Hospice organizations face challenges disposing with controlled drugs

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While some states enacted laws allowing hospice employees to dispose of patients’ unused controlled substances, the federal Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) was enacted in 2018.

The U.S. Government Accountability Office (GAO) reviewed the SUPPORT Act as stipulated in the act by examining the disposal of controlled substances in home hospice settings. The office spoke to seven hospices, 11 state hospice associations, three national hospice trade associations, two national nurse trade associations, the Drug Enforcement Administration, and the Centers for Medicare & Medicaid Services.

GAO contacted three hospices operating in states without state laws instructing employees of qualified hospice programs to dispose of unused controlled substances found in patients’ homes. Two of the hospices began disposing of patients’ controlled substances following the enactment of the SUPPORT Act. Still, the third said its state department of health had directed it not to dispose of drugs until a state law was enacted.

Hospice officials told GAO they use several best practices for disposing of controlled substances including having a witness for the disposal of unused controlled substances, using lock boxes to limit access to controlled substances in situations where diversion is suspected to be a risk, and performing prescription drug counts to determine if controlled substances are being used properly.

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