Drug Diversion Withholds Meds from Patient

I was recently asked by someone what I did for a living. Occasionally I expound some, and people are always fascinated when the conversation goes a bit further than me stopping at  “I am a pharmacist”. They are fascinated because they enter the world of medication safety and drug diversion monitoring with me for a few moments as I describe what I do. They are usually surprised at the thought that there is drug diversion in the hospitals and that a healthcare worker might be stealing medications. They typically assume the meds are being stolen for resale purposes, and you can see the astonished look on their faces when you tell them much of the time they are being stolen for personal use.

In this recent conversation, this person was fascinated by what I do, and then after a few minutes of conversation you could see the expression on his face change. He then proceeded to tell me the story of his mom who was a victim of an addicted nurse. It happened years ago when he was a teenager, but he remembered it vividly. She was in a hospital being worked up for cancer and in a tremendous amount of pain. She insisted that a particular nurse was not treating her pain, but at first her complaints were brushed off because she was “out of it”. She was also accused of being a drug seeker and just trying to get more pain meds. The son remembers his mom insisting she was not being medicated and writhing in pain while the family, very frustrated, did their best to advocate. This particular nurse had been with the hospital for years and was one of the “head nurses” as the son recalled. At some point someone must have believed the mom, or at least felt they should look into the matter. The plan was, according to the son, to carry on business as usual and after a 2 week time period they would draw blood levels to see if there were any pain meds in the patient’s system. The result – negative levels and therefore her complaint was valid. I hope they didn’t really wait two full weeks, but the extended period of painful agony his mother went through left an impression on him.

Pharmacists are not usually the recipient of patient complaints, so there may be little opportunities for us to advocate for the patient. If you are ever in that position, I encourage you to listen. We never want to unjustly accuse a healthcare worker of diversion, but we owe it to the patient to investigate the matter because diversion is real and they may be a victim.

Trust by verify –Ronald Reagan

Terri Vidals
Terri Vidals

Terri has been a pharmacist for over 30 years and is a drug diversion mitigation and monitoring subject matter expert. Her years of experience in various roles within hospital pharmacy have given her real-world insight into risk, compliance, and regulatory requirements, as well as best practices for medication and patient safety.

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