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A proposed rule issued by the U.S. Drug Enforcement Administration (DEA) would mandate that nursing facilities dispose of Schedule II – V controlled substances only in an on-site disposal receptacle provided by a retail pharmacy.
The proposed rule also would require that the facility place controlled substances in the disposal receptacle “immediately,” but in no event later than 3 business days after it is determined that the ultimate user (resident):
Despite these requirements, however, the proposed rule does not mandate that retail pharmacies place disposal receptacles in nursing facilities and requires them to modify their registration status in order to do so. Additionally, the proposed rule is silent as to whether participating retail pharmacies can restrict disposal receptacles only to medications that they dispensed.
Finally, although the proposed rule prohibits the nursing facility from disposing of controlled substances through other means, it permits nursing facility residents to dispose of their own controlled substance medications through mail-back programs and take-back events, though the DEA notes with respect to both of these methods that care should be taken to ensure that nursing facility residents’ use of either or both of these methods results in an accumulation of controlled substances in a single location susceptible to internal or external diversion threats.