List of Narcotics to be Double Locked

CoffeeRTC, BSN, RN · Nov 5, 2008

I haven't seen Valium in yrs, but I do think we locked it.

All of them plus, percocet, oxycontin, morphine, phenobarbs, lyrica, vicodin.

Quickbeam, BSN, RN · Nov 5, 2008

Remember....any of these in suppository form need to be accounted for. These can be/are abused.

GrumpyRN63, ADN, RN · Nov 5, 2008

They are all locked and narcotics, I've never heard of "double locked",not so sure what you mean by that

noc4senuf · Nov 5, 2008

http://www.usdoj.gov/dea/pubs/scheduling.html

This is a federal list. It is dependent on your individual pharmacy and your state laws as to whether you are locking up all of Sched I-V or just some of them. Hope it helps.

CT Pixie, BSN, RN · Nov 5, 2008

They are all locked and narcotics, I've never heard of "double locked",not so sure what you mean by that

All the LTC facilities I have worked in, done clinicals in and presently working for as an LPN, have all narcs "double locked" meaning, they are in the med cart which has a lock and should be locked at all times when you aren't standing right there, but if notthen there is the narc drawer which has its own lock and set of keys. Hense, double lock. Someone would have to grab your med cart keys and your narc keys in order to get to the narcs.

The thing that gets me is the narcs that are supposed to be refridergated. They are in a locked box but its a flimsy type one that you could smash open if you wanted to that are sitting in a regular refrigerator. Just get into the med room, open the fridge and take the narc box...easy as that.

morte, LPN, LVN · Nov 5, 2008

All the LTC facilities I have worked in, done clinicals in and presently working for as an LPN, have all narcs "double locked" meaning, they are in the med cart which has a lock and should be locked at all times when you aren't standing right there, but if notthen there is the narc drawer which has its own lock and set of keys. Hense, double lock. Someone would have to grab your med cart keys and your narc keys in order to get to the narcs.
The thing that gets me is the narcs that are supposed to be refridergated. They are in a locked box but its a flimsy type one that you could smash open if you wanted to that are sitting in a regular refrigerator. Just get into the med room, open the fridge and take the narc box...easy as that.

pixie....the box is supposed to be PERMANENTLY AFIXED to the refridgerator...and if it is a small fridge, chain that to the wall.....

kmoonshine, RN · Nov 5, 2008

Quick sidenote: narcotic refers to opiates, not benzos.

"In a legal context, narcotic refers to opium, opium derivitives, and their semi-synthetic substitutes." http://www.usdoj.gov/dea/concern/narcotics.html

1. Propo-N/APAP: opioid, schedule IV

2. Diazepam: benzo, schedule IV

3. Lorazepam: benzo, schedule IV

Some people prefer use the terms "opiates", "stimulants", "benzos" etc since many people think that "narcotics" includes all controlled substances. In the pharmacy setting, schedule II meds are locked up and double-counted. Most nursing units have all their controlled substances (schedule II-V) locked up and they are double-counted also. I love the drug dispensing machines that drop down the quantity selected (lets say you select "vicodin, 2 tablets", and then only 2 pills drop down...no counting needed).

Prescriptions for schedule II meds cannot be refilled - you need a new prescription each month (and it must be a written prescription). Meanwhile, schedule III-IV drugs can be telephoned in, but are good for 6 months only (and can have 5 refills). No refill imits for schedule V are in place - they can be phoned in and are good for one year.

CT Pixie, BSN, RN · Nov 5, 2008

pixie....the box is supposed to be PERMANENTLY AFIXED to the refridgerator...and if it is a small fridge, chain that to the wall.....

Well its afixed to the refridgerator if you consider a pretty easily ripped off metal chain like thing safey affixing it. Its attatched to the box and the fridge but it could be very easily broken. The fridge is a small, home bar like one..teeny tiny little area that keeps things cold. Easily picked up, not the most convientient thing to walk around with but it could be done if someone really wanted to.

CoffeeRTC, BSN, RN · Nov 6, 2008

Some places will lock up other meds just because they have a high potential for theft. So yes...we lock up non narcotics too. I'm thinkinging we were locking up lomotil at one point?

GrumpyRN63, ADN, RN · Nov 6, 2008

All the LTC facilities I have worked in, done clinicals in and presently working for as an LPN, have all narcs "double locked" meaning, they are in the med cart which has a lock and should be locked at all times when you aren't standing right there, but if notthen there is the narc drawer which has its own lock and set of keys. Hense, double lock. Someone would have to grab your med cart keys and your narc keys in order to get to the narcs.
The thing that gets me is the narcs that are supposed to be refridergated. They are in a locked box but its a flimsy type one that you could smash open if you wanted to that are sitting in a regular refrigerator. Just get into the med room, open the fridge and take the narc box...easy as that.

Oh, thanks, I've never worked LTC, in the hospital everything is controlled by the pyxis, essentially all meds are 'locked 'anyway, narcs removed just like colace.(just not counted).

back in the day when we had med carts, they weren't locked but narcs were kept separate in the med room locked in a cabinet, we no longer have any refrigerated narcs, EVERYTHING is in the Pyxis, BTW I thought from the OP she was asking if some (narcs) are just locked and others double locked and I couldn't figure out what or why that would be, a controlled substance whatever it may be should be secured with the same standards, no ?

PsychNurseWannaBe, BSN, RN · Nov 10, 2008

We have sched II meds "double locked" meaning to gain access you will have to have a key to unlock the med cart and a seperate key to unlock the drawer IN the med cart.

Other sched meds are "single locked", meaning just locked in the drawer of the med cart.

Meds in the fridges....well depends. In order to get to the meds in our fridge you would have to have a key to open the med room, therefore the meds in the fridge is "single locked". Only RN/LPN have the keys to this room. Since it is single locked, nothing needs to be chained inside the fridge. According to our state laws. I just make sure to count the meds in the fridge as well. Many nurses don't...out of site, out of mind.