Using medications beyond 6-month dispense date forbidden

FORT HOOD, Texas (Army News Service, July 6, 2011) -- Soldiers who take their prescription medications six months after
dispensation and pop positive on a urinalysis test could see their careers go down the toilet.

Changes made to Army Medical Command regulation 40-51, issued by the surgeon general via an
ALARACT message Feb.
23, 2011, announced that controlled substances could only be used up to six months from the prescription issuance date.

This announcement may seem minor, but it could potentially be a career-ender for any Soldier who has prescription
medicines, said Col. Kimberly Kesling, deputy commander for clinical services at Carl R. Darnall Army Medical Center, or
CRDAMC.

All it would take is a positive urinalysis test. “A positive urinalysis that occurs after the prescription dispensing date may
result in a no legitimate use finding and subsequent Uniformed Code of Military Justice action,” Kesling said.

This is a major change from how positive urinalysis tests due to prescribed controlled substances were handled in the past,
said Lt. Col. Gwendolyn Thompson, CRDAMC’s pharmacy chief.

“Previously, if a Soldier had a positive urinalysis test, all they had to do was present their medication profile showing they
were prescribed the controlled substance drug within that year and a valid use would be assumed,” she added. “But now,
after six months from the dispensing date, it’s no longer considered valid use.”

Some of the most commonly prescribed controlled substances dispensed at CRDAMC pharmacies are: Percocet,
OxyContin, morphine, Vicodin, Tylenol #3, Xanax, Ambien and Lunesta among others including generics that Soldiers
should be aware of too.
Anyone who receives a controlled substance medication from a CRDAMC pharmacy should be fully
aware of it before they leave the facility Kesling said.

“Controlled substance medications are classified by the Drug Enforcement Agency as a medication with the potential for
abuse,” she said. “These medications are easily identifiable when dispensed at your pharmacy because a signature for
receipt will be required and a pharmacist will counsel you that the medication is a controlled substance.”

CRDAMC pharmacists are also handing out letters to prescription holders on the change in policy and includes a list of the
most commonly prescribed controlled substances, Thompson said.
In addition to advising Soldiers on the policy change,
prescription bottles will be marked with distinct red warning labels which states, “Do Not Use six months after dispensing
date. May result in 'NO LEGITIMATE USE' on urinalysis."

Providers and pharmacies are limiting prescription quantities for these types of medications to a 30-day supply maximum for
acute conditions too.

However, Soldiers with a chronic condition can still get the medications they need, but instead of one large prescription that
would last for several months, they will now get an initial 30-day supply with up to five 30-day refills.

Providers can still write 90-day prescriptions for controlled substance medications that treat attention-deficit hyperactivity
disorder, and deploying Soldiers will continue to receive a six-month supply of their medications before they deploy.

Even though providers and pharmacies are required to follow these new rules, responsibility still falls on Soldiers to make
sure they are in compliance Thompson said.

“We all have medicine cabinets or shelves full of prescription medications,” she said. “Soldiers tend to keep medications that
are for pain if they don’t use it all initially.”

“A year later the Soldier has trouble with pain again and goes to the medicine cabinet and grabs the controlled substance,”
she explained. “That’s what’s going to get them in trouble. They have to read the labels and pay very close attention to the
dispense date.”

Soldiers can avoid this situation all together by safely disposing of the prescribed medication once the six-month grace
period ends.
According to the U.S. Food and Drug Administration’s website, there are several different ways to appropriately
get rid of unused medications.

One way would be to look for medicine take-back programs. Another way would be to mix the medication with unpalatable
substances like kitty litter, put the mixture in a sealable plastic bag and throw it away with household trash.

Highly dangerous medications, like OxyContin, morphine and Percocet that should be flushed down a toilet or sink instead
the website says.

“There are a small number of medicines that may be especially harmful and, in some cases, fatal in a single dose if they are
used by someone other than the person the medicine was prescribed for,” the website states. “When you dispose of these
medicines down the sink or toilet, they cannot be accidentally used by children, pets, or anyone else.”
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