Long-term care facilities often manage and distribute medications that fall under the classification of “Schedule II” controlled substances. Some of those medications include hydromorphone, oxycodone, methadone, meperidine, opium, codeine, morphine and fentanyl.
This classification of substances is regulated by the federal Drug Enforcement Agency (DEA) and the drugs included can only be used for limited medical purposes, with a prescription. Included in those use regulations are strict guidelines related to the proper disposal of abandoned prescriptions for controlled substance medications.
At UnitedRX, we embrace a practice of allowing our long-term care partners to return unused medications. The practice allows for cost savings and avoids unnecessary waste. And, we’re happy to do it.
But that practice does not extend to controlled substances. The DEA does not allow it, for us or for any pharmacy. The responsibility for the proper disposal of abandoned prescriptions for controlled substances falls to the long-term care facility — be it a prison, an assisted living community or a skilled nursing facility.
Improper disposal has a number of consequences, from environmental hazards to accidental poisoning to creating opportunities for abuse. Misuse of prescriptions for controlled substances is a serious problem, as the U.S. Department of Health and Human Services reports millions of people misuse prescription medication every year.
Here are few key points from the DEA regarding proper disposal of controlled substance prescriptions.
Those who can lawfully dispose. The DEA has designated three groups of people who are lawfully permitted to dispose of prescribed controlled substances. Those groups include:
- An ultimate user, who lawfully obtained the medication.
- Someone lawfully entitled to dispose of a decedent’s property in the event of a death.
- Long-term care facilities on behalf of residents or former residents.
Be careful. It is important to be mindful of personal safety and the safety of staff and residents while disposing of abandoned prescription controlled substances. The DEA advises that counterfeit medications can appear as legitimate prescriptions and anyone handling or disposing of medications should use “extreme care.”
Details matter. Clinics, hospitals and facilities often have their own procedures in place for the disposal of controlled substances, which must align with local, state, tribal and federal regulations. And in addition to process, record keeping is essential in the event of an audit.
Implement a program that works. According to the National Center for Biotechnology Information, cited by the National Institutes of Health, the U.S. lacks a uniform protocol for handling and disposing of controlled substance waste — although incineration is ideal to avoid diversion. Since not all facilities have access to incineration for abandoned prescriptions, it’s vital for every organization to have a system in place.
Ultimately, according to the DEA, controlled substances must be disposed of in a way that makes the medication “non-retrievable,” which means their physical and chemical composition or structure is changed to a degree that it is no longer usable. That method of achieving “non-retrievable” status may vary from facility to facility as local and state regulations introduce varying expectations and protocols. However, UnitedRX offers clients products that meet governmental regulations and make medications non-retrievable, such as drug disposal systems.
At UnitedRX, we deliver a hometown pharmacy experience to more than 400 clients across the country. Contact us to learn more about how our approach to treatment can meet the pharmacy needs of your long-term care facility.