LEARNING OBJECTIVE: Recall Hospital Corpsman responsibilities and accountability pertaining to controlled substances; identify controlled substance schedules; and recall controlled substance security, custody, inventory, and survey procedures.

Hospital Corpsmen who handle controlled substances and other drugs are held responsible for the proper distribution and custody of those substances and drugs. Nowhere is the demand for strict integrity more important. Misuse, abuse, loss, and theft of these substances have always, sooner or later, ended in tragedy and severe consequences. No one has ever profited by their misappropriation.

It behooves every Hospital Corpsman to thoroughly understand the responsibility concerning the custody and handling of controlled substances and other drugs and to be familiar with the regulations and laws pertaining to them.

RESPONSIBILITY
Although the MANMED specifically assigns custodial responsibility for controlled substances, alcohol, and dangerous drugs to a commissioned officer (and more specific control to the Nursing Service), you, as a Hospital Corpsman, have the responsibilities of administering and securing them properly. All controlled substances and other drugs are to be kept under lock and key. Neither keys nor drugs should ever be entrusted to a patient.

ACCOUNTABILITY
Hospital Corps personnel are held accountable for drugs entrusted to them. Great care should be exercised to prevent the loss or unauthorized use of drugs. No drug should be administered without proper authority. In addition, U.S. Navy Regulations forbid the introduction, possession, use, sale, or other transfer of marijuana, narcotic substances, or other controlled substances.

Figure 6-5.-Prescription label.

CONTROLLED SUBSTANCE SCHEDULES
Controlled substances and drugs require special handling and security measures. The Controlled Substance Act of 1970 established five schedules (categories) related to a drug's potential for abuse, medical usefulness, and degree of dependency, if abused.

Controlled substances may migrate between schedules, and new products may be added. These changes will be promulgated by the Navy Materiel Support Command in the Medical and Dental Materiel Bulletin.

Schedule I
Schedule I substances have high abuse potential and no accepted medical use (e.g., heroin, marijuana, LSD).

Schedule II
Schedule II substances have high abuse potential and severe psychological and/or physical dependence liability. Examples of schedule II substances include narcotics, amphetamines, and barbiturates. Prescriptions for schedule II substances can never be ordered with refills and must be filled within 7 days of the date originally written.

Schedule III
Schedule III substances have less abuse potential than schedule II substances and moderate dependence liability. Examples of schedule III substances include nonbarbiturate sedatives, nonamphetamine stimulants, and medications that contain a limited quantity of certain narcotics. Prescriptions must be filled within 30 days of the date written and may be refilled up to five times within 6 months.

Schedule IV
Schedule IV substances have less abuse potential than schedule III substances and limited dependence liability. Prescriptions must be filled within 30 days of the date written and may be refilled up to five times within a 6-month period.

Schedule V
Schedule V substances have limited abuse potential. Schedule V substances are primarily antitussives or antidiarrheals that contain small amounts of narcotics (codeine). Prescriptions must be filled within 30 days of the date written and may be refilled up to five times within 6 months.

DANGEROUS DRUGS
Poisonous drugs, chemicals, and similar substances are classified as dangerous drugs. Because these substances are powerful, their containers should have a distinctive color, size, or shape, and the container should be placed in a special storage area so they are not mistaken for other drugs. In addition, the following safeguards should be enforced:

Label all containers of dangerous substances appropriately.

Store caustic acids (such as glacial acetic, sulfuric, nitric, concentrated hydrochloric, or oxalic acids) in appropriate containers, and do not issue to wards or outpatients.

Account for and issue methyl alcohol (methanol) to be used by medical activities in the same manner as other controlled substances.
Methanol should not be stored, used, or dispensed by the pharmacy, ward, or outpatient style="mso-spacerun: yes"> treatment facility.