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Our report, the safer management of controlled drugs 2025, highlights our oversight activity under the Controlled Drugs (Supervision of Management and Use) Regulations 2013.

We are responsible for making sure that health and care service providers, and other regulators, maintain a safe environment for the management and use of controlled drugs in England.

The 2025 report includes key findings from our inspections under the Health and Social Care Act, our work with local controlled drug intelligence networks led by NHS England, and our leadership of the Controlled Drugs National Group and cross-border prescribing subgroup to strengthen collaboration between the UK nations on the safe management and oversight of controlled drugs.

Overall prescribing of controlled drugs in 2025

NHS primary care

Total controlled drug items prescribed decreased slightly in 2025 by 0.3%:

• 73,969,896 items in 2025
• 74,160,671 items in 2024

The cost of this was £585,504,082, compared with 2024 (£585,671,333).

The largest increases were associated with medicines that are licensed to treat attention deficit hyperactivity disorder (ADHD), such as dexamfetamine, lisdexamfetamine and methylphenidate.

Independent primary care

Total controlled drug items prescribed privately across services in Schedules 2 and 3 in 2025 increased by 346,355 (64%):

• 886,582 items in 2025
• 540,227 items in 2024

Since 2021 this upward trend is influenced by the prescribing of Schedule 2 controlled drugs licensed to treat ADHD. This is most likely due to lack of access to NHS mental health services and increased awareness of the condition.

Cannabis-based products for medicinal use (CBPMs)

These are Schedule 2 controlled drugs under the Misuse of Drugs Regulations 2001.Private prescribing of unlicensed schedule 2 CBPMs increased steeply in 2024/25 by 134%:

• 833,525 items were prescribed from 1 April 2024 to 31 March 2025
• 356,335 items were prescribed from 1 April 2023 to 31 March 2024

Services prescribing CBPMs are evolving rapidly and have used independent non-medical prescribers for some time. However, we are aware that some are using supplementary prescribers (non-medical healthcare professionals).

Medicines for attention deficit hyperactivity disorder (ADHD)

The volume of NHS and private prescribing of medicines licensed for ADHD continued to increase in 2025.

NHS prescribing of ADHD medicines:

• lisdexamfetamine increased by 57%
• dexamfetamine increased by 34%
• methylphenidate increased by 11%.

Independent prescribing of ADHD medicines:

• lisdexamfetamine increased by 98%
• dexamfetamine increased by 51%
• methylphenidate increased by 41%

The report highlights concerns that young people who require treatment for ADHD who are transitioning from children’s to adult services can have poor experiences around support with their medicines, and that poor communication between the private sector and NHS services can negatively affect ongoing monitoring of patients who are prescribed medicines for ADHD.

Using our oversight, the report makes recommendations for action to improve the safe management of controlled drugs for both national bodies and government, and for health and care providers, including:

• the need for healthcare professionals who offer diagnosis and treatment for ADHD to work within their scope of practice and areas of competence when prescribing ADHD medicines
• the vital importance of full and complete information before prescribing CBPMs, and effective communication between all relevant services and healthcare professionals about:
  • episodes of care
  • prescribing scrutiny
  • the role and operation of the multi-disciplinary team
  • ongoing oversight of care and prescribing
• the need to provide effective support for newly qualified pharmacists, who will be independent prescribers.