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What You Can Do to Help Prevent Drug Diversions

Created Nov 15 2018, 01:23 PM by Lippincott Solutions
  • opioid epidemic
  • medication safety
  • patient safety
  • opioids
  • Safety

Even as healthcare professionals, law enforcement, and governmental agencies call for more regulation and monitoring of prescription medications, the sad truth remains — millions of Americans still misuse prescription drugs. In many cases, prescription opioids are responsible for overdose, addiction, and death. In fact, unintentional drug overdose is now the second highest cause of accidental deaths for Americans following car crashes.

While many factors contribute to this issue, drug diversion continues to play a key role in prescription drug misuse. Put simply, drug diversion refers to the unintended use of prescription medications by someone other than the person the prescription was written for. Drug diversion occurs both in the home and in healthcare settings; anyone can divert drugs, including healthcare professionals.

Tackling the problem of drug diversion isn’t simple, but organizations around the country are working to find solutions to help keep more Americans safe. Preventing drug diversions starts with healthcare providers, who are on the front lines of efforts to combat and prevent unintentional drug overdoses and deaths.

Drug diversion in the home

Dealing with pain is a significant challenge for healthcare providers. As the United States population ages, more patients visit their providers for help managing chronic pain. A significant number of these patients are prescribed opioids.

But many medications don’t just stay with patients. According to some statistics, over half of all people who abuse prescription pain medications get them from friends or relatives free of charge. And while some patients do hand out their extra medication, many others are victims of prescription drug theft.

And it’s not just adults who misuse prescription drugs — drug diversion touches the lives of a growing number of young children and teenagers. A recent study showed that:

  • From 2000 – 2015, 188,468 children aged 20 or less were exposed to opioids
  • 59.7% of opioid exposures occurred among children aged 0 to 5 years
  • 29.9% of opioid exposures occurred among teenagers
  • Among teens, 71.5% of opioid exposures were intentional, including misuse, abuse, and suspected suicide
  • Hydrocodone (28.7%), oxycodone (17.6%), and codeine (16.5%) were most commonly implicated in drug exposure

Drug Diversion in the Workplace

Unfortunately, drug diversion also occurs in the workplace. It’s not uncommon for patients to complain their pharmacies dispense fewer tablets or capsules than their prescription indicates. And nurses, who may be profoundly affected by the stress of the job, fatigue, caregiver burnout, and extended shift work are at higher risk for diverting drugs from medication dispensaries and narcotic cabinets on the floor. It’s estimated that one in 10 nurses is impaired at work or in recovery from alcohol or drug addiction.

Preventing Drug Diversion Starts With You

Healthcare providers, including nurses, are in prime position to help stop drug diversion in the home and workplace. But it’s not as simple as educating a patient about why they shouldn’t give extra medication to friends or family members, even though education about the problem is certainly important.

Stopping drug diversion is a multifaceted problem. While there’s no easy answer, you can help prevent diversions by:

  • Assessing the effectiveness of prescribed medications and advocating for change if addiction or abuse is suspected.
  • Encouraging prescribing healthcare providers to make use of prescription drug monitoring programs (PDMPs). These electronic databases collect and track prescription data, flagging individuals suspected of misuse or abuse. In many healthcare organizations, PDMPs are easily accessed through the electronic health record.
  • Advocating for the adoption of patient medication packs, eliminating the need for to count out medications. Patient packs consist of prescription medications enclosed in individual blisters, usually in strips of 10. Prescriptions are dispensed in sealed containers holding the quantity of the prescription. This method of prescription dispensing may help eliminate count disputes and could make drugs harder to divert.
  • Looking for and reporting signs of healthcare provider drug diversion. Signs of diversion may include:
    • Changes in job performance
    • Excessive medication errors
    • Incorrect narcotic counts
    • Inappropriate verbal or emotional responses
    • Frequent reports of ineffective pain management from patients
    • Changes in alertness or memory

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