Code of Massachusetts Regulations › 105 CMR - DEPARTMENT OF PUBLIC HEALTH › Title 105 CMR 164.000 - Licensure of Substance Abuse Treatment Programs › Part TWO - REQUIREMENTS FOR SERVICE PROVISION › Section 164.105 - Safe Storage and Administration of Medications

Current through Register 1525, July 5, 2024
(A)
				Licensed and Approve Providers providing medically managed or medically
				monitored withdrawal treatment services shall comply with all federal and state
				laws and regulations relating to the procurement, storage, dispensing,
				administration, recording and disposal of medications and shall comply with the
				following:
(1)
Written Policy and
				Procedure
. The Licensed or Approved Provider shall establish a
				written policy and procedure governing the storage and administration of
				patients' prescription medications.
(2)
Storage
. All
				medications shall be maintained in a locked, secure cabinet, accessible only to
				designated staff positions. The titles of designated positions shall be posted
				on the cabinet. The Licensed or Approved Provider shall ensure that patients do
				not have direct access to the medication cabinet.
(3)
Approval of
				Medication
. The Licensed or Approved Provider shall take
				possession of a patient's prescription and over-the-counter medication upon
				admission. The medical director or their delegated qualified healthcare
				professional shall assess such medication(s) in light of the medical
				examination and medical services to be provided to determine whether the
				patient should continue to take these medications and based upon this
				determination shall implement a process for adjusting the medication
				regimen.
(4) Medications brought by
				patients to the program shall be stored in a locked, secure cabinet separate
				from the facility's supply, except that patients shall retain medications
				required to treat acute episodes, such as asthma attacks or allergic reactions.
(a) If injectable drugs are used, Licensed
				and Approved Provider shall provide containers for safe storage, and proper
				disposal of sharps.
(b) Medications
				requiring refrigeration shall be kept in a refrigerator in the same area where
				other medications are stored. Medications shall not be stored in kitchen
				refrigerators.
(c) The Licensed or
				Approved Provider shall also establish a record of medications which remain in
				the possession of patients for treatment of acute episodes.
(5) Prescription medication
				presented by a patient shall bear a pharmacy label, which shows the date of
				filling, the pharmacy name and address, the filling pharmacist's initials, the
				serial number of the prescription, the name of the patient, the name of the
				prescribing practitioner, the name of the prescribed medication, directions for
				use and cautionary statements, if any, contained in such prescription or
				required by law, and if tablets or capsules, the number in the container. All
				over-the-counter medications shall be kept in the original containers
				containing the original label, which shall include the directions for
				use.
(6) Upon admission the
				Licensed or Approved Provider shall document in writing the number of tablets
				or capsules, or the approximate amount of liquid in each prescribed medication
				brought by the patient. The Licensed or Approved Provider shall ensure that a
				similar count is conducted for all Schedule II through Schedule V medications
				by two staff persons at the beginning of each shift.
(7) The Licensed or Approved Provider shall
				maintain documentation of all medications stored and disposed of.
(8)
Self-administration of
				Medications
. Medications shall be self-administered by the
				patient, unless the Licensed or Approved Provider employs qualified health care
				professionals authorized to administer medications. Patients must be able to
				administer their own medications and, unless the Licensed or Approved Provider
				employs qualified health care professionals for this purpose, staff shall not
				administer medication to any patient. However, staff shall observe the patient
				ingesting the prescribed dose. Medications may not be provided to any patient
				if other patients are in the storage or office area. Licensed and Approved
				Providers shall make provision to provide a supply of medications to patients
				who plan to be absent from the facility when they would normally take a
				medication. The Licensed or Approved Provider shall maintain documentation of
				all administrations of medication, which shall include:
(a) Name of patient to whom medication was
				provided;
(b) Name of staff person
				observing the patient take the medication, or providing needed
				supply;
(c) Date and time
				medication was provided; and
(d)
				Patient initials confirming that the medication was provided and
				taken.
(9)
Disposing of Medications
. Programs shall comply with
				all federal and state laws and regulations relating to the procurement,
				storage, dispensing, administration, recording and disposal of
				medications.
(10)
Improper Use
. The Licensed or Approved Provider shall
				establish a policy regarding improper use of medication which:
(a) may impose corrective actions on patients
				who do not take medications in accordance with prescribed dose and frequency;
				and
(b) shall impose corrective
				actions on patients who illegally obtain and use prescription
				medications.