Archive December 2017 XVIII, No. 12

A Drug Diverter Comes Clean

A CRNA's story of how he got away with stealing fentanyl — and how easily someone should have caught him.

Rodrigo Garcia

Rodrigo Garcia, APN, MBA, MSN, CRNA, ACIT


Mr. Garcia SUPPORTING ROLE Mr. Garcia spoke at OR Excellence 2017 about his addiction, recovery and mission to help healthcare professionals who are battling substance abuse.

I was the last person you'd suspect of being a drug diverter. I was the hospital's hardworking, well-liked chief anesthetist, the team player who didn't mind staying late and taking on extra cases. I walked right past you every day for 6 months as I hid and fed my irresistible and irrational fentanyl addiction, which had gotten to the point where I didn't need the drug to feel good; I needed it to feel normal.

drug diverter "I didn't need fentanyl to feel good; I needed it to feel normal."

Day after day, case after case, nobody noticed that I was giving patients a little less fentanyl and pocketing the waste so I could slip it under my tongue or inject myself. I was spiraling out of control, yet I appeared perfectly normal, a top OR performer even when I was diverting and using large amounts of opioids.

But here's what most people don't get. As clear as the mask on my face, the signs that I was diverting drugs were there all along, from the dramatic spike in my fentanyl ordering and my manic mood swings, to my 60-pound weight loss and my wearing long sleeves on warm days to conceal my track marks. But nobody saw the signs because I wasn't a disheveled, dysfunctional addict. I was happy-go-lucky Rigo.

I can tell you the signs of addiction you never thought to look for, and I can tell you what it feels like to go through this hell, what if feels like to scheme every day to stay a step ahead in my game of catch me if you can. What you might not know is that there are countless other addicts hiding in plain sight, the types like me with a flourishing career as a healthcare provider. The reason most can't see addiction in these roles is because most don't know what addiction feels like. Well here's the scary truth of addiction: It feels normal.

drug diverter THE TIME TO STRIKE Diverters strike when peers are distracted, dipping into wasted supply or replacing medication with placebo substitutes like saline. Keep a watchful eye where drugs are stored.

Innocently enough
I've harbored the makings of a drug addict my entire life: Type A personality, driven, successful, craving validation and chasing thrills. It began innocently enough when I took my first pain medication in 2009. I was prescribed Vicodin after breaking my ankle. I used my prescription heavily right from the start, throughout recovery and the 3 months of rehab that followed. I never felt alarmed. I never felt I had a reason to worry because, as an anesthesia provider, I was confident that I was taking the appropriate steps to manage my pain. This self-certainty is partly what fuels the risk of healthcare providers falling prey to addiction. We're taught that we know what we're doing at all times, that we get results, and that mindset clouds our judgment when it comes to any issues of our own that arise. Not until my first day back at work, after 3 months of healing and physical therapy, did I realize I had a problem.

On that day, I couldn't get through half a shift without popping a Vicodin because the withdrawals were all-consuming: migraines, nausea, chills, sweats, any kind of ache you can imagine. I felt like I had the flu, only I knew exactly what the cure was and, to me, putting pain meds into my body was not just the easy thing to do, but the right thing to do to be normal again. I needed to function; without meds in my system, I couldn't. The longer I needed them to keep working as a CRNA, the more of them I needed, and the more I needed, the more I lied to conceal this underbelly of my day-to-day being.

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