reducing controlled substances diversion...1 . the hria naa n eani icah i r atri ai arieeeitaa aie...

Reducing Controlled Substances Diversion in Hospitals California Hospital Association Medication Safety Collaborative Committee www.calhospital.org/medication-safety-committee

Introduction The ataahee rae aa i ineieee r aacne aa e ieeiti ai a aaai nr heaa ia tane arin raaee ic inaiae e e i ri a e eitri traai. The erac ein a r eei a ear eieee a ewr k nr arr e iane nhe ieeeee eirc aei aie neahirarty r ai rat aa e e i ri a e eitri a rt a . Aatrii nakei ac icain nr nh i a ewr k ihrcae e eeeanee i a inaiea e zee ien r a raeiiei w nh i nhe r tai zatri nr eiic e nhan nhey a e a ina iee.

Sr e aatrii a e eqc ee y aaw r etcaatri (aie a kee w nh ►) wh ae ir e ay e trre ear eieatrii nr ha e i aaaae. Uat aneayy eaah r tai zatri i eiarii ae r ee eara it a e e i ri a e eitri aaai nhan a rneani aateini r aa ee aa e a r ee i ( .e.y nr nhe exnein n affeani a a r ee ’i a a ny nr a aatae nhe a r eii ri r raacaatri acnhr zee y h i r he a aeiiey r i e iar e ee r kirwi nr ha e eitatee i nhe nheey e e i riy r iea -cie r arin raaee ic inaiaei w nh i nhe r tai zatrin.

Credits The ar nnee nhaiki nhe M iieirna Deaa n ein r Heaanh aie M iieirna Hria naa Aiira an ri aie nhe M iieirna D ct D e i ri Craa n ri1 r ee eara it nhe r t iaa erac ein. W nh nhe ae ii riy nh i erac ein c aei cari nhe wr k aie iaaceei Caa r i a-iaea a tc eaiae.

Committee Representation The ar tee iaaceei ea eieinat ei r o

• Aiira atri r Caa r i a c ie eaee i • Caa r i a Aiira atri r Heaanh aa a tei • Caa r i a Bra e r Pha aay • Caa r i a Deaa n ein r Pc a a Heaanh • Caa r i a Hria naa Aiira atri e e hria naai • Caa r i a Hria naa Patein Sa eny tai zatri • Caa r i a Mee aaa Aiira atri • Caa r i a Sra eny r Heaanh Syine Pha aa ini

1 M iieirna Craa tri e e i a e a inee an www.heaanh.inane. i.ci/aateinia eny/e cte e i ri/.

http://www.calhospital.org/medication-safety-committeehttp://www.health.state.mn.us/patientsafety/drugdiversion/

► ie aanei a aetaa r etcaanr y eqc e ein. Pate 2 r 16 CHA Mee aatri Sa eny Cr tee © Caa r i a Hria naa Aiira atri May 2013

Road Map to Controlled Substance Diversion Prevention Applies to health care professionals, patents, faailies, isitors, and others.

Coaponent Specific Acton(s) Self-Assessaent Checklist

Safety Teaas / Organizatonal Structure

1. tai zatri eeeiei Crin raaee Sc inaiae (CSn D e i ri P e eitri P rt a .

1a. The r tai zatri hai ai ine e ia aa ia y nea i ra ee i ee eara it aie r e iee it nhe CS D e i ri P e eitri P rt a .

1 . The CS D e i ri P e eitri P rt a iaaceei a e eitriy eeneatri aie i eittatri.

1a. The CS D e i ri P e eitri P rt a i e ewee y nhe nea aie caeanee an aeain aiicaaay.

1e. CS D e i ri P e eitri P rt a aha a rii ha e eei eeiteee aie ha e eei tianee aaea raei w nh exaeanatrii r nhe raarw it a eaio

• Mee aaa Snaff

• Pha aay

• c i it

• Seac ny

• Hc ai Reirc aei

• Patein Sa eny/R ik Maiate ein/Cr aa aiae

• Ae i in atri

• etaa (ai ieaeiia yn

• Cr ci aatrii (ai ieaeiia yn

2. Ai r tai zatriaa in canc e i i aaaae nhan icaar ni ai effeat e CS D e i ri P e eitri P rt a .

2a. The r tai zatri hai a eei tianee arr e ianr (in r nhe CS D e i ri P e eitri P rt a .

2 . The arr e ianr (in hai eee aanee t e nr ie e i nh i arr e iatri ciatri.

2a. The r tai zatri hai a nea a eaa ee nr eiarie nr iciaeanee CS e e i ri i ncatrii.

2e. The r tai zatri hai aie etcaa ay e ewi ara a ei aie a raeec ei aee eii it aaa aiaeani r nhe CS cie a raeiiei.

2e. The r tai zatri etcaa ay e ewi ara a ei aie a raeec ei nr aiic e ar aa aiae w nh inane aie eee aa aawi.


3. tai zatri a raat eay araaa r anei w nh araaa aaw ei r ae ein.

3a. The r tai zatri (e.t. ieac nyn hai eitatee araaa aaw ei r ae ein (e.t. arciny ihe ffy ah e r ara aen nr e iacii nhe CS D e i ri P e eitri P rt a aie eina a ih a ar ci aatri in anety ( iaace it ac a an a r nr CS e e i ri i ncatrii.

4. tai zatri caeaai aaa ear tit eqc e eini r e e i ri r arii r CS.

4a. ►The rwie ear ni nr nhe Caa r i a Bra e r Pha aay w nh i nh ny eayi r e iar e y r aiy CS ariieiy iaace it nhe a rcini aie in eitnhi.

4 . ►The DEA et in ain r nhe eei tiee ear ni aiy CS nhee r i ti eaain arii nr nhe DEA w nh i rie ci ieii eay r e iar e y.

4a. ►The r tai zatri raarwi rnhe aaaa aa ae eqc e eini. r exa aaey Mee aa e Crie trii r Pa ta aatri inaneio “A ciei aie arii r arin raaee ic inaiaei cin e ear nee i aaar eaiae w nh aaaa aa ae eee aa aie Snane aawiy nr nhe ie ecaa eiarii ae r nhe aha aaectaaa ie aey aie nr nhe ah e exeact e roae y ai aaa ra ane.”

Access to Inforaaton / Accurate Reportng / Monitoring / Sur eillance / Detecton Systea

1. tai zatri e ewi aie ace ni eae ain eana nhan arcae ie aane arneitaa CS e e i ri.

1a. ►The r tai zatri hai a a raeii nr teie ane arin raaee ic inaiae eana ri a i c rinhay ai i icah ai arin raaee ic inaiae ic e aaaiae ear niy h th cie ear ny CS cie nh rcth ear ni/art-iheeni aie CS “D iari tri aie Ii einr y” iheeni.

2. tai zatri n aaki aie e ewi eaic ei ear eieee y Mee aatri Sa eny Cr tee r rnhe eei tianee t rcai ear tit e eanay nr a Mee aaa Snaff Cr tee.

2a. ►The r tai zatri hai a a raeii i aaaae nr e ew aie aiaayze CS eana ri a etcaa ai i.

2 . ►The r tai zatri iha ei eie iti r nhe eana aiaayi i ri a etcaa ai i.

2a. ►The e i a a raeii i aaaae nr aat ane a eiariie nea nhan iaaceei a aatein aa e aiate y aha aayy Hc ai Reirc aei (HRn aie ieac ny whei e e i ri i iciaeanee.

2e. ►The r tai zatri hai a a raeii i aaaae nr arinaan aaw ei r ae ein whei e e i ri r nhee i iciaeanee.

Facility Expectatons

1. tai zatri ar ci aanei nhe exaeanatri nhan inaff “iaeak ca” whei nhey ear e awa e r ai iice eaanee nr CS e e i ri.

1a. ►Sei r aeaee ih a hai aaea ay ar ci aanee nhan aaa inaff a e nr iaeak ca aie w aa e icaar nee i iaeak it ca whei nhey ear e awa e r arii ae e e i ri.

1 . ►The hria naa n eani icah i r atri ai arieeeitaa aie nakei aaa eairia ae ineai nr a rnean nhe arieeeitaa ny r nhe i r atri aie nhe eeitny r nhe e aaryee c i ih it i r atri.

2. tai zatri eina a ihei caa e iaaric e ara ay.

2a. ►The r tai zatri hai a aaea ay eeeiee caa e iaaric e ara ay aie a raeii nr ar ci aane nr aateini/ a a ei whr a e


affeanee y CS a e eitri e e i ri.

3. The r tai zatri’i HR a aataei icaar n ai effeat e r tai zatri-w ee CS D e i ri P e eitri P rt a .

3a. The r tai zatri hai eina a ihee aie ar ci aanee wayi r inaff nr iaeak ca airiy rciay (e.t. hrn a iey aaae r eaean ri a ic ii rin.

3 . The r tai zatri hai a a raeii i aaaae nr e r e ai aa ee aa et e r aatein aa e.

3a. ►The r tai zatri ariecani a e-e aary ein aakt rcie aheaki r aeiiee Iieeaeieein P aattrie i ( IPin aie e aaryeei.

3e. A art r inaff ahrnrt aahi aie i tianc ei a e a ina iee ai aaa ra ane.

3e. The r tai zatri hai a a raeii nr aiate e aaryee aaaeii nr CS i a t eay aih ri whei ne ianee r n aii e ee.

3 . The r tai zatri hai ee earaee a “ r aacie” ara ay r e ct neitit.

4. tai zatri erei irn aaarw iha it r aaii areei.

4a. ►The r tai zatri eina a ihei aie ei r aei a ara ay r irn iha it aaii areei icah ai eaean ri a ee aaa ear e (EMRny Acnr anee D in ctri Maah ie2 (ADMn aie aha aay err areei.

Educaton Staa (and Patentss

1. tai zatri hai i aaaae ai effeat e aie ar a eheii e n a i it aie eecaatri a rt a r aaa inaff ri CS e e i ri a e eitri.

1a. The CS D e i ri P e eitri P rt a nea hai ateieee CS e e i ri a e eitri aie inancnr y eqc e eini n a i it (e.t. atriaa Aiira atri r D ct D e i ri Ii eittanr i [ ADDI]y a r eii riaa aiira atriiy a aeii it ra eiy inaney araaa aie eee aa aaw ei r ae einn.

1 . Exaeanatrii aie icaar tit eecaatri ha e eei iar ar anee inr n a i it r aaa iew inaff aie IPi.

1a. Exaeanatrii aie n a i it iaaceey an a i c y a r e it awa eieii n a i it nr kirw nhe i tii r e e i ri.

1e. Reirc aei a e a a aa ae nr icaar n e aaryeei aie IPiy e.t. E aaryee Aii inaiae P rt a (EAPn aie Heaanh P r eii riaa Se aei P rt a (HPSPn.

1e. The aa a ny eqc ei n a i it ri CS ara a ei aie

2 ADM i a r rta r ar acne zee ee ae i wh ah nhe ee ae ar arieini a e eei tiee nr e in cne e cti i a a aeiiee heaanh aa e aa a ny. A aha aa in i eiarii ae r nhe e ct ein y inr nhe aatein’i a reaey eiaa e ew aie e in ctri r nhe aatein ee aatrii.


a raeec ei a r nr acnhr z it inaff nr ha e CS aaaeii.

1 . The aa a ny a r eei ritr it inaff eecaatri an aeain aiicaaay nr a r rne ia e haiea it r CS aie CS e e i ri awa eieii.

1t. The r tai zatri a r eei aatein eecaatri ri ia e ee aatri haiea ity iaace it arneitaa r e e i ri.

Storage and Security

1. tai zatri inr ei CS aie rnhe h th- ik ne i ieac eayy i aaa ieeiti aie a ac inaiaei.

1a. ►The r tai zatri hai a a raeii i aaaae r ieac it CS (ai eeia ee i ieatri 2 earwn r e e y ieeit aie a ac inaiae.

2. tai zatri hai a a raeii i aaaae r ieac it CS.

2a. e e aea e CS ciateieee.

2 . CS a e inr ee i a arakee araatri (e.t.y ADMy CII3 acan r arakee aa ien/e awe / rxn an aaa t ei.

2a. ADM- aiatee CS a e inr ee i a araatri w nh rie CS-nyae aaaeii. r exa aaey cie i aaiirn ha e aaaeii nr a iearie nyae r CS whei aaaeii it nhe ineieee CS.

2e. Aaaeii nr CS inr ate a eai i a nee nr acnhr zee inaff.

2e. ri-ADM CS aa ieni a e ieac ee w nh a arak it ee ae.

2 . ADM aie iri-ADM aaaeii i e r ee a r anay r ne ianee e aaryeei.

2t. Patein-iaea ea CS i ci rii (e.t.y PCA4y ea ec aay aie ariticrci i ci riin a e eiaariee i a arakee rx.

2h. Keyi a e arin raaee aie aaarcinee r .

2 . P eia atri aaei aie aaae a e inr ee i ADMy arakee araatri r ciee arin ra r ai IP.

2j. aa a ny eei tianei acnhr zee ie ecaai nr r ee a eia atri aaei/aaae e ean r nhe eier r nhe rae atit ci n r aatein aa e a ea.

2k. Eaean ri a aie iri-eaean ri a a eia atrii ar aay w nh inane aie eee aa eqc e eini.

2a. CS rcthn i y a aatein nhan aaiirn e enc iee hr e a e i einr ee y nwr acnhr zee heaanh aa e inaff aie inr ee i

3 Saheecae II arin raaee ic inaiae. 4 Patein-arin raaee aiaatei a.


a arakeey a nee aaaeii a ea.

2 . CS rcthn nr nhe hria naa r cie y nhe aatein ( .e.y Patein’i wi Mee aatrin i ieac eay inr ee aie aaarcinee r ec it nhe hria naa zatri ai weaa ai cari nhe aatein’i e iaha te. In i ear eieee nr ha e a a raeii i aaaae whe e aateini a e arinaanee aee e iaha te nr a ak ca nhe CS i inr ate. CS e a i it i nhe aha aay aie irn a akee ca y nhe aatein aee e iaha te i nr e eein ryee ae nhe hria naa’i ara a ei. P e e a ayy nhe aatein i arinaanee aie aikee nr a ak ca nhe CS.

3. tai zatri ciei aa e a ic e aaaiae i h th- ik a eai ai aaa ra ane.

3a. Ca e a ic e aaaiae i ciee i a a y CS aha aay inr ate a ea (e.t. ia artai acann.

Procureaent 1. tai zatri effeat eay aie ia eay haieaei a rac e ein i nhe hria naa aha aay.

The r tai zatri hai a a raeii i aaaae r a rac it CS nhan iaaceeio

1a. ►I nhe hria naa cta zei nhe arin raaee ic inaiae r ee it iyine (CS Sn5y nhei eaah cie cin ha e nhe rwi aaiiwr e. Paiiwr ei aaiirn e iha ee.

1 . ►Exaace it ae raha aaectaaai6y nhe hria naa aha aay a rac ei aaa CS.

1a. ►Iie ecaai acnhr zee nr r ee CII - CV a e a nee nr nhe DEA et in ain aie acnhr zee ie ecaai. DEA 222 r i a e ieac ee aie aaaeii ae riay nr nheie ie ecaai.

1e. ►Iie ecaai rnhe nhai nhe DEA et in ain acnhr zee nr r ee CS cin ha e a arwe r atr iey ri eae nr exeacne nhe DEA 222 r i ai ae 21C R1305.05.

1e. The ae irii acnhr zee nr r ee CS a e irn nhe ia e ae irii whr eae e nhe CS.

1 . ►Aaa i r aei eae ee a e i tiee aie ha e nhe eane whei nhe ee aatrii we e eae ee.

1t. ► iay a a aeiiee aha aa in r acnhr zee eae it ae iri i tii r nhe arin raaee ic inaiae eea e y.

1h. ►I CS a e eea e ee nr hria naa aein aa eae ity ai

5 Ai eaean ri a DEA 222 a rt a . DEA’i CS S i ai eia yanee eaean ri a arin raaee ic inaiae r ee it iyine enweei a whraeiaae aie nhe DEA a aeiiee’i acnhr zee cie . The DEA’i CS S i nhe a e e ee enhre r CII CS a rac e ein. 6 Cc einayy nhe e i rie CII ae raha aaectaaao DaTiaain (Ire ie I-123 recaaieny a araa ie aiaart ie aanee r in anaa eraa ie n aiiar ne icaa zatri ci it SPECT a i at it nr aii in i nhe e aacatri r aecan aateini w nh iciaeanee Pa k iiri ai iyie r ei.


acnhr zee eae it ae iri i tii r nhe eea e yy aein aa eae it n aii e i CS nr nhe aha aay w nh i rie wr k it eay raarw it eae an y nhe hria naay aie nhei nhe aha aa in ee aneay i einr ei nhe CS.

1 . ►I CS a e eea e ee nr nhe aha aay whei nhe aha aay i aariee aie aha aa in cia a aa aey nhei inr ate r nh i eea e y cin ar aay w nh nhe eqc e eini r Caa r i a Bci ieii aie P r eii rii Cree 4059.5( n.7

1j. ►Aiy e ia eaaiay enweei nhe eae an aie nhe nyae r qcaitny r CS aancaaay eae ee i ear nee nr nhe eea e it whraeiaae r aic aanc e y nhe iexn ci ieii eay aee eea e y.

Prescribing 1. The r tai zatri’i r ee it/ a eia it a aataei i ze nhe ik r CS e e i ri.

1a. ►CS a e a eia ee riay y a aeiiee acnhr zee a eia e i w nh a DEA et in atri r iitnctriaaay aii tiee DEA icox.

1 . ►A aa e r ee r ai acnhr zee a eia e ex ini r aaa CS ae i ine ee.

1a. ►CS a e irn a eia ee y ai acnhr zee a eia e r h /he iea r ee ane a ay e e i.

1e. Patein-iaea ea CS r ee i a e teie anee y eaean ri a iyine i w nh arin raaee aaaeii exaean i e e teia ei i aaar eaiae w nh aaaa aa ae eee aa aie inane aawi aie caei.

1e. Raite r ee i r CS a e i zee.

Preparaton Dispensing

1. The r tai zatri’i a eaa atri aie e iaeii it a aataei i ze nhe ik r CS e e i ri.

1a. ►Ta ae -e eein aaakat it i cta zee r CS a eaa ee y aha aay.8

1 . ►CS n aiiar nee a aiec ata nc e a e iein a ieac ee n aiiaatri.

1a. ►The e cin e a ar-i tianc e r eea e y r CS nr iri-ADM a eai. Drac ein aha i r acinrey.

1e. CS a e e iaeiiee i i itae-ci n-erie aaakat it.9

1e. Seac ey arakeey iri-n aiiaa ein ee aatri eea e y

7 See aaaeie x r B&P 4059.5( n nexn. 8 Ta ae -e eein aaakat it eaii a arina ie w nh i wh ah a e ct i ieaaee ir nhan nhe arineini aaiirn e raeiee w nhrcn r rci eein catri r nhe ieaa. 9 S itae-ci n-erie aaakat it eaii a i itae-ci n arina ie r a taaei ineieee r ae i in atri ai a i itae eriey e ean r nhe arina ie .


aa ni/arina ie i a e ciee nr eea e CS aie aaaeii ae riay y acnhr zee ie ecaai.

1 . ADMi a e cta zee i aatein aa e a eai r nhe e in ctri r CS aie a e ine aaee w nh nhe eaean ri a aatein a reae nr a n aaaeii riay nr ee aatrii r ee ee r a iaea ea aatein.

1t. Rearia a atri i ae r ee ri ADM CS e iaeiie n aiiaatrii r ne ar a y aateini nr eiic e nhan nhe CS wein nr ai aancaa aatein.10

1h. Ba aree iaaii it i cta zee whei eaaei ih it ADMi.

1 . A a ie arcin a raeii i ciee r ia arta acan aie ADM e in cnee CS.11

1j. The ic e r CS ri r e ee inanci i a reae ADMi i i zee (e.t. rie-t e ijeana aei r e e teia ei riayn.

1k. B r en a-ID neahirarty i ciee iineae r aaiiwr ei. I aaiiwr ei a e cieey aaiiwr ei exa e ri a etcaa ine aa.12

1a. ADM erwit e a raeec ei cin e eeeiee nr a ina i nhe arin ray erac einatri aie aaarcina a ny r CS.

Adainistraton 1. The r tai zatri’i CS ae i in atri a aataei i ze nhe ik r CS e e i ri.

1a. The e i a eeeiee t e enweei CS en e aa r inr ate a eai aie t e r ae i in atri aie erac einatri (e.t. w nh i 30 icnei r ADM e r aa r w nh i 30 icnei r nhe eie r nhe a raeec en.

1 . The CS en e ee r a aatein i nhe aaakate i ze eqc aaein nry r nhe aariein a a aa ae nry nhe erie nr e ae i ine ee.

1a. ► iay heaanh aa e a r ee i rae atit w nh i nhe iarae r nhe a aatae ay ae i ine CS.

1e. ►CS a e e r ee r rie aatein an a t e r ADMi aie/r arakee inr ate a eai.

10 r exa aaey a ne ar a y aatein ID ay ha e eei ciee whei CS a e ieeeee i ai e e teiay aie nhe ae ii ri i r atri i irn yen n aii e ee nr nhe ADM. 11 Ba ie arcin i a a raeii cta zee w nh ADM whei eeaa it a arin raaee ic inaiae inr nhe e ct’i ie ecaa araken. The ADM eqceini nhe ae iri eaaei ih it nhe arin raaee ic inaiae nr nhe ADM nr arcin nhe qcaitny i nhe aah ie e r e aee it nhe eeaa. The arcin i nhe araken i irn a eieinee nr nhe ae iri eaaei ih it nhe CS. I nhe arcin eine ee y nhe ae iri eaaei ih it nhe ADM i ar eany nhe ADM w aa aaarw nhe eeaa r nhe arin raaee ic inaiae. 12 r exa aaey nhe ISMP ear eiei ahait it aaiiwr ei e e y 90 eayi r aeii r en a acnheitaatri i irn aair i cie (htao//www. i a.r t/iea aiieii eini/ADC/Sc ey.ae n.

http://www.ismp.org/selfassessments/ADC/Survey.pdf


1e. ►The ie ecaa en e it CS r ADM/arakee inr ate a ea/ rx i aair nhe ae iri nhan ae i ine i nhe ee aatri. The r tai zatri eeeiei exaeatrii (e.t. e e teia ein aie hai a ara ay/a raeii i aaaae nr aiic e aha i r acinrey.

1 . ►Aaa CS a e e awi ca inr iy itei nhany irn ee aneay ae i ine eey a e aa eaee ae iitnctriaa ara ay.

Handling Waste 1. The r tai zatri’i “waine” haiea it a aataei a ina i aha i r acinrey nr i ze nhe ik r CS e e i ri.

Pha aayo

1a. CS waine r Cr arcieee ine ae P recan (CSPn a eaa atri i nhe Pha aay i araaeanee aie aier ay aiiayee.

A eai rcni ee Pha aayo

1 . ►Uicia ae a recan13 (UPn CS a e nr e ee aneay wainee aie w nieiiee y heaanh aa e a r eii riaai ae iaea ea hria naa a raeec ei.

1a. Aaa Prneitaaay Recia ae P recan14 (PRPn e cti a e enc iee nr nhe aha aay r e aacatri r e-cie/ e- iice.

1e. The r tai zatri hai eeiteee nhe h th- ik a eai (e.t. ic t aaay aieinhei ay a raeec aan whe e CS e e i ri raac i.

1e. The r tai zatri hai eeiteee iaea ea h th- ik CS ee aatrii (e.t.y einaiyan nhan a e aier ay aiiayee.

1 . The r tai zatri hai a a raeii nr aier ay r na i aie aiiay UP CS. r aier aiiayiy nhe UP CS wrcae irn e ic jean nr ee ane w nieiiee waine.

2. The r tai zatri’i a aataei r haiea it ciciee CSy e any CS arina ie i r CS enc iee nr aha aay i ze nhe ik r e e i ri.

Wastng of P CSS

2a. ►Aaa r ee enhrei r waitit a CS a e eeeiee ae eee aay inane aie arciny aawi aie etcaatrii.

2 . ►The waitit r aaa CS eqc ei ai ieeaeieein a aeiiee w nieii aie cin e erac einee i nhe ADM r a a rr r cie r y exaean whei UP CS a e enc iee nr aha aay r aiiay.

2a. ►Ai ie ecaa w nieii it CS waitit e eei nhe rac e/a rcin e it wainee anahei nhe erac einatri aie ahyi aaaay wanahei nhe ee aatri e it wainee ae ara ay.

13 UPo Aiy ee aatri nhan ay irn e ciee r a aatein ece nr e nhe nhe inet ny ir arite e it inaan r nhe ee aatri hai exaeee ni exa atri/ eyrie cie eane. 14 PRPo Mee aatrii nhan ha e eei iicee nr a aateiny wh ah ha e irn eei cieey nhe inet ny r icah aaakat it e a ii inaan aie exa atri/ eyrie cie eane aaarw nhe ee aatri nr e e- iicee nr airnhe aatein.


2e. ►E any arina ie i r CS (e.t.y aain a e e iaa eee i a nee aaaeii waine arina ie i.

2e. ►Waine arina ie i w nh n aae UP CS a e ieac ee nr a e ein na ae it.

2 . ►The aha aay aaarcini r aic aanc e r e eaa i ijeana ae arina ie i. Aaa r e eaa a rcini a e aaanc eey e eeey erac eineey aie wainee aaar e itay. Crin raaee ic inaiae r e eaa ihrcae e arii ee ee cicia ae a recan (UPn.

PRP ReturnsS

2t. PRP ADM aiatee CS a e enc iee nr a ieac e enc i i/araken aie irn nr nhe r t iaa ADM araken.

2h. ►Aaa PRP CS enc ii nr aha aay eqc e aha i r acinrey erac einatri i nhe aatein aa e a ea aie i aha aay

Waste or Re erse DistributonS

2 . ►DEA et in ain r nhe eei tiee aii ini w nh aaa ahaiei r n aii e r CS nr a e e ie e in cnr aie/r haza erci waine e iariaa ar aaiy.

2j. Exa ee CS nhan a e qca aitiee r e e ie e in ctri a e a rae ay aaarcinee y way r a art r i einr y a in. The ne i iein aak a e e ie e in ctri arcae e earia aee w nh nhe e e ie e in ctri art r CS.

Monitoring of CS and Process if Di ersion is Suspected

1. tai zatri e r ei aaaeii nr CS e e i ri i iciaeanee.

1a. ►Aaa ae iriiea aatrii (e.t. iciaeii riy ne iatrii aie ei tiatriin a e a r anay ar ci aanee nr aha aay ir aaaeii nr CS aai e e r ee.

1 . ►I nhe hria naa ear ei awa e r ai a ein r ai e aaryee r aa a n cie r CSy nhe hria naa ee aneay ariecani ni rwi i eittatri. The r tai zatri aiieiiei whenhe nr iciaeiey n aii e y ne iane r nake rnhe aatri (e.t.y e r e aaaeii nr CSn ata iin nhe e aaryee.

2. tai zatri etcaa ay ri nr i CS nh rcth i einr yy ear ni aie ace ni.

2a. CS ac ahaie i r aei a e ar aa ee nr CS r ee i aie eae an inr nhe aha aay’i ae aencaa i einr y. Aiy CS ac ahaiei rcni ee r nhe aha aay eeaa n ein a e n aakee. S iae nhe i r ae- eae an aa ay rnh e e r ee w nh CS e e i riy i r aei aair a e earia aee nr inane eini r whraeiaae ac ahaie h inr y ear ni nr eenean ii it i r aei.

2 . Mr e ein r CS nh rcthrcn nhe hria naa i n aakee. r exa aaey ear ni anah ia arta acan n aiiaatrii w nh eae an inr ADM aie/r aaae i einr y ear e w nh R i tianc e r


eae an.

2a. ►CS w nh i ai ADM r ia arta acan a e i einr ee an aeain rinhay.

2e. ri-acnr anee CS inr ate a eai a e i einr ee an eaah ih e ahaite.

2e. ADM ear ni a e e ewee an aeain rinhay y aha aay r aatein aa e aiate i ai eeeiee y nhe r tai zatri. Rear ni ar aa e ADM aat ny w nh ee aatri ae i in atri ear e.

2 . ADM CS aat ny i ar aa ee nr aee i w nh i aa inaoit eiarii a tei aie TE aaar in eini.

2t. T aiiaatri aat ny (e.t. i einr y a ir aa teiy e r aa r qcaittei t eane nhai a eia ee eriey aaiaeaaatriiy enc ii aie wainen i ar aa ee nr aee i.

2h. Patein MARo a rcin aie qcaitny ae i ine eey i ar aa ee nr whan rnhe aa et e i ae i ine ri ic ieqcein ih ei (w nhrcn aatein ahaite i arie trin.

2 . ri-ADM CS inr ate a ea ear e r cie i ar aa ee w nh MAR (e.t. aieinhei a ear ey ieeatri ear ey eMARn nr aiic e aaa ra ane erac einatri r waine.

3. A a raeii i i aaaae nr eira e CS e ia eaaia ei.

3a. ►CS e ia eaaia ei a e eira ee cari e iar e yy ir aane nhai eie r ih e. D ia eaaia ei nhan aaiirn e eira ee a e jr inay e ewee y aha aay aie aatein aa e aeaee ih a w nh eiractri w nh i 24 hrc i (e.t. en ao ci eira ee ic i it ci n CS e ia eaaia ei > 24 hrc i/nrnaa ic i it ci n CS e ia eaaia ei ihrcae e ≤8 ae aeinn.

3 . In i ear eieee nhan a aha aa in earia ae CS e ia eaaia ei i nhe ADMi. ►A aha aa in hai eiarii a ny r nhe e ia eaaiay e ei whei a neahi a ai ae r i nheie ectei.

4. tai zatri a eanei inaiea e a raeii nr i eittane arneitaa e e i ri aaiei.

4a. ►The e i a inaiea e a raeii i aaaae nr i eittane arneitaa e e i ri aaiei.


Selected Legal References15

Federal

21 Code of Federal Regulations Chapter II: Drug Enforcement Administration

Sec. 1301.76 Other security controls for practitioners. (an The et in ain ihaaa irn e aaryy ai ai atein r e aaryee whr hai aaaeii nr arin raaee ic inaiaeiy aiy ae iri whr hai eei ari anee r a eariy rffeiie eaatit nr arin raaee ic inaiaei r whry an aiy t ey hae ai aaaa aatri r et in atri w nh nhe DEA eei eey hae a DEA et in atri e rkee r hai ic eiee ee a DEA et in atri r aacie. r ac ariei r nh i ic ieatriy nhe ne r aaciee eaii a ic eiee i a ec r y r ai a ariieqceiae r y aiy eee aa r inane ae i in at ey a a r a iaa aatri eicatit r ai i eittatri r nhe ie ecaa’i haiea it r arin raaee ic inaiaei.

( n The et in ain ihaaa irt y nhe eae D i ri oae r nhe Ae i in atri i h i a eay i w tity r nhe nhee r i ti eaain arii r aiy arin raaee ic inaiaei w nh i rie ci ieii eay r e iar e y r icah arii r nhee. The et in ain ihaaa aair ar aaeney aie ic n nr nhe eae D i ri oae i h i a eay DEA r 106 eta e it nhe arii r nhee. Whei eene i it whenhe a arii i i ti eaainy a et in ain ihrcae arii ee y a rit rnhe iy nhe raarw it aanr io

(1n The aancaa qcain ny r arin raaee ic inaiaei arin i eaan ri nr nhe nyae r ci ieii; (2n The iaea a arin raaee ic inaiaei arin; (3n Whenhe nhe arii r nhe arin raaee ic inaiaei aai e aiira anee w nh aaaeii nr nhrie arin raaee ic inaiaei y iaea a ie ecaaiy r whenhe nhe arii aai e ann cnee nr ci qce aan n ei nhan ay nake aaaae i ra it nhe arin raaee ic inaiaei; (4n A aanne i r ariiei r e a iaea a n e ae rey whenhe nhe ariiei aaaea nr e aier y aie nhe eicani r e r ni nakei nr eira e nhe ariiei; aiey kirwiy (5n Whenhe nhe iaea a arin raaee ic inaiaei a e a keay aaie eanei r e e i ri; (6n raaa n eiei aie rnhe ie aanr i r nhe e e i ri arnein aa r nhe ii it arin raaee ic inaiae.

Sec. 1301.90 Employee screening procedures. In i nhe ari tri r DEA nhan nhe r na i it r ae na i i r atri y iri-a aattrie i i naa nr a ay aiieii nhe a kea hrre r ai e aaryee ar eit a e ct ieac ny eaah. The ieee nr kirw nh i i r atri i a ate r ci ieii ieaeii nyy eiieitaa nr r e aaa arin raaee ic inaiaei ieac ny. Ii nh i eta ey n i ea e ee nhan ari atri r a ei aie ciacnhr zee cie r arin raaee ic inaiaei a e aat tei nhan a e a rae ic jeani r iqc y. In iy nhe e r ey aiic ee nhan nhe raarw it qceitrii w aa ear e a aa n r ai e aarye ’i ar a eheii e e aaryee ia eei it a rt a o

Questio. W nh i nhe aain e e yea iy ha e yrc eei ari anee r a eariyy r w nh i nhe aain nwr yea iy r aiy iee eair r a e yrc a eieinay r aaay aha tee w nh ar eit a a iaa rffeiies (Dr irn iaacee aiy n aoa raatriiy jc ei ae rffeiiei r a na y ari atriiy exaean y teie aa arc n- a taa.n I nhe aiiwe i yeiy c i ih eena ai r ari atriy rffeiiey araatriy eane aie ieineiae.

Questio. Ii nhe aain nh ee yea iy ha e yrc e e kirw itay ciee aiy ia artaiy a ahena iei r a nc aneiy rnhe nhai nhrie a eia ee nr yrc y a ahyi a ais I nhe aiiwe i yeiy c i ih eena ai.

Advice. Ai acnhr zatriy i w tity nhan aaarwi iqc ei nr e aee r arc ni aie aaw ei r ae ein ateia ei r arii ae aeie it aha tei r ari atrii cin e exeacnee y a ae iri whr i aaarwee nr wr k i ai a ea whe e aaaeii nr arin raaee ic inaiaei aaea ay ex ini. A ae iri cin e ae iee nhan aiy aaie i r atri r r ii ri

15 Th i i irn a ar a eheii e a itit r aaaa aa ae aawi aie etcaatrii.


r i r atri w aa jeraa e ze h i r he ari tri w nh eiaean nr e aary ein. The aaaa aatri r e aary ein ihrcae i r a ae iri nhan i r atri c i ihee r ear e ee ai a eican r aiy iqc y w aa irn ieaeiia ay a eaacee e aary einy cn w aa e arii ee ee ai aa n r ai r e aaa e aacatri r nhe ae iri’i qcaa eaatrii. The a ina i it r a e aary ein a aataeiy nhe a rneatri r nhe ae iri’i thn r a aayy aie nhe aiic aiae nhan nhe eicani r icah iqc ei w aa e n eanee y nhe e aarye i arieeeiae w aa e exaaa iee nr nhe e aaryee.

Sec. 1301.91 Employee responsibility to report drug diversion. Rear ni r e ct e e i ri y eaarw e aaryeei i irn riay a ieaeiia y aa n r ai r e aaa e aaryee ieac ny a rt a cn aair ie ei nhe ac a a ine ein an aa te. In iy nhe e r ey nhe ari tri r DEA nhan ai e aaryee whr hai kirwaeete r e ct e e i ri r h i e aarye y a eaarw e aaryee hai ai r a tatri nr ear n icah i r atri nr a eiarii ae ieac ny roa aa r nhe e aarye . The e aarye ihaaa n ean icah i r atri ai arieeeitaa aie ihaaa nake aaa eairia ae ineai nr a rnean nhe arieeeitaa ny r nhe i r atri aie nhe eeitny r nhe e aaryee c i ih it i r atri. A a ac e nr ear n i r atri r e ct e e i ri w aa e arii ee ee i eene i it nhe eai a ny r aritic it nr aaarw ai e aaryee nr wr k i a e ct ieac ny a ea. The e aarye ihaaa i r aaa e aaryeei ariae i it nh i ara ay.

Sec. 1301.92 Illicit activities by employees. In i nhe ari tri r DEA nhan e aaryeei whr ariieiiy ieaay cie r e e n arin raaee ic inaiaei w aa ic jean nhe iea ei irn riay nr Snane r eee aa a rieactri r aiy aa a n aat nyy cn ihaaa aair ee aneay ear e nhe ic jean r ieeaeieein aatri eta e it nhe ariticee e aary ein. The e aarye w aa aiieii nhe ie rciieii r nhe e aaryee’i raatriy nhe ari tri r eiarii a ny heae y nhe e aaryeey aain ear e r e aary einy ena.y i eene i it whenhe nr iciaeiey n aii e y ne iane r nake rnhe aatri ata iin nhe e aaryee.

Sec. 1301.93 Sources of information for employee checks. DEA ear eiei nhan iqc ei ariae i it e aaryeei’ a iaa ear ei e aee ai raarwio

Lical ioquiries. Iiqc ei ihrcae e aee y ia ey eane aie aaaae r nhy aie rnhe eeit y it i r atriy nr araaa arc ni aie aaw ei r ae ein ateia ei r ear ei r aeie it aha tei aie ari atrii. raaa a aatae ay eqc e icah iqc ei nr e aee i ae iriy anhe nhai y a ay aie a aray r ai acnhr zatri r nhe e aaryee ay e eqc ee y ae na i aaw ei r ae ein ateia ei.

DEA ioquiries. Iiqc ei icaaay it eeit y it i r atri ihrcae aair e c i ihee nr DEA eae D i ri oaei aarit w nh w tei ariiein r nhe ariae iee ie ecaa r a aheak r DEA eaei r ear ei r ari atrii. The Ret riaa aheak w aa eican i a iatriaa aheak e it aee y nhe eae D i ri oae.

42 Code of Federal Regulations, State Operations Manual, Appendix A16

§482.25(a)(3) Current and accurate records must be kept of the receipt and disposition of all scheduled drugs. A-0494

• Rear ei r nhe eae an aie e iari tri r aaa iaheecaee e cti cin e ac ein aie cin e aaac ane. • The hria naa iyine i aaaa ae r eae ay eeit y it arii r e e i ri r aaa arin raaee ic inaiaei i icah a

aiie ai nr i ze nhe t e a e enweei nhe aancaa arii r e e i ri nr nhe t e r eeneatri aie eene iatri r nhe exnein r arii r e e i ri.

• aa a ny ara a ei aie a raeec ei ihrcae i ze iaheecaee e ct e e i ri.

16 Bcaaenee ne i a e r nhe Iine a et e c eea iei r nhan etcaatri.


§482.25(b) In order to provide patient safety, drugs and biologicals must be controlled and distributed in accordance with applicable standards of practice, consistent with Federal and State law. A-500

• D cti aie rart aaai cin e arin raaee aie e in cnee i aaar eaiae w nh aaaa aa ae eee aa aie Snane aawi aie etcaatriiy aie i aaar eaiae w nh aaaa aa ae inaiea ei r a aatae. Aaaa aa ae inaiea ei r a aatae iaacee ar aa aiae w nh aaa eee aa aie Snane aawiy etcaatriiy aie tc eea ieiy ai weaa aiy inaiea ei aie ear eieatrii a r rnee y iatriaaay earti zee a r eii riaa r tai zatrii nhan aaaay nr aha aaectaaa aa e aie nhe arin ra aie e in ctri r e cti aie rart aaai.

• The a raeec ei eina a ihee nr a e ein ciacnhr zee ciate aie e in ctri cin a r ee r ai aaarcitit r nhe eae an aie e iari tri r e cti ic jean nr nhe Cr a eheii e D ct A cie P e eitri aie Crin ra Aan r 1970.

§482.25(b)(2)(i) All drugs and biologicals must be kept in a secure area and locked when appropriate. A-0502 • Aaa arin raaee ic inaiaei cin e arakee.

§482.25(b)(2)(ii) Drugs listed in Schedules II, III, IV and V of the Comprehensive Drug Abuse Prevention and Control Act of 1970 must be kept within a secure area. A-0503

• Aaa Saheecae IIy IIIy IVy aie V e cti cin e kean arakee w nh i a ieac e a ea. A ieac e a ea eaii nhe e cti aie rart aaai a e inr ee i a aiie nr a e ein ci ri nr ee aaaeii y ciacnhr zee ie ecaai.

§482.25(b)(2)(iii) Only authorized personnel may have access to locked areas. A-504 • The hria naa cin aiic e nhan riay acnhr zee ae iriiea ay ha e aaaeii nr arakee a eai whe e e cti aie

rart aaai a e inr ee. • The hria naa’i ara a ei aie a raeec ei cin aair aee eii hrw n a e eini ciacnhr zee ae iriiea r ta i it

aaaeii nr arakee a eai whe e e cti aie rart aaai a e inr ee.

§482.25(b)(7) Abuses and loss of controlled substances must be reported in accordance with applicable Federal and State laws, to the individual responsible for the pharmaceutical service, and to the chief executive of�icer, as appropriate. A-509

• Crin raaee e ct ariiei a e nr e ear nee nr aaa ra ane acnhr tei i aaar eaiae w nh Snane aie eee aa aawi.

State of California

Business and Professions Code 4059.5

(an Exaean ai rnhe w ie a r eee i nh i ahaane y eaite rci e cti r eaite rci ee aei ay riay e r ee ee y ai eitny a aeiiee y nhe ra e aie ihaaa e eea e ee nr nhe a aeiiee a e iei aie i tiee r aie eae ee y a aha aa in. Whe e a a aeiiee i ae tee nr rae ane nh rcth a eei tianee ea eieinat ey nhe eei tianee ea eieinat e ihaaa i ti r aie eae e nhe eea e y.

( n A eaite rci e ct r eaite rci ee ae n aii e eey iraey r eea e ee nr a ae iri w nh i nh i inane ihaaa e n aii e eey iraey r eea e ee riay nr ai eitny a aeiiee y nhe ra ey nr a aic aanc e y r nr ai cat ane cie r nhe cat ane cie ri atein.

(an rnw nhinaie it ic e i rii (an aie ( ny eea e ei nr a hria naa aha aay ay e aee nr a aein aa eae it araatri w nh i nhe hria naa. Hrwe e y nhe eaite rci e cti r eaite rci ee aei ihaaa e eea e ee nr nhe a aeiiee aha aay a e iei w nh i rie wr k it eay raarw it eae an y nhe hria naay aie nhe aha aa in ri ecny an nhan t e ihaaa ee aneay i einr y nhe eaite rci e cti r eaite rci ee aei.


(en rnw nhinaie it aiy rnhe a r i ri r aawy a eaite rci e ct r eaite rci ee ae ay e r ee ee y aie a r eee nr a aic aanc e y ahyi a aiy eeitiny are an iny ranr en iny ene ia aiy ianc raanh a eranr ac icain nr Seatri 3640.7y r aa r anr yy r a ahyi aaa nhe aa in aatit w nh i nhe iarae r h i r he a aeiie. A ae iri r eitny eae it eea e y r a eaite rci e ct r eaite rci ee aey r a ecay acnhr zee ea eieinat e r nhe ae iri r eitnyy ihaaa i ti r nhe eae an r nhe eaite rci e ct r eaite rci ee ae.

(en A eaite rci e ct r eaite rci ee ae ihaaa irn e n aii e eey iraey r eea e ee nr a ae iri rcni ee nh i inaney whenhe r e ti r er eitay ciaeii nhe n aii e r y ieaae y r eea e e erei ir i ar aa aiae w nh nhe aawi r nh i inane aie r nhe Ui nee Snanei aie r nhe inane r arcin y nr wh ah nhe eaite rci e cti r eaite rci ee aei a e nr e n aii e eey iraey r eea e ee. Cr aa aiae w nh nhe aawi r nh i inane aie nhe Ui nee Snanei aie r nhe inane r arcin y nr wh ah nhe eaite rci e cti r eaite rci ee aei a e nr e eea e ee ihaaa iaaceey cn irn e a nee nry eene i it nhan nhe ea a ein r nhe eaite rci e cti r eaite rci ee aei i acnhr zee y aaw nr eae e nhe eaite rci e cti r eaite rci ee aei.

( n rnw nhinaie it ic e i ri (any a aha aay ay nake eea e y r eaite rci e cti aie eaite rci ee aei whei nhe aha aay i aariee aie ir aha aa in i ri ecny aaa r nhe raarw it eqc e eini a e eno

(1n The e cti a e aaaaee i a ieac e inr ate aa a ny i nhe ia e c ae it ai nhe aha aay.

(2n iay nhe aha aa in- i-aha te r a aha aa in eei tianee y nhe aha aa in- i-aha te hai aaaeii nr nhe ieac e inr ate aa a ny aee eaite rci e cti r eaite rci ee aei ha e eei eea e ee.

(3n The ieac e inr ate aa a ny hai a eaii r ie aatit whenhe n hai eei eine ee aee eaite rci e cti r eaite rci ee aei ha e eei eea e ee.

(4n The aha aay a ina ii w tei ara a ei aie a raeec ei r nhe eea e y r eaite rci e cti aie eaite rci ee aei nr a ieac e inr ate aa a ny.

(5n The atein eea e it eaite rci e cti aie eaite rci ee aei ac icain nr nh i ic e i ri aea ei erac eini ie aatit nhe ia e aie a rcin r eaah eaite rci e ct r eaite rci ee ae eea e ee i nhe ieac e inr ate aa a ny.

The aha aay ihaaa e eiarii ae r nhe eaite rci e cti aie eaite rci ee aei eea e ee nr nhe ieac e inr ate aa a ny. The aha aay ihaaa aair e eiarii ae r r na i it aie a ina i it ear ei eaatit nr nhe eea e y r eaite rci e cti aie eaite rci ee aei nr a ieac e inr ate aa a ny.

4081(an Aaa ear ei r aic aanc e aie r iaaey aaqc i triy r e iari tri r eaite rci e cti r eaite rci ee aei ihaaa e an aaa t ei ec it ci ieii hrc i raei nr iiaeatri y acnhr zee roae i r nhe aawy aie ihaaa e a eie ee r an aeain nh ee yea i r nhe eane r ak it. A ac ein i einr y ihaaa e kean …

4332 Aiy ae iri whr a aiy ietaeaniy r e ciei nr a ina i nhe ear ei eqc ee y Seatri 4081 r whry whei aaaaee cari y ai acnhr zee roae r a e e r nhe ra ey a aiy ietaeaniy r e ciei nr a recae r a r ee nhe ear ei w nh i a eairia ae t ey r whr w aa caay a recaei r c i ihei ear ei nhan a e aaiey i tc any r a iee eair .

Health and Safety Code 11209. (an r ae iri ihaaa eea e Saheecae IIy IIIy r IV arin raaee ic inaiaei nr a aha aay r aha aay eae it a eay ir ihaaa aiy ae iri eae e arin raaee ic inaiaei ri ehaa r a aha aay ciaeiiy an nhe t e r eea e yy a aha aa in r acnhr zee eae it ae iriiea i tii a eae an ihrw it nhe nyae aie qcaitny r nhe arin raaee ic inaiaei eae ee. Aiy e ia eaaiay enweei nhe eae an aie nhe nyae r qcaitny r arin raaee ic inaiaei aancaaay eae ee ihaaa e ear nee nr nhe eea e it whraeiaae r aic aanc e y nhe iexn ci ieii eay aee eea e y nr nhe aha aay.


Title 16, Division 17, California State Board of Pharmacy

§1714 Operational Standards and Security (en Eaah aha aa in wh ae ri ecny ihaaa e eiarii ae r nhe ieac ny r nhe a eia atri eeaa n einy iaace it a r i rii r effeat e arin ra ata iin nhee r e e i ri r eaite rci e cti aie ee aeiy aie ear ei r icah e cti aie ee aei. Priieii ri r a key nr nhe aha aay whe e eaite rci e cti aie arin raaee ic inaiaei a e inr ee ihaaa e ein anee nr a aha aa in.

§1715.6 Reporting Drug Loss The rwie ihaaa ear n nr nhe Bra e w nh i nh ny (30n eayi r e iar e y r aiy arii r nhe arin raaee ic inaiaeiy iaace it nhe a rcini aie in eitnhi.

Title 22, Division 5, Licensing & Certi�ication of Health Facilities…, Chapter 1, General Acute Care Hospitals

§70263 Pharmaceutical Services General Requirements (an(1n The [aha aay aie nhe aaectais ar tee ihaaa ee eara w tei ara a ei aie a raeec ei r eina a ih ein r ia e aie effeat e iyine i r a rac e einy inr atey e in ctriy e iaeii it aie cie r e cti aie ahe aaai. The aha aa in i ariicanatri w nh rnhe aaa ra ane heaanh a r eii riaai aie ae i in atri ihaaa e eiarii ae r nhe ee eara ein aie aae einatrii r a raeec ei.

(an Mee aatrii ihaaa irn e aee an nhe aatein’i eei ee ciaeii nhe a eia e ir r ee i. Scah eei ee ee aatrii ihaaa e kean i a aa ieny e awe r i ariieii ri r nhe aatein. D cti ihaaa irn e aee an nhe eei ee wh ah a e a inee i Saheecaei IIy III aie IV r nhe eee aa Cr a eheii e D ct A cie P e eitri aie Crin ra Aan r 1970 ai a eieee. I nhe hria naa ae ni eei ee inr ate r ee aatriiy w tei ara a ei aie a raeec ei ihaaa e eina a ihee r nhe e iaeii ity inr ate aie ear ei r ciey r icah ee aatrii.

(qn(10n D cti a ina iee ri nhe ic i it ci n ihaaa e iiaeanee an aeain rinhay y a aha aa in. Aiy etcaa tei ihaaa e ear nee nr nhe e eanr r ic i it ie ae aie ai eqc ee y hria naa ara ay.

(qn(11n(An D cti a inee i Saheecaei IIy IIIy r IV r nhe eee aa Cr a eheii e D ct A cie P e eitri aie Crin ra Aan r 1970y ai a eieeey ihaaa e eein ryee i nhe a eieiae r nwr aha aa ini r a aha aa in aie a et ine ee ic ie e aaryee y nhe hria naa. The ia e r nhe aateiny nhe ia e aie in eitnh r nhe e cty nhe a eia atri ic e y nhe a rcin eein ryeey nhe eane r eein catri aie nhe i tianc ei r nhe w nieiiei eqc ee a r e ihaaa e i nhe aatein’i ee aaa ear e r i a ieaa ane art. Scah a art ihaaa e ena iee r an aeain nh ee yea i.

§ 70265 Pharmaceutical Service Staff A aha aa in ihaaa ha e r e aaa eiarii a ny r nhe aha aaectaaa ie ae. He ihaaa e eiarii ae r nhe a rac e einy inr ate aie e in ctri r aaa e cti ai weaa ai nhe ee eara einy arr e iatriy icae i ri aie e ew r aha aaectaaa ie aei i nhe hria naa.

§70269 Pharmaceutical Service Space ( n Aaa iaaaei aie a eai ciee r nhe inr ate r e cti ihaaa e araka ae aie aaaeii ae nr acnhr zee ae iriiea riay.

Reducing Controlled Substances Diversion in HospitalsCalifornia Hospital Association Medication Safety Collaborative Committee www.calhospital.org/medication-safety-committeeIntroductionCreditsCommittee Representation

Road Map to Controlled Substance Diversion PreventionSelected Legal References14FFederal21 Code of Federal Regulations Chapter II: Drug Enforcement AdministrationSec. 1301.76 Other security controls for practitioners.Sec. 1301.90 Employee screening procedures.Sec. 1301.91 Employee responsibility to report drug diversion.Sec. 1301.92 Illicit activities by employees.Sec. 1301.93 Sources of information for employee checks.

42 Code of Federal Regulations, State Operations Manual, Appendix A15F§482.25(a)(3) Current and accurate records must be kept of the receipt and disposition of all scheduled drugs. A-0494§482.25(b) In order to provide patient safety, drugs and biologicals must be controlled and distributed in accordance with applicable standards of practice, consistent with Federal and State law. A-500§482.25(b)(2)(i) All drugs and biologicals must be kept in a secure area and locked when appropriate. A-0502§482.25(b)(2)(ii) Drugs listed in Schedules II, III, IV and V of the Comprehensive Drug Abuse Prevention and Control Act of 1970 must be kept within a secure area. A-0503§482.25(b)(2)(iii) Only authorized personnel may have access to locked areas. A-504§482.25(b)(7) Abuses and loss of controlled substances must be reported in accordance with applicable Federal and State laws, to the individual responsible for the pharmaceutical service, and to the chief executive officer, as appropriate. A-509

State of CaliforniaBusiness and Professions CodeHealth and Safety CodeTitle 16, Division 17, California State Board of Pharmacy§1714 Operational Standards and Security§1715.6 Reporting Drug Loss

Title 22, Division 5, Licensing & Certification of Health Facilities…, Chapter 1, General Acute Care Hospitals§70263 Pharmaceutical Services General Requirements§ 70265 Pharmaceutical Service Staff§70269 Pharmaceutical Service Space

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