Drug Diversion Defined: Steps to Prevent, Detect, and Respond to Drug Diversion in Facilities

Posted on by CDC's Safe Healthcare Blog
Injection Safety
Injection Safety

Guest Author: Kimberly New, JD BSN RN,
President, Tennessee Chapter of the National
Association of Drug Diversion Investigators

In my last blog, I talked about the impact of drug diversion on hospitals and healthcare facilities. Today, I will be discussing the frequency of diversion within healthcare facilities and what facilities can do to prevent, detect, and appropriately respond to diversion.

There are no reliable statistics about diversion by healthcare providers. This is because diversion is done covertly, and methods in place in many institutions leave cases undetected or unreported. At a facility with a strong diversion program and a nursing staff of about 1,000, I identified 1-2 new cases of staff members diverting each month. Well over 50% of those caught were diverting and using injectable opioids.

Diversion of controlled substances happens at all institutions. Because diversion can’t be stopped entirely, facilities must prevent it to the extent they can, identify cases quickly, and respond appropriately.

The essential elements of a healthcare facility diversion program include

  • Policies to prevent, detect, and properly report diversion,
  • A method of observing processes and auditing drug transaction data for diversion,
  • Prompt attention to suspicious audit results,
  • A collaborative relationship with public health and regulatory officials, and
  • Diversion education for all staff.

In conjunction with its investigation of a diversion incident, the New Hampshire Department of Health and Human Services observed, “Highly educated and well-trained staff failed to recognize or overlooked behaviors indicative of addiction…or failed to follow established policies to address staff with substance abuse problems.” Ensuring that all staff are aware of the signs of diversion and impairment, and that they know reporting avenues, can facilitate quick recognition and response.

Whenever diversion is identified, healthcare facilities should promptly report to appropriate enforcement agencies and, ideally, obtain complete details from anyone caught diverting.  If injectable medications were diverted and tampering is suspected, facilities should also engage public health officials to assess the need for patient notification.

Posted on by CDC's Safe Healthcare Blog

3 comments on “Drug Diversion Defined: Steps to Prevent, Detect, and Respond to Drug Diversion in Facilities”

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    Monday was pushed injections on every part of my body I’d lndicated pain (15yr old level 3spibe fusion and splondiac arthritis which needs proper diagnosis) video recording inadvertently captured my visit, reviewing still painful -11 separate attempts to inject everything from thumb to hip to shoulder -completely immobilized now – offered an anti-depressant: need a proper diagnosis/treatment
    Soo much Injection pushing within 10min raised huge flags

    Yes, Drug diversion is bad…. Detection is important. What action is “best” once detected. Firing the impaired individual so they can do this again with another organization? Mandating drug rehab for the individual who does not want to go through it at the time of discovery and risk labor related litigation?

    Are there evidence based policies/guidelines to respond to it AFTER it is detected?

    Pls respond

    While the author explains the importance of this issue and identifies many of the areas in which diversion can and does occur, and while it is also important to involve the appropriate authorites and investigative processes to identify individuals involved (including patients), we should not forget these people also have an addiction that requires careful treatment for their disease. Every effort should be taken to assure through due process, their illness is not overlooked and is treated.

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Page last reviewed: January 15, 2021
Page last updated: January 15, 2021