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Healthcare's Biggest Secret

Addiction in the Workplace 

The diversion of controlled substances from healthcare facilities is an elephant-in-the-room type of problem that no one likes to discuss. The sad fact is that most hospitals and other facilities do not recognize that they have a diversion problem until something tragic happens. A quick internet search will turn up dozens, if not hundreds, of articles picked up by the media regarding nurse, physician and pharmacist overdoses that were facilitated by medications diverted from the workplace. These professionals were suffering from the disease of addiction and their disease continued to progress right under the nose of hospital administrators until it was too late.  The common thread in most of these cases was that coworkers suspected their colleges were abusing medications,  yet did nothing.  Even more troubling is the rate at which diversion in the workplace is occurring.

It is generally accepted that at least 10-15% of the  public has a problem with substance abuse, including alcoholism. Healthcare workers, especially pharmacists and anesthesia providers, are known to be at an even higher risk for several reasons including accessibility to medications, high stress occupations, and professional status. Using the lowest acceptable estimate, if 10% of a healthcare facility’s staff have a problem with addiction (where controlled substances are readily available), a conclusion can be made that diversion amongst health care providers is in the hundreds of thousands Nationwide. In a recent study of over 9,000 heroin addicts, 75% admitted that their problem started after becoming addicted to legally prescribed pain medication. They turned to heroin only after they were unable to continue using prescription drugs. In a healthcare setting, controlled substances are readily available, diversion has been described as *easy* without sufficient controls and accountability in place, and the result is that healthcare workers are not only becoming addicted at work but also perpetuating the disease process while working.   But why would a healthcare professional resort to stealing medications from work?

Healthcare professionals, like other Highly Accountable Professionals, have a significant amount of time, money, education, and pride invested in their chosen profession. They often are the primary source of income for their family and have jobs that are high-stress, high-responsibility, and provide immediate access to highly addictive controlled substances. Professionals with substance abuse problems are described as highly intelligent, typically graduate in the top 25% of their class, are highly respected by their peers and are often the last ones that would be suspected of having a problem. This means that these individuals are often reluctant and unlikely to seek help for substance abuse until it is too late, for fear of significant consequences. Job loss, legal and licensure issues, financial difficulties, loss of respect and a loss of identity are all factors cited by professionals as reasons to not seek treatment. With so much riding on their career, professionals that become addicted to a legal prescription often feel they have nowhere to turn. Rather than risk a loss of their livelihood by seeking professional help, they will attempt to quit on their own, only to find out it simply isn’t possible. They become trapped, cut off from their legal prescriptions and remaining fearful of seeking treatment.   With access to controlled substances at work, the decision to divert is made.  As a result, the diversion and substance abuse often continues until ending in tragedy for the provider or for a patient.

One significant mistake made by healthcare administrators is to believe that just because a problem isn’t obvious or noticed must mean it doesn’t exist. Administrators and hospital management frequently overlook the signs, symptoms and evidence of drug diversion simply because they do not have the appropriate accountability and monitoring procedures in place.   70% of healthcare workers surveyed have stated that they believe the control systems at their facility are inadequate. Professionals with a substance abuse problem report 75% of the time that they believe other co-workers knew of their problem but didn’t report them. The simple fact is that this is a known problem occurring in nearly every healthcare facility across the country, but little is being done to systematically address the issue. As a result, diversion will continue until something tragic occurs and the hospital ends up with a public relations, possible patient injury, and insurance nightmare while the addicted professional, if they survive, loses everything.

So what can be done?

The most important step is for the public to become informed.  To think that this situation will self resolve is unrealistic.  Diversion and addiction will likely never be completely eradicated but with a proper, aggressive, and uniform approach, it can be managed and the consequences can be mitigated.   Parkdale can help healthcare facilities develop comprehensive policies and procedures to prevent diversion, investigate suspected diversion, satisfy legal and regulatory reporting requirements and compassionately treat the addicted professional. Our dedicated team has experience and professional training in anesthesia, pharmacy, healthcare administration, nursing, addiction medicine, and Federal diversion investigation. In addition, a major goal is to prevent the professional from continuing to use and putting others in harms way.  An unfortunate reality is that diversion in the healthcare field will get worse before it gets better.  If you, your facility, a loved one , or a coworker would like more information and requires assistance, contact us today.~ Parkdale