Archive July 2017 XVIII, No. 7

Anesthesia Alert: Can You Spot a Drug Diverter in Your Midst?

Anesthesia providers are vulnerable to on-the-job opioid abuse.

Perry Ruspantine, CRNA, APRN

drug diversion WHO AM I HURTING? Drug diversion should never be thought of as a victimless crime.
Note: Photo is for illustration only. The person depicted is a model.

All the troublesome ingredients that can lead to drug diversion are intensified in anesthesia providers. They work in high-stress environments, they may suffer professional burnout and they have much easier access to opioids than most. They may also be prone to the false beliefs that they can stop any time, and that their knowledge and education will keep them from becoming addicted.

Diverters may steal drugs for themselves, for money, or for a friend who's addicted or in pain (see "Detecting Diverters: Signs Are Plentiful"). Regardless, if we choose to look the other way, we enable them. It can be tempting to do so. We sympathize with their stress. Or we don't want to subject colleagues to professional or legal sanctions. We may even fear reprisal.

Or we might just find it difficult to accept that a respected longtime coworker could do such a thing. So we make excuses. We give them lighter assignments to help alleviate stress. Or we complain to each other about suspected diverters, but don't take our concerns to the proper level. After all, what if I'm wrong?

But the longer someone is permitted to steal drugs, the greater the potential consequences. Reporting your concerns is the first step toward helping that person. When a coworker needs help, we owe it to ourselves, our profession and to him to help him get it. Providers have lost their lives because others chose not to get involved. Diversion might cost patients their lives, too. Abuse or addiction supported by drug diversion isn't a victimless crime.

Patients. Our patients needlessly suffer if they don't get the medications they need, or are given adulterated or contaminated drugs.

Employers. Surgical facilities lose the revenue associated with pilfered drugs and may have to deal with poor performance on the part of the diverter. They may also face civil liability for failing to recognize, address or prevent drug diversion. If a health-care worker's illicit drug use harms a patient, both the worker and the employer are liable.

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