Who is in control of your controlled substances?
Every veterinarian has the right to prescribe and dispense controlled substances. This privilege comes with responsibilities, inclusive of mitigating the risk of inappropriate or illegal access to controlled drugs. Veterinary rules related to the management of controlled drugs, including disposal, have always been rigorous. Given that, it is surprising that the following scenarios are not uncommon at the time of facility inspection or member investigation:
- the absence of a protocol for the acquisition of controlled drugs
- the absence of a controlled drug log
- the absence of any auditing of the drug log
- the lack of staff knowledge on how to complete a log or an audit
- the lack of reporting of the disappearance of controlled substances from a clinic
The law is clear that veterinarians, in particular the facility director, are responsible for the access to and the use of any controlled substances in an accredited facility. Further, veterinarians are responsible for appropriate prescribing, appropriate dispensing, maintaining appropriate logs, completion of audits, and the management of every controlled substance in an accredited facility.
There is an ever-increasing need for veterinarians to be aware of the public health risks of drugs stored in a facility – valium, ketamine, fentanyl, hydromorphone, and butorphanol to name a few. Understanding the street value of controlled substances, knowledge of the "latest and greatest" substance receiving abuse, and awareness of drug seeking behaviours all assist a veterinarian in keeping on top of this professional privilege.
Protect your patients, your clients, your staff, and your licence - be rigorous, stay informed, know the rules, recognize you have an important role in public protection and public health related to controlled substances.
Controlled Substances Management Checklist
How does your Practice Rate?
Have you -
- Read and implemented the rules - the College's Professional Practice Standard and Guide on the Management and Disposal of Controlled Drugs. This is the best reference
- Established a protocol for the acquisition of controlled substances
- Maintained a comprehensive controlled drug log
- Ensured regular audits are performed - not less than weekly is required for companion animal facilities, and is recommended for all others
- Stored controlled drugs securely at all times - this means locked up
- Limited access to only trained and trusted individuals
- Reported unreconciled loss or theft to Health Canada and the police
- Destroyed controlled drugs in accordance with federal, provincial and municipal rules