15 April 2019
A Significant Threat to Safety
Drug diversion is when a controlled substance is illicitly displaced from its intended medical purpose and/or the person the drugs were prescribed to. It’s an increasing problem in health care facilities and a key factor contributing to the nationwide opioid epidemic. The Department of Justice (DOJ) and the Drug Enforcement Administration (DEA) are ramping up efforts to bring awareness to practitioners and tackle the growing problem of drug diversion.
Although diversion happens in many different settings, hospitals and the multiple sites of integrated delivery networks are particularly vulnerable due to the considerable number of controlled substances that may be administered in these settings. As such, all health care organizations should create a robust drug diversion prevention program that preserves patient and staff safety. Here are some key points to keep in mind when establishing mitigation strategies.
Common Pharmaceuticals Targeted for Diversion
According to the Bureau of Labor Statistics, 94 percent of the most abused prescription drugs are Schedule II, III or IV medications—and are often painkillers. Examples include hydromorphone and oxycodone (Schedule II), Tylenol with Codeine (Schedule III) and Diazepam or Lorazepam (Schedule IV). As frequent targets for drug diversion, it is important to be aware of these and other high-risk drugs your organization uses to make sure any interventions fully address potential hazards.
Proper Medication Disposal Is Key to Diversion Prevention
Founder of Diversion Specialists and an expert on controlled substance security, Kimberly New, JD BSN RN, indicates that waste receptacles can be a primary risk point for diversion. Unused drugs can be diverted if they are not rendered non-retrievable after disposal. To mitigate risk, organizations should look beyond common disposal methods such as sharps containers or flushing, as these do not fully meet the DEA standard for rendering the drugs as non-retrievable.
Health care facilities should consider specially-designed receptacles that deactivate the drugs on contact to ensure they are rendered useless once discarded. Additionally, organizations should place these containers in convenient locations, allowing staff to quickly dispose of controlled substance waste.
Provide Comprehensive and Compelling Training
A critical element in averting drug diversion is educating staff members on the importance and intent of drug administration and disposal procedures, ensuring they are aware of the seriousness of the problem and their responsibility in preventing it. Staff members should also learn how to recognize suspicious situations and where to report them.
To maintain compliance and be most effective, training should be convenient, easily accessible and timely, and employ real-world examples to bring the problem to life. Online tools, posters displayed near drug waste containers and timely reminders and alerts can all be helpful in keeping staff up-to-date and reminded of the rules throughout the year.
Give Staff Tools to Address Patient Questions
Oftentimes, if patients have unused controlled medications, they will ask staff what to do with them. Since the DEA does not allow health care organizations to collect unwanted controlled medications from patients, staff should be aware of disposal resources patients can use. For example, local takeback events like National Take Back Day happening biannually in the spring and fall. In addition, health care organizations can obtain specially designed products that can be provided to patients to have their own drugs properly disposed.
To reduce the risk of drug diversion, health care organizations must have a well-considered and detailed mitigation plan in place. Learn how Stericycle can help your organization develop a comprehensive plan that includes equipment designed to keep patients and staff safe, while maintaining ongoing compliance.
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