I s your healthcare provider a narcotic abuser? How would you know? Substance abuse among healthcare providers is a real issue. Nurses and physicians unfortunately partake in such illicit activity, but which ones and how many? If you review the studies you will find that about 10% -15% of healthcare providers in the U.S. practice drug diversion for their own personal use. Perhaps 10% -15% doesn't sound like that many, but when you take the number of healthcare practitioners that are in the U.S., which amounts to some 5.3 million, that number starts getting to be a bit large. How large? Well just over 530,000 healthcare practitioners are likely to be substance abusers. (Bureau of Labor and Statistics)
The most frequent drugs taken by these providers are Opiates, like Morphine, Dilaudid, Vicodin, and Oxycodone, as well as Benzodiazepines, like Versed, Valium, Librium - which was the first benzo discovered, Ativan, Klonopin, Xanax and the list goes on. How do these providers get their hands on these medications? Well not surprising is the fact that when you work in a hospital it is relatively easy to gain access to controlled medications. Those areas where narcotic diversion takes place the most are in emergency departments and operating rooms. ( National Institute on Drug Abuse)
Nurses and doctors especially those that work in anesthesia have easy access to all kinds of narcotics, that are is easy to steal and hide. I am not going to go into the details or how to do it but let's just say it is pretty simple to steal narcotics if you want to. Medications that are intended to ease a patients pain, anxiety, or to keep them sedated are taken out of the medication dispensing system that most hospitals have and then simply not given to the patient. Patients either don't know they weren't given a medication or they were given a placebo.
Within the medical community the percentages of narcotic abusers in healthcare are about the same as the number found in the general population. There aren't more of them. The good news is that thanks to paper trails and narcotic audits it is usually just a matter of time before these people get caught. I have worked in a number of healthcare organizations that have had both nurses and doctors that have been caught stealing narcotics. Most of the time I never would have guessed they were doing it. On one occasion one was someone I worked with regularly.
The problems here are concerning though. What if your next visit to an emergency department you are being taken care of by a provider that is taking Dilaudid, Valium or something else? What if while you're on the operating table and your anesthesia provider is taking a little bit of what they are giving you while the surgeon is fixing your insides? OK, perhaps a bit dramatic but the point here is easily seen. Impaired providers increase the risk of preventable medical error and harm exponentially.
So what do hospitals do to help protect patients and ensure that providers are not drug abusers. Well human resource departments with the help of local law enforcement officials do criminal background checks on all providers before they get hired. At the state level the boards of licensing also do background checks on all providers applying for a license to practice. Those are good things. Narcotics are counted all the time in hospitals to make sure that the count is correct and the amount of medication ordered by a providers is documented as being administered and any medication left over is properly wasted with a witness. All good policies and programs.
So why are there still problems you say. Again the system is not perfect. Although it is harder to access and tamper with narcotics than it used to be the practice is clearly still present. One program that would go along way to further impede those that are diverting controlled substances would be to institute randomized drug testing at hospitals. To my knowledge few healthcare organizations have randomized drug testing. Whether this is a cost issue or not is unclear. Does your hospital conduct drug testing for employees? Have you worked with or know any providers that have been diverting controlled substances?
The most frequent drugs taken by these providers are Opiates, like Morphine, Dilaudid, Vicodin, and Oxycodone, as well as Benzodiazepines, like Versed, Valium, Librium - which was the first benzo discovered, Ativan, Klonopin, Xanax and the list goes on. How do these providers get their hands on these medications? Well not surprising is the fact that when you work in a hospital it is relatively easy to gain access to controlled medications. Those areas where narcotic diversion takes place the most are in emergency departments and operating rooms. ( National Institute on Drug Abuse)
Nurses and doctors especially those that work in anesthesia have easy access to all kinds of narcotics, that are is easy to steal and hide. I am not going to go into the details or how to do it but let's just say it is pretty simple to steal narcotics if you want to. Medications that are intended to ease a patients pain, anxiety, or to keep them sedated are taken out of the medication dispensing system that most hospitals have and then simply not given to the patient. Patients either don't know they weren't given a medication or they were given a placebo.
Within the medical community the percentages of narcotic abusers in healthcare are about the same as the number found in the general population. There aren't more of them. The good news is that thanks to paper trails and narcotic audits it is usually just a matter of time before these people get caught. I have worked in a number of healthcare organizations that have had both nurses and doctors that have been caught stealing narcotics. Most of the time I never would have guessed they were doing it. On one occasion one was someone I worked with regularly.
The problems here are concerning though. What if your next visit to an emergency department you are being taken care of by a provider that is taking Dilaudid, Valium or something else? What if while you're on the operating table and your anesthesia provider is taking a little bit of what they are giving you while the surgeon is fixing your insides? OK, perhaps a bit dramatic but the point here is easily seen. Impaired providers increase the risk of preventable medical error and harm exponentially.
So what do hospitals do to help protect patients and ensure that providers are not drug abusers. Well human resource departments with the help of local law enforcement officials do criminal background checks on all providers before they get hired. At the state level the boards of licensing also do background checks on all providers applying for a license to practice. Those are good things. Narcotics are counted all the time in hospitals to make sure that the count is correct and the amount of medication ordered by a providers is documented as being administered and any medication left over is properly wasted with a witness. All good policies and programs.
So why are there still problems you say. Again the system is not perfect. Although it is harder to access and tamper with narcotics than it used to be the practice is clearly still present. One program that would go along way to further impede those that are diverting controlled substances would be to institute randomized drug testing at hospitals. To my knowledge few healthcare organizations have randomized drug testing. Whether this is a cost issue or not is unclear. Does your hospital conduct drug testing for employees? Have you worked with or know any providers that have been diverting controlled substances?