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Discussion

Controlled substances not locked or counted!?

Just started a new job... they keep a 'Narcotic Log' which is counted out each shift but certain drugs are not included and just kept in the med cart along with everything else. Hydrocodone, Xanax, Ativan.. I was always under the impression those are controlled substances?! Is this a state by state regulation? have any of you worked somewhere that didnt treat those as controlled substances?

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    We count all schedule II narcs every shift.

    We do not count schedule IV (Xanax/Ativan, etc.) every shift IF it is a scheduled med. The count is kept track of in the MAR when administered, and it would be noted then if the count was off.

    We DO count schedule IV PRN cards every shift. As these are not used every shift, if a card went missing or a count was off, it could be a long time to notice, and impossible to pin point when it went missing.

    We do keep ALL meds locked at all times though, we cannot leave a cart unlocked if it is out of sight. (Schedule II are double locked). I'm very surprised your meds aren't locked at all?

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    If you are working in LTC or an ALF you will not schedule II drugs. Some facilities do, and some don't. In a hospital setting you will most likely count all narcs....

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    Most ALFs do not count or lock up schedule II drugs as C&CRN said. What I find odd though is that most LTCs lock up Tramadol as it is not classed as an opiate.

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    • Experts
    Most ALFs do not count or lock up schedule II drugs as C&CRN said. What I find odd though is that most LTCs lock up Tramadol as it is not classed as an opiate.

    Tramadol (Ultram) has an addiction potential, so many facilities will treat it as though it was controlled and lock/log it.

    Actually, some states do classify Tramadol as a C-IV med, and others are starting to consider following suit.

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    I was shocked about the tramadol as well, when I saw it was counted in a hospital setting.

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    I owned an RCF for almost 20 years and all the medications your have mentioned were counted each shift and doubled locked. We had no problems.

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