Drug destruction and disposal
 148. (1) Every licensee of a long-term care home shall ensure, as part of the medication management system, that a written policy is developed in the home that provides for the ongoing identification, destruction and disposal of, (a)  all expired drugs; (b)  all drugs with illegible labels; (c)  all drugs that are in containers that do not meet the requirements for marking containers specified under subsection 156 (3) of the Drug and Pharmacies Regulation Act; and (d)  a resident’s drugs where, (i)  the prescriber attending the resident orders that the use of the drug be discontinued, (ii)  the resident dies, subject to obtaining the written approval of the person who has signed the medical certificate of death under the Vital Statistics Act or the resident’s attending physician, or (iii)  the resident is discharged and the drugs prescribed for the resident are not sent with the resident under section 137. O. Reg. 246/22, s. 148 (1). (2) The drug destruction and disposal policy must also provide for the following: 1.  That drugs that are to be destroyed and disposed of shall be stored safely and securely within the home, separate from drugs that are available for administration to a resident, until the destruction and disposal occurs. 2.  That any controlled substance that is to be destroyed and disposed of shall be stored in a double-locked storage area within the home, separate from any controlled substance that is available for administration to a resident, until the destruction and disposal occurs. 3.  That drugs are destroyed and disposed of in a safe and environmentally appropriate manner in accordance with evidence-based practices and, if there are none, in accordance with prevailing practices. 4.  That drugs that are to be destroyed are destroyed in accordance with subsection (3). O. Reg. 246/22, s. 148 (2). (3) The drugs must be destroyed by a team acting together and composed of, (a)  in the case of a controlled substance, subject to any applicable requirements under the Controlled Drugs and Substances Act (Canada) or the Food and Drugs Act
(Canada), (i)  one member of the registered nursing staff appointed by the Director of Nursing and Personal Care, and (ii)  at least one of, (A)  another member of the registered nursing staff appointed by the Director of Nursing and Personal Care, (B)  a physician, (C)  a pharmacist, (D)  a member of the College of Nurses of Ontario who is a registered nurse in the extended class, (E)  a member of the College of Pharmacists who is a pharmacy technician, or (F)  a member of the Royal College of Dental Surgeons who is a dentist in the general class; and (b)  in every other case, (i)  one member of the registered nursing staff appointed by the Director of Nursing and Personal Care, and (ii)  one other staff member appointed by the Director of Nursing and Personal Care. O. Reg. 246/22, s. 148 (3); O. Reg. 66/23, s. 31. (4) Where a drug that is to be destroyed is a controlled substance, the drug destruction and disposal policy must provide that the team composed of the persons referred to in clause (3) (a) shall document the following in the drug record: 1.  The date of removal of the drug from the drug storage area. 2.  The name of the resident for whom the drug was prescribed, where applicable. 3.  The prescription number of the drug, where applicable. 4.  The drug’s name, strength and quantity. 5.  The reason for destruction. 6.  The date when the drug was destroyed. 7.  The names of the members of the team who destroyed the drug. 8.  The manner of destruction of the drug. O. Reg. 246/22, s. 148 (4). (5) The licensee shall ensure, (a)  that the drug destruction and disposal system is audited at least annually to verify that the licensee’s procedures are being followed and are effective; (b)  that any changes identified in the audit are implemented; and (c)  that a written record is kept of everything provided for in clauses (a) and (b). O. Reg. 246/22, s. 148 (5). (6) For the purposes of this section a drug is considered to be destroyed when it is altered or denatured to such an extent that its consumption is rendered impossible or improbable. O. Reg. 246/22, s. 148 (6).