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 164.139 - Safe Storage and Administration of Medications

Current through Register 1525, July 5, 2024
(A) Licensees providing medically managed or
				medically monitored detoxification services shall ensure that management,
				storage and administration of medication comply with requirements established
				by accreditation standards and by the United States Drug Enforcement Agency and
				Food and Drug Administration.
(B)
				Licensees providing clinically managed detoxification services shall comply
				with the following:
(1)
Written
				Policy and Procedure
: The licensee 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 licensee
				shall ensure that patients do not have direct access to the medication
				cabinet.
(3)
Approval
				of Medication
: The licensee shall take possession of a patient's
				prescription and over-the-counter medication upon admission. The medical
				director 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.
(4) Medications brought by patients to the
				program shall be stored in a locked, secure cabinet that is 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, licensees
				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 licensee
				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
				licensee 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 licensee shall ensure that a similar count is conducted by two
				staff persons at the beginning of each shift.
(7) The licensee 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 licensee employs qualified health care professionals
				authorized to administer medications. Patients must be able to administer their
				own medications and, unless the licensee 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. Licensees 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 licensee 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
: The licensee shall not
				permit expired medications, medications left behind by patients, or unused
				medications to accumulate in the storage area. The licensee shall establish
				policy and procedure for return of patient's medication upon discharge and for
				safe disposal of medications.
(10)
Improper Use
: The licensee shall establish a policy
				regarding improper use of medication which:
(a) may impose sanctions on patients who do
				not take medications in accordance with prescribed dose and frequency;
				and
(b) shall impose sanctions on
				patients who illegally obtain and use prescription medications.