Both the blessing and the curse of modern medication efficacy lies in the remarkable strength and ability of drug agents to influence the body. Inasmuch as today’s most powerful drugs provide life-saving benefits to millions of patients, the significant narcotic (not to mention financial) value represented by numerous agents commonly used in the hospital setting should never be lost. Although individuals vary widely in their motivations and methods for diverting drugs, the fact of the matter is always the same—diversion of medications and other pharmaceutical agents is here to stay.
The reasons for, and degree of, diversion can indeed run the gamut, but so can the results, and those results usually range from bad to catastrophic. In a recent case involving diversion, a nurse in Wisconsin was alleged to have taken syringes of morphine and hydromorphine intended for patients more than 40 times in a six-month period. Among the results of this alleged theft was an outbreak of Serratia marcescens at the hospital resulting in the death of a patient.
Although the facts of this case have yet to be fully fleshed out, the message to hospital pharmacy is clear: Do not take medication security for granted. Although little can be done to curb human nature, much can be done to limit the often terrible repercussions of drug diversion. Pharmacy plays an integral role in helping to prevent such nightmares from occurring, not just by identifying staff members who may be impaired, but by taking a wider view and truly saving lives by preventing these scenarios from developing in the first place.
A successful diversion program will comprise staff buy in, automation, and security technology, and foremost, robust administrative support. Drug diversion cannot be dismissed as something that only happens elsewhere, as its widespread pervasiveness is clear, but nor can a successful program be marginalized; the stakes are simply too grave. Please read this month’s cover story (p. 6) for more information on combatting this unfortunate byproduct of modern medicine.
All the best,
All the best,
R. Mitchell Halvorsen