Recent studies document that substance abuse is a significant problem among anesthesia personnel. We have developed a system to better control the accountability of narcotics and other potentially addictive drugs. The system consists of a three-phase approach: (1) an individual anesthesia cart/narcotics box; (2) computer analysis of drug usage; and (3) an anesthesia drug audit. A standard stock issue of drugs is maintained by each resident. Drugs are issued daily to those residents administering anesthesia. Each drug transaction is recorded by the resident according to the patient's name, hospital number, type and length of the surgical procedure, type and amount of drug used, and the amount of each drug discarded. A weekly computer-generated report shows individual usage trends for each drug and a summary of "high" users for that period. The computer does not "flag" an individual as a drug abuser, but monitors trends in controlled substance usage. Those residents having a significant alteration in their drug usage pattern that is not explained legitimately are comprehensively audited.