September 16, 2018

Limiting Drug Diversion: Three Steps for a Safer Healthcare Facility

Healthcare organizations are working hard to reduce controlled substance diversion. Drug security expert Kim New weighs in with critical tips for proactively getting a handle on the issue.

Prescription painkillers are fueling the U.S. opioid crisis. In response, many agencies—such as The Joint Commission—have increased emphasis on wastage under standard MM.03.01.01 to hold healthcare organizations more accountable for how they order, administer and dispose of controlled substances. The goal is to restrict when and how much of these drugs are prescribed, but also prevent opportunities for drug diversion—when staff or patients steal the drugs for recreational use.
There are numerous risks associated with drug diversion for organizations, the individuals taking the drugs and those around them. For example, if a nurse takes an opioid and then treats a patient while impaired, the patient can be harmed. If the nurse gets into a car after his or her shift and drives while under the influence, he or she could hurt him or herself as well as others in the community.
According to Kimberly New, JD BSN RN, founder of Diversion Specialists and an expert on controlled substance security, there are a few key strategies organizations should implement to dramatically reduce theft.

  • Use waste receptacles that deactivate the medication. Diversion can happen when staff dispose of unused or expired medications along with other regulated medical waste. Red bags and sharps containers can be accessed relatively easily and are not meant to prevent theft. However, by using specifically designed containers, which include a substance that neutralizes the controlled drug, organizations decrease the threat of diversion.


  • Monitor drug disposal. Organizations cannot merely install controlled substance containers and assume staff are using them. They should regularly audit disposal efforts, making sure staff are consistently following proper procedure. This may involve conducting risk rounds in which department leaders observe employees and check waste containers. In addition, leaders should ask staff to state the organization’s policy and demonstrate the disposal process.


  • Provide training. Controlled substance disposal must be witnessed with one staff member attesting that the other correctly and completely disposed of the drug. Organizations should be sure to train staff on both wasting and witnessing procedures. This education should cover the organization’s policy, the reasons behind it, and the individual and community risks that drug diversion presents. Staff should fully appreciate their role in preserving safety and understand the job and licensing ramifications if they do not closely follow both procedures.

Hospitals and health systems are not alone in facing diversion issues—non-acute care facilities are also experiencing this problem first-hand and must have processes in place. Whether you are a hospital or a non-acute facility, Stericycle can help in designing and implementing a comprehensive diversion program. For more information call 855-602-6279.

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