A four-year study and a number of reports by healthcare organizations, including The Joint Commission (the nation’s oldest and largest standards-setting and accrediting body in healthcare), as well as an NPR report (Oct. 2020), point to a substantial increase in hospital drug thefts, tied to healthcare workers struggling with substance use disorders.
According to a wide-scope review by Mark Fan, et al. published in the Journal of Hospital Medicine, “Drug losses and theft from the healthcare system are accelerating,”[1] and this being in the midst of the U.S. “struggling with unprecedented opioid-related mortality.”[2]
Last fall, Brian Mann from National Public Radio (NPR), titled an article, “Some Health Workers Suffering from Addiction Steal Drugs Meant for Patients,” after finding a growing number of health industry experts and researchers cautioning that this kind of on-the-job drug theft by healthcare workers may be increasing.[3]
“It’s extremely common and the consequences can be very, very grave,” said Kimberly New, an expert on medical drug misuse, known in the industry as diversion.[4]
The problem is multi-faceted, in that it ripples out, creating dire consequences in many people’s lives. Diverting patient’s medications or stealing them outright from hospital pharmacies can be harmful to individual patients, the care provider(s) involved, the providers’ colleagues, the hospital and the health care system as a whole.”[5]
And indications are that this wave of drug thefts in hospitals and other medical facilities has been growing for a number of years. Per a report by The Joint Commission (with data collected by Protenus), “166% more legally prescribed opioids were stolen in 2018 than the year prior. Of these, 34% of incidents of diverted opioids happened in hospitals, followed by private practices, long-term care facilities and pharmacies.”[6]
The harm and risk of danger to patients from drug diversion can be severe, even dangerous. Those patients undergoing cancer treatments or post-surgical recovery without proper pain relief can end up having complications as a result.
“Patients will be left to linger in pain and not receive the doses that they were supposed to receive,” New said. “The diverter has progressed (in their addiction) to the point where they’re no longer willing to share with the patients.”[7]
And per the NPR report, studies by the CDC and the Mayo Clinic also found healthcare workers who steal drugs frequently tamper with the prescribed medications, leaving them contaminated and patients ultimately becoming infected with blood-born pathogens.[8]
In fact, the Mayo Clinic study found as many as 28,000 hospital patients had been “put at risk of contracting Hepatitis C over a 10-year period because of this kind of drug theft and tampering.”[9]
The personal consequences for healthcare workers who divert drugs can also be devastating, including loss of career, respect of colleagues and family, and significant legal troubles. Let alone their having to deal with the horrors of drug addiction itself. Addiction treatment for healthcare workers is certainly part of the solution, but improved detection of hospital drug thefts is high on many agencies’ priorities lists, as well.
The NPR article states that Kit Check, a company that monitors drug inventories at hundreds of U.S. hospitals, brought home this point in spades when they published a report indicating huge quantities of high-risk medications couldn’t be accounted for by healthcare facilities. “There are 111,000 instances here where the folks who were reviewing drug inventories could not figure out why the math didn’t add up,” said Kit Check CEO Kevin MacDonald.[10]
As for policing such, it was pointed out that U.S. hospitals and clinics are required by federal law to have some kind of security and inventory system for opioids and other controlled medications. But according to Mark Fan, who led the previously mentioned 4-year study on hospital drug diversion, those systems may not consistently protect the drugs or the patients they’re intended to help.
He said, “We know that staff are really overworked, they’re under a lot of time pressure. It’s not uncommon for people to let things slide.”[11] But Fan’s study concluded by pointing to safeguards that exist and his exhorting hospitals to consider ways to implement them more rigorously to prevent drug diversion. “Careful configuration of healthcare technologies and processes in the hospital environment can reduce the opportunity for diversion.”[12]
[1] Diversion of Controlled Drugs in Hospitals: A Scoping Review of Contributors and Safeguards | Journal of Hospital Medicine
[2] The Burden of Opioid-Related Mortality in the United States | Addiction Medicine | JAMA Network Open | JAMA Network
[3] Some Health Workers Suffering From Addiction Steal Drugs Meant For Patients : NPR
[4] Ibid.
[5] ISMPCSB2020-i8-Opioid-Diversion (ismp-canada.org)
[6] Detecting Drug Diversion in the Health Care Workforce | The Joint Commission
[7] Some Health Workers Suffering From Addiction Steal Drugs Meant For Patients : NPR
[8] Ibid.
[9] Ibid.
[10] Ibid.
[11] Ibid.
[12] Diversion of Controlled Drugs in Hospitals: A Scoping Review of Contributors and Safeguards | Journal of Hospital Medicine