Controlled drugs records are the part of pharmacy governance where a small procedural drift becomes a serious problem quickly. The aim is not a perfect register — it is a register where an error surfaces within days and can be explained.
This is a practical refresher, not legal advice. Check the current regulations and your own SOPs for the detail that applies to you.
The register
- Kept in the required form, bound or electronic, with a running balance maintained.
- A separate section per drug, strength and form. Mixing strengths in one section is how discrepancies become untraceable.
- Entries made as the transaction happens, not batched.
- Corrections made properly — never obliterated. A marginal note, dated and signed, with the original still legible.
Balance checks
Running balances are only useful if something checks them against the physical stock.
- Choose a defensible cadence and hold to it. Weekly is a common and defensible standard; some branches do high-movement lines more frequently.
- Two people where you can: one counts, one reads the register. Self-checking finds fewer errors, for the obvious reason.
- Record the check itself — date, drugs checked, result, who did it. A check that is not recorded did not happen as far as anyone reviewing is concerned.
When a balance does not match
The instinct to "look again later" is the one to resist. A short, written sequence works better:
1. Recount with a second person. 2. Re-read the recent entries for the same drug — a transposed strength or a missed entry accounts for most discrepancies. 3. Check the physical locations — the CD cabinet, any awaiting-collection area, and anything set aside for destruction. 4. Check the paperwork trail — invoices, requisitions, returns. 5. Escalate if it is not resolved, on the route your SOP specifies, to the superintendent or the accountable officer as appropriate. Do not leave an unresolved discrepancy sitting in a notebook. 6. Record what you found, what you concluded, and what changed as a result.
An unresolved discrepancy that was investigated and documented is a much better position than one that was quietly corrected.
Destruction and returns
- Destruction of stock CDs requires the appropriate authorised witness, and the record kept for the required period.
- Patient-returned CDs are recorded separately from stock. Keeping them in the same place is a recurring audit finding.
- Denaturing kits, not the sink.
Making it survivable
Most CD problems trace back to one of three things: entries made later than the transaction, one person doing both the count and the read, or a discrepancy that was never escalated. Fix those three and the register mostly looks after itself.
For logs, balance-check records and an audit trail kept in one place, see the compliance tools.
