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Narcotics Reconciliation in the Pharmacy

Throughout the past several decades, prescription drug abuse has reached epic proportions in Canada, with statistics released in the 2012 Canadian Alcohol and Drug Use Marketing Survey indicating that an estimated 410 000 Canadians have reported abusing prescription drugs. According to the International Narcotics Control Board, Canada has been declared the second largest per capita consumer of prescription opioids, second only to the United States. The report also advises that Canada’s prescription opioid use has risen at a sharper rate than that of the United States, with a 203% increase between 2000 and 2010, and in 2011 it was reported by the Canadian Alcohol and Drug Use Marketing Survey that approximately 23% of Canadians over the age of 15 had reported using a prescription drug in the past twelve months. In a 2013 publication entitled Opioid Overdose Prevention & Response in Canada, the Canadian Drug Policy Coalition advised that overdose deaths related to opioids are now believed to represent an estimated 50% of annual drug deaths, and a study conducted by scientists at St. Michael’s Hospital and the Institute for Clinical Evaluative Sciences has linked opioids to approximately one in eight deaths in young adults, aged 25 to 34. Health Canada Initiatives In an effort to address the issue, Rona Ambrose, Canada’s Minister of Health, has implemented a number of initiatives intended to target the issue, with the allocation of over $44 million over the next five years to extend the National Anti-Drug Strategyto include prescription drug abuse. In accordance with these initiatives, Health Canada has also announced $13 million in funding designed to increase pharmacy inspections in an effort to impose strict limitations on the potential for prescription drugs to reach illegal markets. In a study by researchers at St. Michael’s Hospital published in Canadian Family Physician in 2014, statistics showed that high-dose opioid prescriptions increased across Canada at a rate of approximately 23% from 2006 to 2011, equal to approximately 30 million patches or tablets. Given the high volume of these prescriptions, the inspections are intended to enable the government to work closely in conjunction with pharmacies in order to ensure increased safety in the storage, security and handling of prescription drugs throughout the country. Narcotics In Canadian Pharmacies According to the Narcotic Control Regulations (NCR), the onus is directly on the pharmacist to ensure that all narcotics in their possession are handled with the utmost security. Pharmacists are therefore being held responsible for taking all reasonable action in order to ensure safe narcotics management and are required to report any issues relating to the loss or theft of narcotics within ten days of discovery. Pharmacists are also advised to take into account a variety of factors when working to establish adequate policies and procedures around narcotics handling, such as physical security matters and other factors such as internal miscounts or theft, forgery and a variety of other internal and external risks. From screening prospective staff members to implementing a narcotics security plan which takes into account the layout of the pharmacy and keeping accurate and current Narcotics Sales Reports that align with inventory checks, pharmacists need to focus on outlining strong and proactive policies and procedures around narcotics handling. Narcotics Inventory Management Due to the highly sensitive nature of narcotic inventory, it is recommended that pharmacists conduct a complete narcotics inventory count every six months at a minimum– for those pharmacies that may be considered at high risk for issues with narcotics, such as those with rotating staff, high attrition rates or significant numbers of part time staff, it is advisable to conduct checks on a more frequent basis. It is recommended that the inventory count not be carried out by the same staff member who is responsible for the receipt and recording of narcotics in the purchase records. Upon conducting a physical count, inventory should be subjected to a full reconciliation. Narcotics Reconciliations: A narcotics reconciliation is a comprehensive process that allows the pharmacy to reconcile the exact inventory on hand with that purchased and dispensed– it is a detailed audit designed to uncover any losses or overages in order to identify whether any further action must be taken. The narcotics reconciliation process begins with the starting inventory and takes into account any purchases and subsequent sales as well as the inventory that should be on hand– if these quantities do not match up, further action must be taken. In the event of a shortage, the pharmacy has ten days to report the discrepancy to the Office of Controlled Substances, and the pharmacy should be able to produce detailed and well-documented records from the arrival of any narcotics in the pharmacy in order to assist in accounting for any missing stock. The iApotheca Narcotics Reconciliation Module The iApotheca Narcotics Reconciliation Module has been specifically designed to allow for the detailed and meticulous recording of all narcotics within the pharmacy, allowing for accurate and efficient reconciliation with the amount of inventory that should be on hand. The module makes it easy to understand where you should be with your inventory in order to reconcile it with your current count, along with all the documentation the pharmacist needs to account for any discrepancies and determine what, if any, action should be taken. For more information on the iApotheca Narcotics Reconciliation Module and how it can help you comply with Health Canada and any other required regulations, watch our blog for module updates and feel free to contact iApotheca today at 1-800-209-6052.