CONTROLLED SUBSTANCE PROGRAM

Question 1

Who is responsible for the oversight

of the controlled substance program and must review and sign all controlled substance inventories.

Answer 1

CO

Question 2

_______________is recognized as the ship’s Controlled Substance Custodian. As a result, the MDR will maintain custody of all controlled substances that are authorized for shipboard use. Accountability of these controlled substances will be maintained in the form of a working stock log and periodic inventories.

Answer 2

The ship’s MDR

Question 3

When there is no pharmacy tech assigned to the ship who is the Working Stock Custodian?

Answer 3

IDC

Question 4

Can the Working Stock Custodian be the Bulk stock custodian or be a member of the CSIB?

Answer 4

No

Question 5

Working stock

All records must be maintained for how long?

Answer 5

3 years

Question 6

Who trains the bulk stock custodian and the CSIB Members?

Answer 6

Working stock custodian

Question 7

The Bulk Stock Custodian will be a

_________ appointed in writing with responsibilities delineated by the current __

Answer 7

commissioned officer, CO

Question 8

Can the Bulk Stock Custodian be a member of the Controlled Substance Inventory Board

Answer 8

no

Question 9

Bulk stock records will be

maintained for ______ .

Answer 9

3 years

Question 10

What form is the

combination change envelope

Answer 10

SF 700

Question 11

The Bulk Safe and Working Stock Safe shall have their combination changed immediately upon turnover, suspicion of compromise, and periodically _________.

Answer 11

every six months

Question 12

Prescriptions for controlled substances SHALL NOT be issued by an IDC while in their homeport, unless __________________________

Answer 12

an emergency situation exists and treatment will be delayed

Question 13

A person receiving a controlled substance will not normally be returned to duty for a period of ___ after the last medication

Answer 13

8 hours

Question 14

A ______________is the only form and method authorized to prescribe and dispense outpatient medications. The form will be prepared, dated, have the quantity, strength, prescription number and signature of dispenser

Answer 14

DD Form 1289

Question 15

Units shall procure and/or dispense ONLY the controlled substances on the AMAL specific to their platform. Exceptions to this provision must be granted in writing by _________________

Answer 15

the applicable TYCOM Force Surgeon

Question 16

The written AMAL waiver granting authorization shall be maintained with the ______ records.

Answer 16

bulk stock

Question 17

What letter is used as a prefix for controlled substance prescriptions.

Answer 17

“C”

Question 18

Additionally, patients will acknowledge receipt of the drug on……

Answer 18

the back of the prescription

Question 19

If the patient is incapacitated how is acknowledgement obtained?

Answer 19

the person administering the medication and a witness will sign the back stating the recipient was incapable of signing

Question 20

______responsible for the accounting of all controlled substances through conducting periodic inventories.

Answer 20

CSIB

Question 21

CSIB shall be composed of at least ____ members; two must be ______ and the third may be enlisted E-7
or above

Answer 21

three, commissioned officers

Question 22

More CSIB members may be appointed

at the discretion of the __.

Answer 22

CO

Question 23

A minimum of ____ CSIB members must be present to conduct a CSIB inventory with the exception of ships/units with an assigned crew of less than 100.

Answer 23

three

Question 24

When can one commissioned officer and one Chief Petty Officer may constitute the board and conduct the CSIB inventory

Answer 24

Ships with crew of 100 or fewer

Question 25

Periodicity of CSIB inventory

Answer 25

quarterly

within 30 days of a transaction

Question 26

Any loss of controlled substances must be reported immediately to the ___ and _____.

Answer 26

ISIC and TYCOM

Question 27

DEA form 106

Answer 27

Report of

Theft of Controlled Substances

Question 28

DEA form 106 original and 3 copies to where?

Answer 28

• one copy to the nearest DEA office
• one copy to BUMED,
• one copy to the nearest field representative of the NCIS

Question 29

DD Form 200

Answer 29

Financial Liability of Property Loss

Question 30

______approval must be received prior to destruction of any controlled substances

Answer 30

CO

Question 31

A minimum of _____ CSIB members, including the Senior CSIB Member, must be present to at time of destruction.

Answer 31

three

Question 32

Each CSIB member must sign as witness to destruction on the _____

Answer 32

DD Form 200.

Question 33

Fractional medications are defined as

Answer 33

an unused portion of a medication

Question 34

fractional medications that shall be……

Answer 34

wasted and not returned to the working stock

Question 35

Platforms with Medical Officers. Any unused portion of medication must be wasted/destroyed by _________ or one HCP and the ship’s Pharmacy Technician and documented on the NAVMED 6710/1.

Answer 35

two licensed healthcare professionals (HCP)

Question 36

Platforms with IDCs as Senior Medical Department Representatives. Any unused
portion of medication must be wasted/destroyed in the presence of ________ and documented on the NAVMED 6710/1 with forms filed behind NAVMED 6710/5 in the working stock binder.

Answer 36

one CSIB member

Question 37

Wasted meds are documented on what forms

Answer 37

documented on the NAVMED 6710/1