What Is Drug Diversion?

Drug diversion is a serious issue in the medical field, involving the illegal distribution or abuse of prescription drugs for purposes not intended by the prescribing physician. From the time these drugs leave the manufacturer to when they reach the patient, there are numerous opportunities for diversion to occur. Unfortunately, even members of the medical profession may be involved in diverting these drugs for their own recreational or financial gain.

The most common forms of drug diversion include selling prescription drugs on the black market, “doctor shopping” to obtain multiple prescriptions, utilizing illegal internet pharmacies, drug theft, and prescription pad theft and forgery.

The National Institute on Drug Abuse and the U.S. Drug Enforcement Administration have identified certain classes of prescription drugs as having a particularly high potential for diversion and abuse, including anabolic steroids, central nervous system depressants, hallucinogens, opioids, and stimulants.

To minimize the risk of drug diversion, doctors and other healthcare providers must take precautions such as being cautious with patients who request or use combination drugs, thoroughly documenting their prescribing decisions, keeping DEA or license numbers confidential, and switching to electronic prescriptions. It’s a matter of concern for the healthcare industry and society, and it’s necessary to be vigilant and proactive in preventing it from happening. It’s a problem that can cause severe harm to individuals and communities, and it must be addressed with the utmost urgency and attention. Drug diversion is a crime that destroys lives, and we must take all necessary steps to end it.

Drug Diversion Defined

The term “drug diversion” refers to the illegal movement of medications from legal sources to illicit, unregulated endpoints. If, for example, a legally produced jar of prescription painkillers is given or sold to a person without a prescription, the case would constitute drug diversion. While this example represents the most common type of diversion, the practice can occur at any step of a medication’s journey.

How Drug Diversion Occurs

There are many illegal activities that fall under the category of drug diversion. What they all share is the end result: regulated substances reaching an illegal destination. Some drug diversion takes place between friends or relatives with an individual who has received a prescription medication simply giving it to someone else. Someone who has legally received prescribed medications can also sell the drugs on the illicit market.
Other instances of drug diversion take place at the pharmacy level. People sometimes forge prescriptions to get the drugs they crave, and a small minority will even rob pharmacies by force. Illegal pharmacies operating online will also provide drugs for people with fraudulent or illegitimate prescriptions.
Doctors can also be the source of drug diversion, especially when they prescribe medications to people who plan to abuse them. Some abusers engage in a practice called “doctor shopping,” visiting one physician after another until they find one who will prescribe them the drugs they’re after. While most doctors make a serious effort to keep drugs away from potential abusers, some bad actors write needless prescriptions for financial gain.

Preventing Drug Diversion

Preventing drug diversion requires continued effort at multiple levels, from the physicians who prescribe medications to the consumers who receive them. Doctors should adhere to strict guidelines when prescribing drugs, always looking for signs of addiction in the patient. Such signs include a desire to obtain drugs that abusers frequently combine to produce heightened effects.
Pharmacists should be on the constant lookout for red flags signaling potential abuse. Patients who hold suspicious prescriptions, return too quickly for refills, or show visible signs of addiction should all be scrutinized before they receive medications. Pharmacists are also required to adhere strictly to all refill-related policies.

On an individual level, people should never give prescription drugs to a friend, relative, or acquaintance. Only the person whose name appears on the prescription is allowed to possess or consume the medication.

Across the spectrum, from doctors to individual consumers, people should report suspected instances of drug diversion. Putting a stop to the practice will help slow addiction on the individual and societal levels. Doctors, pharmacists, and individuals should also recognize that drug diversion is often punishable by law. Irresponsible behavior that allows drugs to flow toward illegal channels can bring considerable consequences.

To avoid legal issues while helping society overcome a devastating cycle of addiction, everyone involved should do their part to combat drug diversion.

It is a startling reality that a staggering 10-15% of healthcare professionals will fall prey to drug or alcohol addiction during their careers. The most commonly abused substances include benzodiazepines and opiates, with specialties such as psychiatry, emergency medicine, and anesthesia being the environments most frequently associated with this disturbing trend. Tragically, medical students often turn to these substances for recreational purposes, while attending physicians and residents may use them as a means of coping with anxiety, depression, or pain.

Drug diversion, the illegal obtaining of prescription medications for personal use, is a critical issue that poses a significant threat to patient safety. When healthcare workers obtain controlled substances and other prescription drugs, it puts patients at risk. The harm that can result from this includes denial of pain medication, subpar care from an impaired healthcare worker, and even an increased risk of infections such as hepatitis C if injectable drugs are tampered with.

It is clear that drug diversion is a byproduct of addiction among healthcare workers, making it imperative that institutions implement a controlled-substance diversion-prevention program (CSDPP) in order to protect patients, the organization, and the community. This requires adherence to federal, state, and local regulations, with a focus on key areas such as procurement, preparation and dispensing, prescribing, administration, and waste removal.

Controlling the chain of custody and ensuring accountability for controlled substances is crucial. Federal and state laws, as well as compliance organizations such as The Joint Commission and the Centers for Medicare and Medicaid Services, provide guidelines for hospitals to follow in their policies and procedures. System-level controls, including human-resources management, technology and automation, monitoring and surveillance, and investigation and reporting, must also be implemented to keep patients safe from harm.

Healthcare organizations must also address provider responsibilities, including chain of custody, storage and security, internal pharmacy controls, prescribing and administration, returns, waste, and disposal. Automated dispensing devices should be accessed with biometric identification, and controlled-substance cabinets and carts should be protected with electronic locks that require a badge swipe, biometric identification, or code.

In short, implementing policies and practices to deter, detect, and respond to drug diversions is the key to preventing controlled-substance drug diversion and ensuring the safety of patients. It is a crucial task that healthcare organizations cannot afford to neglect.