This comprehensive review article delves into the complex issue of nurse adherence to hospital policies concerning the administration and management of narcotic drugs and its potential impact on patient safety and compliance. Narcotic drugs, including opioids, play a vital role in managing pain and suffering, but their misuse or mismanagement can pose significant risks to both healthcare providers and patients. This study explores the reasons behind deviations from established policies, the consequences of non-adherence, and the measures that can be taken to ensure better compliance. By examining these critical aspects, this article aims to provide insights into improving patient safety and promoting more effective medication management within healthcare settings.