Assisted Living: Controlled Substances Medication Management

The United States Congress passed the Controlled Substances Act in 1970. This law controls how some drugs are made, stored, and given to people. These drugs are called "controlled substances."

Controlled substances schedules

Controlled substances are placed into one of five "schedules," or groups.

• Schedule I: A drug with no medical use and/or a high risk of misuse
  • Example: Illegal drugs like heroin
• Schedule II: A drug with medical use but a high risk of misuse
  • Example: Pain medication like morphine
• Schedule III: A drug with medical use and a medium risk of misuse
  • Example: Certain kinds of steroids
• Schedule IV: A drug with medical use and a low risk of misuse
  • Example: Anxiety medication like Xanax
• Schedule V: A drug with medical use and a lower risk of misuse than schedule IV
  • Example: Over-the-counter cough medication

Controlled substance misuse

Controlled substances are sometimes stolen, used, or sold. When this happens, residents don't get the medicine they need. If a caregiver uses a drug, residents may receive care from someone under the influence.

Caregivers should watch for signs that drugs are being stolen or used incorrectly. Signs to watch for include:

• A staff member who always needs to check in drugs.
• A staff member who is having money problems.
• A family member who always visits when new drugs come in.
• Vendors who want to know how drugs are stored.

Caregivers also should watch how often drugs are given to residents.

Regulations

Community-Based Residential Facility

• Wisconsin Admin. Code § DHS 83.37(1)(j)
• Wisconsin Admin. Code § DHS 83.37(3)(g)

Resources

• Assisted Living: Medication Storage and Disposal
• U.S. Department of Justice Drug Enforcement Administration (DQA) Diversion Control Division Drug Disposal Information

FAQs (frequently asked questions)

Do all controlled substances need to be counted?

Schedule II drugs must be counted daily in a community-based residential facility (Wis. Admin. Code § DHS 83.37 (1)(j)). Facilities with a history of illegal use of controlled substances may count these drugs more often. They also may count other drug schedules.

Do all controlled substances need to be locked?

Schedule I drugs should be locked separately from other drugs in a community-based residential facility (Wis. Admin. Code § DHS 83.37(3)(g)).