D.C. Mun. Regs. tit. 22, r. 22-A6316
Controlled substances shall be maintained in accordance with applicable Federal and District laws and regulations.
An SUD treatment program shall implement written policies and procedures to govern the acquisition, safe storage, prescribing, dispensing, labeling, administration, and the self-administration of medication, including medications clients may bring into the program that shall have a record of the prescribing physician's order or approval prior to the administration or self-administration of medication.
Any prescribed medication brought into a facility by a client shall not be administered or self-administered until the medication is identified and the attending practitioner's written order or approval is documented in the client record.
Verbal orders may only be given by the attending practitioner to another physician, PA, APRN, RN, or pharmacist. Verbal orders shall be noted in the client's record as such and countersigned and dated by the prescribing practitioner within twenty- four (24) hours.
Medication, both prescription and over-the-counter, brought into a facility must be packaged and labeled in accordance with Federal and District laws and regulations.
Medication, both prescription and over-the-counter, brought into a facility by a client that is not approved by the attending practitioner shall be packaged, sealed, stored, and returned to the client upon discharge.
The administration of medications, excluding self-administration, shall be permitted only by licensed individuals pursuant to applicable District laws and regulations.
Medications shall be administered only in accordance with the prescribing practitioner's order.
Only a physician, APRN, RN, or PA shall administer controlled substances or injectable drugs, excluding self-administered drugs.
Program staff responsible for supervision of the self-administration of medication shall document consultations with a physician, APRN, RN, pharmacist, or referral to appropriate reference material regarding the action and possible side effects or adverse reactions of each medication under their supervision.
As applicable, a program shall provide training to the staff designated to supervise the self-administration of medication. The training shall include but not be limited to the expected action of and adverse reaction to the self-administered medication.
Only trained staff shall be responsible for observing the self-administration of medication.
Medication administration training shall be facilitated by the following Qualified Practitioners, as led by signature and date on the training certificate:
A program shall ensure that medication is available to clients as prescribed.
A program shall maintain records that track and account for all medication, ensuring the following:
An attending practitioner shall be notified immediately of any medication error or adverse reaction. The staff responsible for the medication error shall complete an incident report, and the practitioner's recommendations and subsequent actions taken by the program shall be documented in the client record.
A program shall ensure that all medications, including those that are self-administered, are secured in locked storage areas.
The locked medication area shall provide for separation of internal and external medications.
A program shall maintain a list of personnel who have access to the locked medication area and, where applicable, are qualified to administer medication.
A program shall comply with all Federal and District laws and regulations concerning the acquisition and storage of pharmaceuticals.
Each client's medication shall be properly labeled as required by Federal and District laws and regulations, shall be stored in its original container, and shall not be transferred to another container or taken by clients other than the client for whom it was originally prescribed.
Medications requiring refrigeration shall be maintained in a separate and secure refrigerator, labeled "FOR MEDICATION ONLY" and shall be maintained at a temperature between thirty-six degrees Fahrenheit (36°F) and forty-six degrees Fahrenheit (46°F). All refrigerators shall have thermometers, which are easily readable, in proper working condition, and accurate within a range of plus or minus two (2°F) degrees Fahrenheit.
A program shall conspicuously post in the drug storage area the following information:
A program shall conduct monthly inspections of all drug storage areas to ensure that medications are stored in compliance with Federal and District laws and regulations. The program shall maintain records of these inspections for verification.
Where applicable, the program shall implement written policies and procedures for the control of stock pharmaceuticals.
The receipt and disposition of stock pharmaceuticals must be accurately documented as follows:
A program shall implement written procedures and policies for the disposal of medication.
Any medication left by a client at discharge shall be destroyed within thirty (30) calendar days after the client has been discharged, with the exception of Methadone and other controlled substances which must be returned to the point of issue or destroyed in accordance with Federal regulations.
The disposal of all medications shall be witnessed and documented by two (2) staff members.
D.C. Mun. Regs. tit. 22, r. 22-A6316