18 June 2018
It can happen in an instant. A health care worker throws away unused prescription drugs or other controlled substance, and an unauthorized person quietly retrieves it for recreational purposes. This type of drug diversion is occurring with increasing frequency in health care facilities, and it is a crisis no care setting can ignore.
Although many believe this kind of event only happens in places like hospitals or health systems, the reality is that every health care organization that dispenses and administers controlled substances is at risk for drug diversion, including physician practices, outpatient clinics and other ambulatory settings. As such, these locations should have mitigation strategies in place to prevent drug diversion.
According to Kimberly New, JD BSN RN, founder of Diversion Specialists and an expert on controlled substance security, waste receptacles can be a primary risk point for diversion. Organizations should make sure that controlled waste is not retrievable once discarded. Although some organizations may choose to use sharps containers when disposing of surplus or expired controlled drugs, these receptacles do not meet Drug Enforcement Agency (DEA) standards for rendering the waste non-retrievable.
Another common disposal method involves flushing the drugs down the drain. Again, this action alone does not meet the DEA standards. Plus, with this approach, an organization runs the risk of having the controlled substance leach into the environment, which can contribute to possible damage and health issues for the community.
To ensure that controlled drug waste is fully non-retrievable for possible diversion, an ambulatory organization should consider using drug disposal containers that employ deactivating agents that render the medication useless after it is disposed. Organizations should place these containers in convenient locations, so staff can easily and quickly dispose of controlled substance waste.
Keep in mind, partial, unused or expired controlled medications should be disposed in front of another staff member who serves as a witness. Both the “waster” and the witness should document their names as part of the disposal record. The DEA supplies specific forms for this purpose.
Patients may ask staff to take back medications that they can't use. However, the DEA forbids organizations to collect unwanted controlled medications from patients, and staff should be trained to decline these requests. If you find that patients are asking about this on a regular basis, it may be helpful to keep a list of registered take-back sites handy. Organizations can also provide patients with specially designed products that they can use to return or destroy their own controlled substances.
Identifying and dealing with drug diversion requires a multifaceted effort. Partnering with a waste disposal expert like Stericycle can ensure that any waste-related processes are designed to thwart diversion. Learn more about how Stericycle can partner with you to limit diversion risks.
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