controlled drugs

1. By,
Naga Raju B

2.  Regulatory agency: drug control department
 Discrepancies: A situation resulting the ‘expected
count’ and ‘actual count’ of a controlled substance not
being identical. A discrepancy can be identified by
physical count when tracking is done manually or can
be automatically identified
 Unresolved Discrepancy: A situation where a
discrepancy has been investigated through reviewof
data and interview of employees that had access to the
controlled substances in question and no explanation
for the discrepancy is identified.
 Legally Qualified Health Care Professionals:
Doctors, Pharmacists, Nurses
 Acts: Concerned to controlled Drugs
 Records: Concerned to controlled Drugs
 Routinely used Narcotics: Inj. Cod Phos, Tab. Cod
Sul, Morphine Sul and Pethidine injections.

3.  Hospital control Procedures
 Responsibility for controlled substances
 Ordering ward stock of controlled substances
from Pharmacy
a)Requisition Book
b)Administration forms
c)Summary of Daily Report
 Ordering Non-ward stock of controlled
substances from Pharmacy
 Prescribing controlled Drugs in the OP Dept
 Dispensing controlled Drugs for home use
when Pharmacy is closed

4.  Procedure in case of waste or
Destruction, Contamination etc
a)Part of Narcotic solution unused
b)Prepared dose refused by Patient
c)Prepared dose cancelled by Prescriber
d)Accidental destruction and contamination
of drugs
 Control of Narcotics on the ward by Nurses
a) HOC &
b) TOC
 Narcotics Delivery to the ward
 Charges for Narcotics to the Patients

5.  Protocol for Reporting Drug abuse or Diversion
Diversion:
Known loss or theft, Discrepancy found in
inventory or audit, Tampering, any suspected
incident
Abuse:
 unusual behavior of employee, Incapable of
performing normal duties, witness.

6.  Drugs included in protocol
 Persons affected by this protocol
 Explanation of outside agencies
 Events covered by this protocol which should
be reported to outside agencies
 Procedure for reporting suspected diversion or
abuse within the hospital

7. Diversion cases:
– Physicians selling prescriptions to drug
dealers or abusers
– Pharmacists who falsify records and
subsequently sell the drugs
– Employees who steal from inventory
– Executives who falsify orders to cover illicit
sales
– Prescription forgers
– Individuals who commit armed robbery of
pharmacies and drug distributors

8.  Largest problem:
criminal activity of physicians and pharmacy
Personnel, diversion investigators, special
agents, chemists, pharmacologists, program
analysts, etc.
 Investigation of Incidents within the hospital
 Procedure for making reports to outside
agencies
 Grounds for imposing penalty on hospital
employees
 Educational programmes

9.  Forwarding controlled substances by post
 Tax(duty) free alcohol
its procurement ,control and storage
New systems