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Drug diversion prevention programs: Do they belong in compliance?

Heidi McNeely (heidi.mcneely@childrenscolorado.org) is a Drug Diversion Prevention Officer at Children’s Hospital Colorado in Aurora, CO.

In 2017, overdose deaths involving opioids were six times higher than what they were in 1999, with about 130 people dying every day from an opioid overdose.[1] The increasing trend in opioid-related fatalities and overdoses is being called an epidemic. The individuals misusing opioids are not just the patients our healthcare organizations treat, but they include our colleagues, the healthcare workers providing care within our own organizations. Estimates of how many people working in healthcare have substance use disorders or addictions vary. Sources suggest around 10% of healthcare workers have an addiction at any given time.[2] Rates of addiction among healthcare workers may be similar to the general public; however, addiction may be higher in healthcare workers because of high-stress jobs, working long hours, and having knowledge about and access to prescription medications. Because only about 1 in 10 people who need treatment for substance use disorder actually receive treatment,[3] it will remain a challenge to accurately estimate the numbers of healthcare workers with addiction.

Pharmacists, pharmacy staff, nurses, and anesthesiologists may have higher rates of opioid use because of their access to these medications. Anesthesiologists often have the highest rates of opioid use compared to other physician groups.[4] ,[5]USA Today (2014) reported that, in a given year, more than 100,000 healthcare workers are abusing or dependent on prescription drugs.[6] Healthcare providers have access to medications to help ease pain, anxiety, and sleeplessness, and medications that help reduce withdrawal symptoms. Unfortunately, there are times when healthcare workers choose to take these medications from their place of employment for their own use. Drug diversion is the illegal use of prescription medications for purposes not intended by the prescriber.[7] It is relatively easy for healthcare workers to divert drugs in their workplace8 because of their familiarity with the systems and because of common gaps in security measures. Drug diversion affects more than individuals; it can affect patients, coworkers, payers, and the reputation of the facility where it occurred.[8]

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