In the circumstances it is my statutory to report to you: heard evidence from representing the West Timperley Medical Centre: He acknowledged that the known side effects of both pregabalin and oxycodone, both individually and concomitantly, presented risk of having depressive effect on the respiratory system_ He also acknowledged that Ms Chapman'$ COPD represented an underlying compromise of her respiratory system. The evidence heard from the records held at the medical centre did not reveal the extent to which enquiry was made of Ms Chapman as to her current misuse of illicit drugs either on the occasion of her re joining the medical practice as a patient in July 2018 or at subsequent consultations. There were clear signs of a dependence on the prescribed opiate drugs and the medical records equally revealed long-term illicit opiate misuse_
3. The evidence heard from the medical records held at the medical centre did not reveal, beyond the admitted dependence on the prescribed medication, what enquiry had been made from Ms Chapman in relation to her continued misuse of illicit or her response to those enquiries: In the absence of that information, it was not possible, from the medical records, to ascertain what level of risk the continued illicit misuse of opiates posed to Ms Chapman and therefore, whether, on an informed basis, pregabalin and oxycodone were appropriate prescriptions 5 . Furthermore, the evidence did not reveal any system in place at the West Timperley Medical Centre to ensure that the information about illicit misuse is obtained and recorded from patients in order to ensure that an informed assessment of the risks of the concomitant use prescribed and illicit drugs could be made and reviewed: