are plenty of steps you can and should take to ensure leftover drugs are dis-
posed of properly so that they won't wind up in the hands of diverters. One
of the most popular methods involves expelling leftover syringe substances
into a liquid-dissolving agent combined with a charged activated charcoal
that begins neutralizing medications on contact. Regardless of the method
you use, the key is to ensure every trace of expelled drugs is rendered irre-
trievable.
2. Anesthesia providers should collect all narcotic discards and present
those discards for witnessing by another licensed professional at the
end of each day.
a. true b. false
Answer: b
While on the surface this might seem like a safe and efficient way to han-
dle discards, it actually presents an opportunity for drug diverters to take
advantage of a gap in safety processes and the chain of control. Diverters
may use the lack of real-time discarding to substitute, say, fentanyl with
saline solution. Then, by the end of the day, the witness to the discarding
will only see clear liquid and have no way of discerning the actual contents
within the medication container. In light of the opioid crisis, you must
meticulously document your medication disposal processes. That means
creating an easy-to-follow trail of daily controlled drug removal from clini-
cal areas with records of when and by whom the drugs were dispensed.
There should always be at least 2 licensed individuals involved in this
process. You'll also want to ensure a licensed individual witnesses discards
of partial portions of controlled substances — with both the witness and
the discarder signing off at the time of discard. Finally, you must also vali-
date a count of the controlled drug cabinet at the beginning and end of
each day. This is a long-standing element of "controlling the controls."
1 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 9
