Automated dispensing cabinets (ADCs), also known as automated distribution devices or automated dispensing machines, were first introduced in hospitals in the 1980s and function as an electronic point-of-care storage device for medication distribution. 1 Paparella S. Automated medication dispensing systems: not error free. J Emerg Nurs. 2006; 32: 71-74 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar , 2 Harolds J.A. Harolds L.B. Quality and safety in health care, part x. Other technology to reduce medication errors. Clin Nucl Med. 2016; 41: 376-378 Google Scholar , 3 Grissinger M. Safeguards for using and designing automated dispensing cabinets. P T. 2012; 37: 490-530 PubMed Google Scholar , 4 Brummond P.W. Chen D.F. Churchill W.W. et al. ASHP guidelines on preventing diversion of controlled substances. Am J Health Syst Pharm. 2017; 74: 325-348 Google Scholar , 5 Roman C. Poole S. Walker C. Smit D.V. Dooley M.J. A “time and motion” evaluation of automated dispensing machines in the emergency department. Australas Emerg Nurs J. 2016; 19: 112-117 Abstract Full Text Full Text PDF Scopus (15) Google Scholar Varying levels of decentralized drug distribution can be accomplished using an ADC, including in outpatient areas, such as the emergency department. 6 Findlay R. Webb A. Lund J. Implementation of advanced inventory management functionality in automated dispensing cabinets. Hosp Pharm. 2015; 50: 603-608 Google Scholar , 7 McCarthy Jr., B.C. Ferker M. Implementation and optimization of automated dispensing cabinet technology. Am J Health Syst Pharm. 2016; 73: 1531-1536 Google Scholar , 8 Fanning L. Jones N. Manias E. Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study. J Eval Clin Pract. 2016; 22: 156-163 Google Scholar ADC functionality has advanced over the years, providing the potential for safety advantages compared with nonautomated storage options, such as reduced medication selection errors, enhanced efficiency among nursing and pharmacy disciplines, and the ability to monitor inventory and deter drug diversion by way of accurate medication tracking and record keeping. 3 Grissinger M. Safeguards for using and designing automated dispensing cabinets. P T. 2012; 37: 490-530 PubMed Google Scholar , 5 Roman C. Poole S. Walker C. Smit D.V. Dooley M.J. A “time and motion” evaluation of automated dispensing machines in the emergency department. Australas Emerg Nurs J. 2016; 19: 112-117 Abstract Full Text Full Text PDF Scopus (15) Google Scholar , 7 McCarthy Jr., B.C. Ferker M. Implementation and optimization of automated dispensing cabinet technology. Am J Health Syst Pharm. 2016; 73: 1531-1536 Google Scholar , 8 Fanning L. Jones N. Manias E. Impact of automated dispensing cabinets on medication selection and preparation error rates in an emergency department: a prospective and direct observational before-and-after study. J Eval Clin Pract. 2016; 22: 156-163 Google Scholar , 9 Billstein-Leber M. Carillo C.J.D. Cassano A.T. Moline K. Robertson J.J. ASHP guidelines on preventing medication errors in hospitals. Am J Health Syst Pharm. 2018; 75: 1493-1517 Google Scholar However, such safety gains can be achieved only with careful planning and implementation of automated dispensing systems, along with well-designed and clearly communicated practice expectations for practitioner interaction with the device. Without attention to such details, the risk of medication errors can still be present with ADC use. Samantha J. Burton is 2018-19 Institute for Safe Medication Practices (ISMP*) Safe Medication Management Fellow, ISMP, Horsham, PA.