On October 24, 2018, the President signed into law H.R. 6, the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act, also known as the SUPPORT for Patients and Communities Act. The Act includes a section which amends the Controlled Substances Act and allows a hospice employee to handle lawfully dispensed controlled substances of deceased hospice patients to assist with disposal of the controlled substances, so long as the disposal occurs onsite in accordance with applicable law. Prior to this amendment to the Controlled Substance Act, hospice personnel were only allowed to instruct family members in proper disposal of controlled substances and were prohibited from handling the substances and/or assisting in the disposal. The law specifies that the disposal occurs onsite, meaning at the place of death, and that it is in accordance with any state or local laws.
Hospice agencies may now revise their policies, procedures, and practices to reflect this change. Policies such as Disposal of Controlled Substances, Procedures at Time of Death, Documentation Requirements at Time of Death, and electronic medical record revisions to include details of items disposed are some examples to consider. Agencies should keep in mind that this law is specific for disposal of controlled substances at time of death and does not include disposal of discontinued controlled substances on live patients. Educating clinicians and implementing the revised practice changes as soon as possible will help decrease the opioid diversion and misuse across America.
The summary of H.R. 6, sponsored by Rep. Greg Walden of Oregon, can be found at https://www.congress.gov/bill/115th-congress/house-bill/6. For details related to the hospice disposal, refer to Sec. 7062, Safe Disposal of Unused Medication Act.