Narcotics disposal in home

[SCgirl1962]

What are your hospice policies regarding disposal of unused narcotics in the home after a hospice patient death?

[notanumber]

Not hospice, but in our LTC these are returned to pharmacy. We fax notification of death along with narc record and request for pickup.

[wereallmadhere, ADN]

We were required to put the medications in kitty litter that we kept on hand. If it was liquid morphine I would just pour it in the Ziploc bag of kitty litter and throw away in the trash. If there were tablets that also needed to be disposed of I would run hot tap water in the bottles, shake until dissolved, and then pour in the kitty litter.

[grateful_RN]

We would use kitty litter or coffee grounds to dispose of liquid Morphine or Ativan. If in pill form, I crush the pill and include in the coffee grounds which are disposed of in the trash in double bag. Document disposal with two signatures (one from RN and one from family member or facility staff) and place in chart.

[NurseSpeedy, ADN, LPN, RN]

Not hospice either but a question that I struggled with when at an ALF. The kitty litter was used for a wasted medication (ex: refused, fell on floor, etc)...but if the patient died we were required to notify the POA that they had medications and then hand all meds over to the family if they did not direct us to dispose of them. Luckily, I was never there during a "pick up" (brief employment) but I always questioned our regional director when this subject came up. I thought the appropriate place was returning all meds, especially narcotics, to the pharmacy as the appropriate action. The facility stated that the family paid the copay so they owned the meds. My argument was that they may have paid the copay when the family member was alive-but now there is no one who should be in possession of a narcotic, such as PO dilaudid or OxyContin, picking up the controlled substance that was prescribed to someone who is no longer living. The family member does not get ownership after death of controlled substances. This policy made absolutely no sense to me.

[SouthpawRN]

This sounds like a really good question to send to the DEA and get the definitive answer.

[hppygr8ful, ASN, RN, EMT-I]

When my dad was on hospice and passed in his bed at home the hospice nurse called the pharmacy who came a picked up the meds.

Hppy

[KelRN215, BSN, RN]

Never worked hospice but I did once have an issue with a pediatric patient who was in state custody d/t evidence that her family had tampered with her liquid valium. Because Child Protective Services is so dysfunctional, they took legal custody of the child but left in her home. Eventually, her Neurologist decided that since the valium was just for spasticity and there were so many social issues, the best thing would be to wean her off the valium and put her on baclofen. She needed a refill shortly before she was to finish her taper so there was a significant amount of valium left and again, given the issues that had transpired in the past, it fell to me to ensure that the remainder of the medication was wasted. We ended up mixing it in coffee grounds and throwing it away. I had the aunt, who the state appointed as her foster mother, sign as a witness.

[Tippyrn]

Plastic bags can not be put in the trash anymore in some states.