It was a rough morning at physical training today and the work day hasn’t even begun.
The Soldier hadn’t had a problem with his knee since he completed physical therapy following a surgery, but after a six-mile run this morning, it throbs and looks swollen.
Desperate, the Soldier rummages through his medicine cabinet in search of relief. In his search, he comes across his prescription bottle of hydrocodone, a controlled substance he was prescribed for pain for problems with his knee just under a year ago. It would take care of the pain, but should he take a medication that was prescribed almost a year ago?
“We underestimate medications and the effects they can have on us. It’s important to only use medications as prescribed,” said Lt. Col. John F. Detro, deputy surgeon of Clinical Operations/Training for the XVIII Airborne Corps. “Part of that is the length of time you should use the medication for.”
Medical Command Regulation 40-51 outlines the procedures for medical review officers to use when determining if a medical explanation exists for a positive urinalysis drug testing result. The regulation states that Soldiers are authorized to use a prescribed, controlled substance for six months from the prescription date printed on the label.
“We are trying to educate the Soldiers about the change, even though it is a few years old, so that they understand and don’t accidently take something after that six months,” said Detro.
The update to MEDCOM Regulation 40-51 was published in July 2010. According to Detro, some Soldiers are still unaware of the six month expiration on controlled medications in the Army.
Detro said that if Soldiers test positive for a substance on urinalysis, even if it is from a medication they were prescribed, if the prescription is more than six months old, it can result in Uniform Code of Military Justice action.
Reducing the time frame that a Soldier can take a prescribed controlled substance is one of the efforts initiated to reduce the misuse and improve the Army’s force.
The reason Soldiers keep medication past the expiration date may not always be with bad intentions, said Detro.
“If you are in enough pain where you need narcotics, you want to be seen (by a health professional) because, at that point you have a medical issue that needs to be addressed,” said Detro.
The policy includes medication that is prescribed off-post.
The proper disposal of medication is another important step to the safe use of prescribed medications.
“Non-controlled medications can be mixed with coffee grounds or kitty litter and disposed of in the garbage,” said Detro.
This can be accomplished placing medication in a plastic bag and crushing it, then mixing it with the coffee grounds or litter before throwing it away.
“If it is controlled medication, it’s the one time where we tell people to flush them down the toilet,” said Detro. “The reason we don’t want to flush all medications down the toilet is because it’s an environmental risk”.
If medication involves syringes, those should be placed in a sealed container that cannot be penetrated by the needles and then taken out with the trash, said Detro.
Medication can also be disposed of at any time at the amnesty box located at the provost marshals’ office.
There are many resources available for Soldiers who have questions about their medication.
When Soldiers pick up their prescription, they can have a pharmacist answer questions about the medication, said Detro. He also suggested seeing the unit physician assistant or your provider to resolve any questions or issues you have with a medication.
“We are trying to prevent soldiers from making mistakes that could end their career or be life threatening,” said Detro.
He encourages leaders to incorporate the six month expiration policy on controlled substances and the responsibility Soldiers have to inform their provider of controlled substances prescribed off-post into their unit’s safety briefs.
The Soldier looks down at the prescription. The medication is tempting, but with the printed date more than six months ago it is past expiration. He empties the bottle into the toilet and flushes it. The relief would not be worth the risk. He picks up the phone to schedule an appointment to evaluate his knee.