Methadone balance...

[Onion Bunny]

sorry everyone if this sounds stupid... but I'm having trouble with my methadone balance...I don't know how it happens but I seem to run into 'negative' quantity of methadone balance... even though I'm sure I've entered everything correctly (having corrected a few 'normal' and 'SF' mix ups, etc)

I know it's my fault I haven't been calculated the balance everytime I enter the register (due to lack of time, calculator, etc)... so I couldn't recall when I've went wrong! I've kept most of the methadone invoices copy from Sep 07 (some I have lost... ), I've re-checked them again but I seem to have entered all that has to be entered! Can anyone give me any advice? Thanks!

[Web Ferret]

Re: Methadone balance...

I usually find an overage.
The company I locumed for today said that a -/+ 6% was acceptable.

If you have ever "lined up" a row of unopened 500ml bottles you will soon see the differences in the levels.

When you get to a convenient stock ie 2 full and a dreg then "balance" your register ie 1003ml. Write in overage added 60ml or whatever and carry on.
Methadone will never balance as the bottles are not filled very accurately, just record what you have and do a regular balance check.

[Pharmanaut]

Re: Methadone balance...

I usually find an overage.
The company I locumed for today said that a -/+ 6% was acceptable.

If you have ever "lined up" a row of unopened 500ml bottles you will soon see the differences in the levels.

When you get to a convenient stock ie 2 full and a dreg then "balance" your register ie 1003ml. Write in overage added 60ml or whatever and carry on.
Methadone will never balance as the bottles are not filled very accurately, just record what you have and do a regular balance check.

Probably this won't make a lot of difference if you are way out but here goes.
Don't round up to the neareast millilitre, round down.
If you round up you are saying that you have got more than you have, albeit a fraction.
Dispensing measures are for measuring an known amount, not an unkown amount, as are dispensing weighing balances.

[johnep]

Re: Methadone balance...

It has got so bad that in some pharmacies I check balance and have it witnessed before and after opening hours.
johnep

[Onion Bunny]

Re: Methadone balance...

Thanks for the tips! I actually got loads more than the register says so... I always pre-pack a day or so in advance. You think it'll still be OK if I just measure out and write a new balance even though I've not put down the balance for pages?

[Linnear]

Re: Methadone balance...

At the moment running balances are still just good practice.

If you've got a discrepancy I'd start again from scratch. Mark it something like "Balance reconciled" and initial.

If the balance is out by litres then it would be best to try to find it. Re the invoices you can always contact your wholesaler as they must keep a record of all their CD supplies to you.

Remember the discrepancy can depend on the amount of Methadone you use. If you have two addicts then the overage isn't going to account for much.

Our two shops have around 50 addicts between them and get through about 6 litres of Meth a week. That's 12 bottles so if each is out by 10ml thats 120ml a week.

Plus that many addicts amount to 30 or so measurements a day if you're only out by 1ml that could add up to 150ml a week!

In that context discrepancies can build up quickly

[Pharmanaut]

Re: Methadone balance...

At the moment running balances are still just good practice.

If you've got a discrepancy I'd start again from scratch. Mark it something like "Balance reconciled" and initial.

If the balance is out by litres then it would be best to try to find it. Re the invoices you can always contact your wholesaler as they must keep a record of all their CD supplies to you.

Remember the discrepancy can depend on the amount of Methadone you use. If you have two addicts then the overage isn't going to account for much.

Our two shops have around 50 addicts between them and get through about 6 litres of Meth a week. That's 12 bottles so if each is out by 10ml thats 120ml a week.

Plus that many addicts amount to 30 or so measurements a day if you're only out by 1ml that could add up to 150ml a week!

In that context discrepancies can build up quickly

Wonder if it is worth noting amounts for reconciliation just as you go to open a new container, and reconcile from that point?

[paco]

Re: Methadone balance...

I use 500ml methadone bottles which are always over. Are you drinking it your self?

[Pharmanaut]

Re: Methadone balance...

I use 500ml methadone bottles which are always over. Are you drinking it your self?

No just saving having to measure the best part of a 500ml bottle.
400ml Plus of methadone in a measure is just asking to be knocked over.

[johnep]

Re: Methadone balance...

I prefer the Nekem cylinders for measuring liquids.
johnep

[Pharmanaut]

Re: Methadone balance...

I prefer the Nekem cylinders for measuring liquids.
johnep

Agree with you there.
Dispensing measures are good for measuring a known amount.
Cylinder types are better for an unknown amount.

[SolomonQ]

Re: Methadone balance...

I cant see why the balances would be down, from what ive experoiienced so far the are more likely to be up, the reason for this: well each bottle of methadone 500ml actually contains something like 510-515ml extra, dont know why, but its a fact. check it for yourselfs

[Pharmanaut]

Re: Methadone balance...

I cant see why the balances would be down, from what ive experoiienced so far the are more likely to be up, the reason for this: well each bottle of methadone 500ml actually contains something like 510-515ml extra, dont know why, but its a fact. check it for yourselfs

I'm wondering if this amount would be lost in the bit that is left over in the measures, and the drips when pouring as the bottles in use now do not have a pouring lip.

Anyone here using a methadone pump?
Wondering how that affects the balances.
Do you also lose some during the pumpl cleaning routine?

[SolomonQ]

Re: Methadone balance...

Thats the most probable reason for it being more i think, but amount lost depends on pouring techniques and if a pharmacy had 15 addicts on the same methadone type e.g. s/f then most likely all will be prepared in one go in the morning meaning only one rinse of the measuring aparatus is needed minimising wastage and the 20-15ml on top i mentioned above was actually an under-estimate its more like >20ml, and because of the need to keep a running balance the dispenser of methadine would try their hardest to minimize wastage e.g. trying more hard to increase the accuracy of the measurement and to pour out the last drop of methadone back in the bottle before rinsing.

PS running balances are still good practice not obligatory

[Pharmanaut]

Re: Methadone balance...

Thats the most probable reason for it being more i think, but amount lost depends on pouring techniques and if a pharmacy had 15 addicts on the same methadone type e.g. s/f then most likely all will be prepared in one go in the morning meaning only one rinse of the measuring aparatus is needed minimising wastage and the 20-15ml on top i mentioned above was actually an under-estimate its more like >20ml, and because of the need to keep a running balance the dispenser of methadine would try their hardest to minimize wastage e.g. trying more hard to increase the accuracy of the measurement and to pour out the last drop of methadone back in the bottle before rinsing.

PS running balances are still good practice not obligatory

As undergrads we were trained never to pour back into a stock container.
Doesn't apply to Methadone!