Narcotic Diversion Prevention

Over the last 5 years I have focused on narcotic diversion prevention. In 2018 a national report stated that over 30 million doses of narcotics were diverted from healthcare facilities in the US that year. That was an increase of over 100% from the previous year. Because many healthcare workers aren't exposed to diversion on a daily basis, it's easy to forget that this epidemic is a growing concern. I've been speaking across the country on this topic, delivering drug diversion prevention talks directly to staff and management teams. My discussions target those most likely to encounter diversion and my message is always the same: we absolutely cannot afford to put our patients at risk. Our patients, who are entrusting us with their lives while they undergo procedures, in our centers, should never be placed in jeopardy because their care is compromised by an impaired employee. Employees become impaired when they are under the influence of the controlled substances they have diverted and most likely used while working. But there are additional risks for patients. Some individuals who divert drugs will replace the narcotic in the empty vial with saline, draw a syringe full of the saline, and administer that to the patient instead of the intended medication. Risks here are two fold: patients are now exposed to blood borne pathogens because the vial and potentially the syringe are contaminated from the diverter, and the patient is not receiving the drug that was ordered for them. Drug diverters often use the same syringe on themselves as they later use for the patient. Why? They are moving as quickly as possible and do not want to draw extra attention by creating more medical waste (i.e. the used syringes) than normal.

Beyond providing education and speaking at conferences, I've been working hard with our JDJ Consulting team to prevent and address diversion among our clients. I have customized a 100 point drug diversion analysis for my clients that has been very effective in heightening staff awareness and improving security of narcotics. During this day-long risk analysis, a JDJ Consulting team reviews all areas of narcotic activity in a healthcare facility. We perform chart reviews, narcotic record audits, carefully analyze the controlled substance handling continuum, and evaluate the center's security and storage of narcotics. Upon completion, we deliver findings and recommendations in a comprehensive report.

FINDINGS Past Narcotic Diversion Risk Analyses have been extremely successful in identifying diversion, revealing areas of exposure, and improving security and safety measures at surgical facilities. Results of past risk analyses have included:

  • identification of staff that had diverted narcotics, support provided from the facility, and rehabilitation

  • revision of narcotic tracking and inventory system

  • changes to staffing protocols that reduce employee risk

  • increases in physical security measures

  • increased efficiency of staff's narcotic handling time

  • identification of controlled substance loss

  • verification of controlled substance stock

  • implementation of process improvement projects, where necessary, to increase security and efficiency

During past investigations, I have witnessed security footage of staff accessing controlled substances without authorization, security footage of staff mishandling controlled substances, found evidence of unauthorized purchasing and theft upon delivery, identified forged narcotic records, patient charts, and inventory sheets, and have quantified thousands of units of stolen controlled substances.

If you're not already strategizing narcotic diversion prevention, you should be. Call me, Brittney, or Madison, and we'd be happy to discuss how to improve your narcotic security, how to schedule an in-service, or even provide more information about our Narcotic Diversion Risk Analysis. Far too often my clients come to me after diversion happens. Don't wait that long. As I always say... IT'S NOT A PROBLEM, UNTIL IT'S A PROBLEM!

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