EMS Narcotic Storage Requirements by State

"All controlled substances shall be secured behind no less than two locks upon initial receipt. If a provider service stores a controlled substance at a central location, it shall be placed in a separate container with a lock, and inside a safe, cabinet, file cabinet, or similar device, which is secured to the wall and floor of the building."

"All fluids and medications shall be stored in a locked (keyed or combination) compartment when not in use by appropriately licensed EMSP."

No Alaska rule found that says how EMS services must lock up or account for controlled substances; drug use is left to each service's medical director and the federal DEA rule is the storage standard. In May 2026 the Board of Pharmacy noted a DEA recommendation that each EMS service hold its own DEA registration, but no state rule followed.

"If a controlled substance, in a hard-shelled container that is difficult to breach without the use of a power cutting tool and: (1) Locked inside a motor vehicle or aircraft registered to the emergency medical services provider or ambulance service, (2) Otherwise locked and secured in such a manner as to deter misappropriation, or (3) On the person of an EMCT authorized access to the agent;"

"While on a motor vehicle or aircraft registered to the emergency medical services provider or ambulance service, secured in a manner that restricts movement of the agent and the receptacle specified in subsection (F)(2)(d)(i)"

"(1) The controlled substances storage area at the ambulance service's physical location shall be accessible only to specifically authorized employees. ... (3)(A) All controlled substances shall be stored under a mounted double-lock security. (B) All other prescription drugs shall be stored under a single-lock security."

"(2)(A) The licensee shall provide adequate security for all legend (prescription) drugs onboard all registered vehicles. ... (3)(A) All controlled substances shall be stored under a mounted double-lock security."

"Access should be limited to one (1) person responsible for the accountability during shift; ... (D)(i) Services shall have a quality assurance process for all controlled substances that includes a routine audit process."

"Ensure that security mechanisms and procedures are established for controlled substances, including, but not limited to: ... controlled substance master supply storage, security and documentation; ... vehicle storage and security; ... usage audits."

No Colorado rule sets locks or seals for controlled substances on ground ambulances or at stations. Ground services must record routine medication checks and keep them two years for state inspection, and only air ambulances must keep controlled substances securely maintained under drug laws.

"Medications, fluids and controlled substances shall be securely maintained by air ambulance licensees in compliance with local, state, and federal drug laws."

No EMS-specific rule. Connecticut law requires all controlled substances to be 'properly safeguarded and securely kept', and the state's security regulation for DEA registrants (which includes DEA-registered EMS agencies) requires a secure area for authorized staff only and storage kept locked with keys removed. Nothing is said about vehicles, double locks or seals.

"Controlled substances and preparations shall at all times be properly safeguarded and securely kept."

"Medications carried on the charge provider's person do not require double lock security. ... Keys to access the secured medications must always be in the possession of the charge clinical provider, or the responsible person, on the ambulance."

"All medications falling under Schedule II, III, and IV of Title 21 United States Code (USC) Controlled Substances Act that are stored or carried on board the unit must be secured under double lock with the exceptions:"

"Each ALS and air ambulance provider shall develop, implement, maintain, and have available for review by the department written operating procedures approved and signed by the medical director for procuring, storing, handling, dispensing, and disposal of all controlled substances, medications, and fluids."

"Security procedures which include the provider's method of ensuring against theft, tampering with or contamination of controlled substances, medications, and fluids and the identities and position titles of employees who have access to controlled substances."

"Such dangerous drugs and controlled substances shall be furnished, secured, and stored in the manner provided for in O.C.G.A. 26-4-116."

"Pharmaceuticals shall not be left unattended on vehicles unless such vehicles are maintained in environmentally controlled facilities, or the pharmaceuticals are kept in environmentally controlled boxes ... and such vehicles are locked. ... Narcotics must be maintained in accordance with Georgia Pharmacy Regulations."

"A standard ward inventory may be placed on an emergency vehicle licensed with the State Department of Human Resources. A contract or agreement must be signed between the hospital and the ambulance service"

Hawaii has no state rule on how EMS must lock or seal controlled substances; agencies need a state registration for each storage location, and the Narcotics Enforcement Division may require alarms or enclosures case by case. Storage is set by each county; for example, a 2023 Hawaii County Fire Department policy requires a double lock and locked unattended ambulances.

No Idaho EMS rule on narcotic storage. State controlled substance law requires whoever holds the registration (in practice the medical director's practitioner CSR for the address where drugs are stored) to store controlled substances per state and federal law, which in effect means the DEA security rules.

"Persons registered under this chapter shall keep records, store controlled substances and maintain inventories in conformance with the recordkeeping, storage and inventory requirements of state and federal law."

"The EMS medical director must review and update protocols, policies, and procedures at least every two (2) years."

"Administrative, Legal and EMS Protocols and Guidelines shall include, but not be limited to the following: ... Storage and security of medication"

"Access to any sub-stock of controlled substances shall be limited to advanced emergency medical technicians or paramedics within their approved scope of practice and require at least two (2) locks with different keys or other secured access. (2) Controlled substances must be secured in a locked box within a locked stationary cabinet under two (2) separate, secured, and independent locking systems."

"Controlled substances must be secured in a locked box within a locked stationary cabinet under two (2) separate, secured, and independent locking systems."

"Security. The EMS program will ensure security of prescription drugs and records to prevent and detect unauthorized access."

"Physical security controls will be commensurate with the schedules and quantities of such substances in the possession of the registrant or permittee in normal business operation and in accordance with 21 CFR Part 1301."

Kansas ambulance services register with the Board of Pharmacy (form BA-09, 'Ambulance or EMS (in state)'), and every registrant must guard against theft and diversion under the federal DEA security rules, which Kansas adopts by reference. The Board's ambulance inspection form checks that controlled substances are locked.

"Each applicant and registrant shall provide effective controls and procedures to guard against theft and diversion of controlled substances in conformance with the security requirements of federal law, including the requirements of 21 CFR 1301.71"

"All agencies shall store controlled substances in a locked storage box. Controlled substances on a vehicle shall be stored in a locked storage box and in a locked compartment on the vehicle that is immediately accessible to personnel."

"All controlled dangerous substances carried on ambulances must be under the personal control of a licensed EMS practitioner ... or kept in a substantially constructed, securely locked cabinet on the vehicle. ... All controlled substances kept at the ambulance service's central location must be stored in a substantially constructed securely locked cabinet or a safe."

"Ambulance services must maintain both a dispenser's log and a perpetual inventory of their controlled substances, unless the service is part of a hospital and are maintained by the hospital."

Under the chapter now in force, Maine requires controlled substances in a storage box closed with a one-time, pharmacy-type, numbered seal, with the seal checked and logged at least daily; the rule does not mention locks. Maine EMS has proposed a full rewrite of Chapter 6 (comment closed Sept. 18, 2026) whose draft drops the seal language, and no adoption had been found as of Oct. 23, 2026.

"All controlled substances must be secured in a storage box unless otherwise approved by the Board. The box must be secured with a one-time, pharmacy-type, numbered seal applied."

"Controlled substances which are stored in a controlled access system acceptable to SOCALR;"

"If medications are stored on the Ambulance, Ambulance doors are locked when the ambulance is not in use. Cabinets containing Schedule II, III, and IV controlled substances are uniquely keyed drug boxes, secured by numbered seals."

"All applicants and registrants shall provide effective physical security controls against theft and other diversion of controlled substances. All applicants and registrants shall provide physical security controls which meet the conditions set forth in guidelines issued by the Department."

"Licensed EMS clinicians will ensure that a proper seal is in place on medication containers. ... Medication containers and IV supplies shall be locked and secured in the temperature-controlled environment, except when required for patient care."

"A licensee shall establish and implement written procedures for responding to ambulance service complaints, maintaining ambulances and equipment, procuring and storing drugs, and controlling infection. The licensee shall maintain the procedures in its files."

"Controlled substances must be secured in accordance with applicable state and federal regulations. The paramedic's narcotics should be secured in a designated location when he is not on duty ... When on duty, each paramedic should keep his controlled drugs in his immediate possession or securely locked in the vehicle at all times."

"Prescription items and drugs should always be stored and carried in secure locations accessible only to authorized personnel."

"Security of medications, fluids and controlled substances shall be maintained by each air ambulance licensee. Controlled substances are in a locked system and kept in a manner consistent with Drug Enforcement Agency (DEA) regulations and approved by the service's medical director."

"Controlled substances listed in Schedules I and II shall be stored in a securely locked, substantially constructed cabinet. (B) Controlled substances listed in Schedules III, IV and V shall be stored in a securely locked, substantially constructed cabinet."

"All controlled substances in a building must be stored in a securely locked substantially built safe or cabinet. ... Controlled substances on ambulances should be stored in locked containers and storage areas. Most services use a serially numbered tag system."

"After the initial inventory is taken, the registrant shall take a new inventory of all stocks of controlled substances on hand at least once a year."

"The medical director shall be responsible for and approve a system to assure the inventory, storage, and security of all the medications utilized by the ECPs to whom the medical director provides medical oversight. The medical director may delegate the day-to-day duties where appropriate but retains overall responsibility."

"A physician medical director is responsible for: ... (viii) The oversight of the distribution, storage, ownership and security of medications and controlled substances utilized by the emergency medical service."

"Nevada EMS permit inspections may verify: ... Physical security (vehicle cabinets, facility storage, locking procedures)"

"each controlled substance must be: (a) Stored in a locked cabinet in the ambulance, air ambulance or agency's vehicle; or (b) Under the direct physical control of a paramedic or a registered nurse. 3. When a controlled substance is not being used, it must be secured ... in a manner approved by the medical director of the service."

"Each time the responsibility for the controlled substances changes from one crew to another, an entry must be made in the record. The entry must include ... the current inventory upon transfer and the initials of each paramedic or registered nurse of the receiving crew. ... Each service shall conduct an inventory of all controlled substances monthly."

"When stored on a vehicle, the drug kit shall be stored in a secured compartment, separate from the non-controlled substance medication container."

"All controlled drug kits shall be prepared and sealed by the pharmacy"

"All medications are to be kept in a locked storage box or compartment when not under the direct control of an ALS crewmember."

"All substances identified in Schedules I through V of the New Jersey Controlled Dangerous Substances Act (N.J.S.A. 24:21-5 through 8.1) shall be kept under a double lock system that requires two separate keys for access, except when under the direct control of an ALS crewmember responsible for their custody."

"All dangerous drugs must be stored with appropriate security to limit access when authorized personnel are not present. Extra precautions shall be provided for security of controlled substances. B. Jump kits shall be kept in the possession of a licensed emergency practitioner or in a locked compartment of a mobile unit when not in use. C. Jump kits shall be stored in the facility if the mobile unit is parked outside of a secure vehicle bay."

"When access to the patient compartment of an ambulance is kept locked at all times, controlled substances shall be secured in a locked cabinet using a key lock different than the patient compartment. ... must be secured in a locked box within a locked stationary cabinet under a two lock system using different keys. ... A written change of shift inventory for any substock shall be conducted"

"Any stock or substock of controlled substances shall be stored in a locked cabinet of substantial construction at the location registered with the Department. The cabinet shall be stationary, be made of steel or other metal ... Access to any stock or substock of controlled substances will be limited to the agent and require at least two locks with different keys."

"develop and implement written operational protocols for the management of equipment, supplies, and medications ... (C) to assure that supplies and medications are not used beyond the expiration date and stored in a temperature controlled atmosphere according to manufacturer's specifications."

"Controlled substances must be sealed in a double lock secure system."

Ohio's current rule (effective December 1, 2025) only requires EMS controlled substances to be physically secured with access limited to paramedics, AEMTs and affiliated prescribers, RNs or pharmacists, plus an annual inventory. The Board of Pharmacy is mid-way through amending it (business impact comment period closed September 14, 2026) to require a securely locked, substantially constructed cabinet or safe that cannot be readily removed, matching the 2026 DEA rule.

"Board staff will review and document how the licensee monitors its inventory of controlled substances (e.g., daily count, perpetual inventory, etc.). ... All dangerous drugs shall be removed from the vehicle and properly secured at the licensed facility."

"Except as provided in paragraph (B)(2) of this rule, all controlled substance dangerous drugs maintained by the EMS organization shall be physically secured with access limited to persons listed in paragraph (B)(1) of this rule."

"An EMS organization shall conduct an annual inventory of all controlled substances in accordance with rule 4729:5-3-07 of the Administrative Code."

"An ambulance service, with personnel licensed to utilize such, is hereby authorized to carry a limited supply of controlled substances, secured and stored in a manner that is compliant with State and Federal statutes and regulations. ... An inventory shall be kept and signed according to the requirement of the Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD), and the United States Department of Justice Drug Enforcement Administration (DEA)."

"controlled substances shall be in a locked system and kept in a manner consistent with Federal and States requirements and applicable sections of this Chapter."

"A signed and dated policy describing the type and amount of controlled substances stored on each ambulance and how controlled substances will be stored, accessed, recorded, administered, destroyed and secured. It is the responsibility of the EMS medical director to ensure that the procedure meets the minimum US Drug Enforcement Administration requirements."

"Controlled substances, when authorized by the EMS medical director, are stored, accessed, inventoried, administered, destroyed and secured in a manner consistent with the signed and dated procedure established by the EMS medical director. The procedure must be in accordance with the regulations promulgated by the US Drug Enforcement Administration."

"Storage and security of medications including controlled substances if authorized by the emergency medical services (EMS) medical director as required by the Oregon Board of Pharmacy and the US Drug Enforcement Administration in accordance with OAR 333-250-0300;"

"An EMS agency may stock medications as approved by the Department and shall store medications in a temperature-controlled environment, secured in conformance with the Statewide EMS protocols and the EMS agency's policy and procedures on the storage and environmental control of medications."

"(2) Storing medications as required under The Controlled Substance, Drug, Device and Cosmetic Act ... (4) Maintaining records of medications administered, lost or otherwise disposed of and records of medications received and replaced. ... (9) Securing medications in a manner so that only those EMS providers authorized to administer the medications in providing EMS have access to those medications."

"I attest that the polices listed below have been established and communicated to all appropriate staff. ... Storage and environmental control of medications 1027.5"

"Controlled substance security ... Stored securely with at least two (2) locks, keyed or combination"

"Each ambulance service must have written policies and procedures ... m. Acquisition, security and disposal of controlled substances and other drugs in accordance with applicable Federal and State Regulations"

"The EMS Agency shall ensure controlled substances listed in Schedules II, III, IV, and V shall be stored in a double locked system and kept in a manner consistent with Regulation 60-4 and federal Drug Enforcement Administration (DEA) regulations. The EMS Agency shall ensure medications are monitored and attended to prevent access by unauthorized individuals."

"Medication Management to include written Protocols for storage and maintenance of controlled substances; periodic inspection and inventory of maintained controlled substances by the EMS Agency Director, EMS Agency Assistant Director, Medical Control Physician and/or Assistant Medical Control Physician"

"Controlled substances are in a double locked system and kept in a manner consistent with state and federal controlled substances laws and regulations;"

No South Dakota EMS rule on narcotic storage, and ambulance inspection forms do not check it. The only state storage rule is the Department of Health rule that controlled substance registrants keep stock in a securely locked, substantially constructed cabinet, which reaches ambulance stock only through the medical director's registration, and the state has not said so.

"Controlled substances shall be stored in a securely locked, substantially constructed cabinet."

No Tennessee rule says how EMS agencies must lock up or account for controlled substances; the EMS rules only require medications to be stored for sterility, cleanliness, dosage and expiration. The Board of Pharmacy does not license or register ambulance services, so the federal DEA rule is the storage standard.

"Medications must be packaged and stored in accordance with pharmacological guidelines for sterility, cleanliness, dosage, and expiration."

"(J) the security of medications, fluids, and controlled substances in compliance with local, state, and federal laws or rules;"

Utah H.B. 402 (2026) created a state controlled substance license for EMS agencies (Utah Code 58-37-310, effective May 6, 2026) and orders DOPL to write rules on how agencies store controlled substances. As of October 23, 2026 no such rule has been proposed or adopted, and the current EMS rules (R911) only require medications to be stored per manufacturer temperature and packaging recommendations.

"The rules the division makes under this section shall include rules addressing: (i) the storage of controlled substances by a registered agency; (ii) restocking controlled substances in a registered agency's emergency medical service vehicle at a hospital;"

"All EMS agencies that carry prescription drugs shall have a system approved by the district medical advisor for receiving, storing, safeguarding, rotating, and recording all prescription medications carried and used."

"Drugs in Schedules II through V stored on a ground EMS vehicle, other EMS vehicle, or EMS vehicle that is a licensed fixed-wing aircraft shall be stored in a sealed, secured kit or device within a locked cabinet that is accessible from the patient compartment of the vehicle."

"The method of sealing the kits shall ensure that once the seal is broken, it cannot be reasonably resealed without the breach being detected. ... In lieu of a seal, a kit with a built-in mechanism preventing resealing or relocking once opened except by EMS personnel may be used."

"Drugs shall be maintained in a lockable cabinet, cart, device, or other area that shall be locked at all times when not in use. The keys or access code shall be restricted to the supervising practitioner and persons designated access ..."

"The MPD must: (a) Establish policies as directed by the department to include a policy for storing, dispensing, and administering controlled substances. Policies must be in accordance with state and federal regulations and guidelines;"

"5.1.10. All EMS vehicles must have a lockable storage compartment for medications in accordance with federal Drug Enforcement Administration regulations."

"Required policies and procedures include, but are not limited to, operation and maintenance of services; equipment and facilities management; ... a medication management plan compliant with federal and state requirements;"

"7. Controlled substances and how the service provider will obtain, store, secure, exchange, and account for any and all controlled substances used to provide patient care."

No Wyoming rule says how EMS agencies must lock up or account for controlled substances. The EMS rules only list approved medications and leave stocking to the agency's medical director, and the Board of Pharmacy does not register ambulance services, so the federal DEA rule is the storage standard.