in question in return.
BtM prescription: Validity
In Germany, a BtM prescription may generally be filled at the pharmacy up to the 8th day (including the date of issue). After that, it is no longer valid.
In Austria, narcotic prescriptions must be obtained from a pharmacy within 14 days. After that, the prescription loses its validity.
In Switzerland, the validity of BtM prescriptions is one month from the date of issue.
