Hello, I work at a SNF on a floor where we get a lot of IVDAs whom need long term antibiotic therapy. We've been having a lot of patients lately that cheek their narcotic pain meds. One particular patient has been using his tongue to place the med behind his front lower gum and when I ask him to pull out his lip he has refused or clearly takes the pill out of him mouth and puts it under his blanket. There's high suspicion of him shooting it in his picc line from syringes they get from the sharps box (by using tape on spoons to reach them etc. they are very creative). The next nurse had the same problems with him and got an order from the MD to have meds crushed. The next day the patient went to the chief clinical officer and said he was being targeted and they put him meds back to whole with mouth checks. I caught him today doing the gum thing and he refused so the md said if he does it one more time put it back to crushed. I guess my question is what are the proper policies in other places. This facility allows patients to go outside and smoke when their active iv drug users with picc lines and this is supposedly a. On smoking facility. I fear my license may be at risk if a patient ODs or gets a PE (which has already happened once on my time) when nurses aren't supported at times regarding patients Cheeking their meds and the amount of freedom they get.