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dependence. Schedule Categories of Controlled Substances Schedule Examples Description I Some examples of substances listed inSchedule I are heroin, lysergic acid diethyl- Substancesinthisschedulehavenocurrentlyaccepted amide (LSD), Cannabis, peyote, methaqualone, and methylenedioxymethamphetamine- medicaluseintheUnitedStates,alackofaccepted amine(MDMA) safety for use under medical supervision, and a high potential for abuse. II, Adderall), methamphetamine (Desoxyn), and methylphenidate (Ritalin). Other Schedule II substances include amobarbital, glutethimide, and pentobarbital. III Examples ofSchedule III narcotics include products containingnot more than 15 mg Substances in this schedule have a potential for abuse ofhydrocodoneper dosageunit(acetaminophen withhydrocodone) or90 mgof less than substances inSchedules I orII, and abuse codeineperdosageunit(acetaminophenwithcodeine),andbuprenorphineand may lead to moderate orlowphysical dependence or naloxone. high psychological dependence. Examples of Schedule IIIN nonnarcotics include benzphetamine, phendimetrazine, ketamine, and anabolic steroids such as Depo-Testosterone. IV Examples of Schedule IV substances include alprazolam, carisoprodol, clonazepam, Substances in this schedule have a low potential for clorazepate, diazepam, lorazepam, midazolam, temazepam, and triazolam. abuse relative to substances inSchedule III. V ExamplesofScheduleVsubstances includecoughpreparations containingnot Substancesin this schedulehave alowpotentialfor more than 200 mg of codeine per 100 mL or per 100 g (guaifenesin with codeine, abuse relative to substances listed inSchedule IVand promethazinewithcodeine),andezogabine. consistprimarilyofpreparationscontaininglimited quantities of certain narcotics. From Controlled substance schedules. (n.d.). U.S. Department of Justice, Drug Enforcement Administration, Office of Diversion Control. Retrieved from hdefine Nurses are key to creating a culture of safety and accountability related to controlled substances. As such, nurses must: • Verify orders prior to drug administration. • Account for all controlled drugs. • Maintain a controlled-substance log that ensures all required information is documented accurately. • Document all discarded or wasted medication; wastage must be witnessed by anothernurse. • Ensure timely documentation in the patient record following drug administration, including patient response to drug administration. • Keep all controlled drugs in a locked storage area; keep narcotics under double lock. Be certain that only authorized persons have access to the keys, including keys for patient-controlled analgesia and epidural pumps. Medication may also be administered via an automated dispensing cabinet, with bioidentical identifiers used for access. • The ANA recognizes the significant threat to patient safety and liability to health care organizations caused by nurse drug diversion and recommendsthat allstates have a peer-to-peer assistance program for addicted nurses. Reporting is mandatory if suspected or known diversion occurs. Commented [SL29]: This section of text was previously embedded within a third-level (H3) head above. Because of its importance, it was moved out of the H3 section. A separate second-level (H2) head and ELO were created to align with the material. (p. 8) Commented [SL30]: This table presents complex information in an easier-to-read format. (p. 14) 11 H2: Canadian Drug Regulation ELO: Identify the primary governing body and pieces of legislation that regulate drug standards in Canada. In Canada, prior to approval and becoming available to patients, drugs must be reviewed for safety, efficacy, and quality by the Health Products and Food Branch (HPFB) of Health Canada. Health Canada is a federal department tasked with the mission of improving the quality of life of all Canadians. (Further information can be found at www.hc-sc.gc.ca). In 1996, the Canadian government passed the Controlled Drugs and Substances Act. This act broke controlled drugs and substances into eight schedules and two