Disposal of Controlled Substances in Long Term Care Facilities

Effective April 1, 2018, the Ohio State Board of Pharmacy implemented new rules intended to reduce the potential for drug diversion of controlled substances and to curb the opioid crisis in Ohio. Ohio Administrative Code 4729:5-3-01 contains significant changes that impact long term care facility practices related to controlled substance disposal.

The new rule requires controlled substances to be destroyed no later than five days from the date the medication is removed from the medication cart or storage area. To comply with this requirement, ICP recommends establishing a procedure to regularly destroy controlled substances on a specific day each week. For instance, medications removed from the medication cart Monday through Friday are routinely destroyed every Friday.

In addition, to allow facilities to meet this shortened time period, the rule authorizes destruction to occur between the Director of Nursing and a supervisory level nurse (Assistant Director of Nursing, Charge Nurse, Unit Supervisor). If desired, your consultant pharmacist is still permitted to participate in destruction when at your facility.

The rule applies to the destruction of discontinued or expired ultimate user (i.e. patient specific) controlled substances. The method of destruction must render the drug “unavailable and unusable.” RxDestroyer Pharmaceutical Disposal System or similar products meet this requirement.

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