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    A real-world solution to drug diversion in health systems


    At the beginning of this year, the Centers for Disease Control and Prevention (CDC) issued a report about the drug abuse epidemic sweeping the nation. The numbers are staggering.

    From 2000 to 2014, almost half a million people in the United States died from drug overdoses. In 2014, more Kim NewKim Newindividuals died from drug overdoses than from motor vehicle accidents. Opioids such as oxycodone and hydrocodone, along with heroin, were the drugs of choice in those overdose cases.

    "As healthcare professionals, we are not immune to those statistics and that type of behavior," said Kim New, BSN, JD, former diversion specialist at University of Tennessee Medical Center and founder of Diversion Specialists. "We have the increased access and availability, and that whole issue can become harmful very quickly."

    See also: Health system drug diversion harms patients

    The need for action

    Health systems must be proactive to protect their patients and their employees against drug diversion. Initiatives include education and transparency.

    "Historically, [health systems] have kept very hush-hush, because they don't want anyone to know that it happens. Many times these events are treated as isolated events. They are dealt with, people move on, and nobody talks about it," said New, who worked as a neonatal critical-care nurse for several years. 

    "Staff need to understand that they are at risk, their colleagues are at risk, patients are at risk, and that drug diversion can impact them and their institution," she continued. The issue is personal for her; a friend died from an overdose of drugs acquired through diversion.

    To prevent, detect, and respond to drug diversion, health systems need a formal program in place. Continuous monitoring in the pharmacy and on patient floors is essential to quick detection of diversion. In order to be effective, a multidisciplinary effort is needed, with nurses and pharmacy managers working collaboratively to provide the best coverage for diversion prevention and detection, New said.

    See also: Diversion of oipioids: Red flags and green flags

    Auditing tools

    One of the newest auditing tools available to aid in drug-diversion management is the Omnicell Analytics platform, released at the ASHP meeting in New Orleans last December.

    Nilesh DesaiNilesh DesaiThis web-based diversion-analytics tool helps to streamline the process of detection of potential drug diversion by tracking usage of controlled substances and supplementary drugs such as acetaminophen, as well as dispensing patterns over time, said Nilesh Desai, RPh, MBA, administrator of pharmacy and clinical operations, Hackensack University Medical Center, Hackensack, N.J.

    The analytics platform is able to track whenever an automated dispensing cabinet (ADC) is accessed, noting the time, the user, the amount dispensed, and any returns. This dispensing information is compared to the medication orders for each nurse and also compared to usage patterns of their peers. A trending score generated for each healthcare employee dispensing these medications can identify any outliers very quickly.

    Julia Talsma, Content Channel Director
    Julia Talsma is lead editor for Drug Topics magazine.


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