Drug Diversion and Abuse by Health-Care Staff: Facing the Hushed Epidemic

Abstract

Objective:

To increase pharmacy technician awareness of substance abuse and diversion in the health-care setting.

Data Sources:

A literature review of PubMed (September 2004-present) was performed. The 2008 Texas State Board of Pharmacy Annual Report was also reviewed.

Study Selection and Data Extraction:

There was a limited number of articles available, with most being from nursing and physician literature.

Data Synthesis:

The abuse and diversion of controlled substances by health-care professionals is a growing problem. With over 13% of the employed population having substance abuse problems, and higher rates seen with health-care professionals, the problem has become a quiet epidemic. Most impaired health-care workers exhibit typical behaviors, such as volunteering to work with controlled substances; having unwitnessed medication losses, waste, or spills and requesting to work less supervised shifts. Health-care workers should know the signs and symptoms of drug abuse in order to alert management to the possible problem. State and federal agencies outline requirements for reporting diversion. Substance abuse is a complex disease that chemically alters the function of the brain. Treatment of the substance abuser involves stopping the drug, maintaining a drug-free state, and rebuilding a life without drugs.

Conclusions:

Coworkers frequently observe substance abuse behaviors and can alert management in helping to prevent the problem from escalating and harming patients. Addicted staff members who are not helped can harm themselves, patients, the workplace, and their profession.