A portable medication dispensing system is described. In some embodiments, the system includes a portable medication tote comprising a securable compartment configured to hold medication, and a controller, responsive to access information, configured to assign a patient to the securable compartment such that medications for the patient are authorized for placement into the securable compartment. The controller is also configured to selectively permit a user access to the medications for the patient in the securable compartment when the access information indicates the user has access to the securable compartment, and restrict access to retrieval of the medications for the patient in the securable compartment when the access information indicates the user does not have access to the securable compartment. The system also includes an information output module configured to output usage information regarding access to the securable compartment.