Policy Watch: CQC Publishes Annual Controlled Drugs Report Highlighting Rise in ADHD and Medicinal Cannabis Prescribing

The Care Quality Commission (CQC) has published its annual report, The Safer Management of Controlled Drugs 2025, outlining its oversight of the safe management and use of controlled drugs across England.

Produced under the Controlled Drugs (Supervision of Management and Use) Regulations 2013, the report brings together findings from CQC inspections, intelligence gathered through NHS England’s local controlled drug intelligence networks, and the work of the Controlled Drugs National Group and cross-border prescribing subgroup.

Overall NHS prescribing remains stable

The report shows that prescribing of controlled drugs in NHS primary care remained largely unchanged during 2025, with almost 74 million items prescribed, representing a small decrease of 0.3% compared with 2024. Overall NHS spending on controlled drugs also remained broadly stable.

Significant growth in private prescribing

In contrast, private prescribing of Schedule 2 and Schedule 3 controlled drugs increased substantially during 2025, rising by 64% compared with the previous year.

The CQC says this continuing upward trend has largely been driven by medicines licensed to treat attention deficit hyperactivity disorder (ADHD), which it believes is most likely linked to increased public awareness of ADHD alongside ongoing challenges in accessing NHS mental health services.

ADHD medicines continue to increase

The report identifies continued growth in prescribing of licensed ADHD medicines across both NHS and independent services.

Within the NHS, prescribing increased by:

• Lisdexamfetamine – 57%
• Dexamfetamine – 34%
• Methylphenidate – 11%

Private prescribing also increased significantly:

• Lisdexamfetamine – 98%
• Dexamfetamine – 51%
• Methylphenidate – 41%

The CQC highlights concerns about continuity of care for young people moving from children’s to adult ADHD services and says poor communication between private providers and NHS services can affect the safe monitoring of patients receiving ADHD medicines.

Medicinal cannabis prescribing continues to rise

The report also records a sharp increase in the private prescribing of unlicensed cannabis-based products for medicinal use (CBPMs). Between April 2024 and March 2025, more than 833,000 items were prescribed privately, representing a 134% increase compared with the previous year.

The CQC notes that services providing CBPMs are evolving rapidly and stresses the importance of robust prescribing practices, comprehensive patient information and effective communication between all healthcare professionals involved in a person’s care.

Recommendations for providers

The report sets out a number of recommendations for national organisations, government and health and care providers to strengthen the safe management of controlled drugs. These include ensuring healthcare professionals diagnosing and treating ADHD prescribe only within their competence, improving communication between NHS and independent providers, strengthening oversight of prescribing and multidisciplinary working, and providing effective support for newly qualified pharmacist independent prescribers.

The CQC says these measures are intended to improve patient safety while supporting the safe and effective use of controlled drugs across health and care services.

Stay informed with the stories shaping health and social care.