in writing a member of the branch clinic as custodian.On board large naval vessels, the CO will appoint anofficer of the Medical Department or another officer inwriting as the bulk custodian. This officer will beresponsible for, and maintain custody of, all bulkcontrolled substances. On board smaller naval vessels,access to controlled substances is limited to the bulkcustodian and the senior medical departmentrepresentative (SMDR). Only individuals whoseofficial duties require access to such spaces areprovided the safe combinations.INVENTORY OF CONTROLLEDSUBSTANCESMonthly (or more frequently, if necessary), theControlled Substances Inventory Board takes anunannounced inventory of controlled substances.NOTE: An exception to this frequency maybe made for ships with an Independent DutyCorpsman. On these ships, the inventory maybe conducted on a quarterly basis if there havebeen no transactions of controlled substances(including filled prescriptions or receipts ofitems requisitioned from supply).The CO appoints the members of the board in writing.The board consists of three members, at least two ofwhom are commissioned officers. After the boardconducts the inventory, it submits a report to the CO.The officer having custodial responsibility cannot be amember of the board. On small ships and installations,the SMDR may be a board member. For furtherguidance on controlled substance inventory procedures,refer to NAVMEDCOMINST 6710.9, Guidelines forControlled Substances Inventory.SURVEY OF CONTROLLED SUBSTANCESSchedule I and II controlled substances, ethylalcohol, and locally controlled drugs that have becomeoutdated, deteriorated to the point of not being usable,are of questionable purity or potency, or have had theiridentity compromised, must be reported to the CO. Ifdestruction is indicated and directed by the CO,destruction must be accomplished in the presence of amember of the Controlled Substance Inventory Board.A certification of destruction form contains thecomplete nomenclature and quantity of the substancesto be destroyed together with the method of destructionto be used. After certification is completed, approvedby the CO, and signed by the members witnessing thedestruction, the certification of destruction is retainedand filed as required by current instructions. Thedestroyed substances should then be removed from thestock records and the controlled substance log.SUMMARYInpatients and the majority of outpatients willreceive pharmaceutical products as part of theirtreatment. As a healthcare provider who mayadminister these products or fill prescriptions, it iscrucial for you to have a good foundation of knowledgein pharmacology, toxicology, and the proper handlingof prescriptions and controlled substances. Thischapter touched on each of these topics to assist you inyour duties. However, you should consult therecommended publications, such as the Manual of theMedical Department, Drug Facts and Comparisons,and the Physicians’ Desk Reference, to provide youwith the guidance and knowledge you will need toprovide the best possible care for your patients.6-26
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