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Drug Abuse

Prescription Painkillers: Killing More Than Pain

By: Ethan Bickelhaupt

By: Ethan Bickelhaupt

Over the last 10 years there has been an enormously towering issue casting a shadow on our American way of life that has reached far beyond anything anyone could have imagined.  A new foe has made itself evident in the now decades long so called “War on Drugs” growing with ISIS like proportions and leaving behind thousands of victims of in its wake.  While we have long waged war on drugs and on those who supply them, the fight has become increasingly more complex where the enemy, much like ISIS, is hiding in plain sight. In fact, you may have been affected by this foe in one way or another and if you’re one of the thousands of Americans who struggle with chronic pain, chances are this enemy lives right in the comfort of your own home. Yes, we’re talking about prescription painkillers and what was once originally meant to kill pain is now killing human beings.  According to the National Institute of Health, in 2014, “approximately one out of twenty Americans reported misuse or abuse of prescription painkillers.” It has literally become the fastest growing drug issue we face as a nation.

The suppliers, however, are no longer limited to street corner thugs and other stereotypical apothecaries of the night. Today, suppliers are often well dressed, white collar workers who wear a suit and tie...perhaps even a lab coat. The market for prescription painkillers is wide and supplier pockets are deep. And with the ever increasing need for painkillers among Americans, this fight seems to have no end in sight. Deaths due to prescription painkillers have been long attributed to overdoses, but according to The Fix’s May Wilkerson, “A new study suggests that highly addictive painkillers may also contribute to heart related death and other fatalities, meaning opioids could be even more dangerous than we think.” Imagine that. In addition to potentially fatal overdoses, those who who have become victims of these highly addictive painkillers also face the threat of not only moving toward the abuse of other illegal drugs like heroin, but may also experience breathing issues, “irregular heartbeats, heart attacks or sudden death.” (see reference below)

The enormity of the prescription painkiller epidemic goes far beyond the threat of overdose but can serve as a gateway to a host of other health issues and addictions. The CDC has recommended that doctors only prescribe these types of painkillers if absolutely necessary. And programs are being put in place to help in the fight against this issue. Medical facilities and treatment centers are also providing state of the art techniques to help manage pain in a way that doesn’t require pills at all. The important thing to recognize is that prescription painkillers don’t have to be the end all be all of pain management. It is important to seek out the right help necessary to not just accommodate your need for pain relief but to address the problem at its root. Knowledge is the most important gain one should always receive from their pain.


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What Hospitals Don’t Know May Hurt Them: Drug Diversion In Healthcare

By: Ethan Bickelhaupt

By: Ethan Bickelhaupt

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 stolen 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. 

It is known that at least 10-15% of the general public has a problem with substance abuse.  Healthcare workers, especially pharmacists and anesthesia providers, are known to be at an even higher risk for several reasons.  Even using the lowest possible estimate, if 10% of a healthcare facility’s staff has an problem with addiction and controlled substances are readily available, it is an obvious statement of fact to conclude that diversion occurs at a significant rate.  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 is *easy* without sufficient controls and accountability in place, and the result is that healthcare workers turn to diversion from the workplace.   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, fearful of seeking treatment with access to controlled substances taken from work.  As a result, the diversion and substance abuse often continues until ending in tragedy. 

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 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 and insurance nightmare and the addicted professional, if they survive, loses everything. 

So what can be done?

Parkdale Center 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 all-star team has experience and credentials in anesthesia, pharmacy, healthcare administration, nursing, addiction medicine and diversion investigation.  We will work with your facility to comprehensively address the issue of diversion from the ground up to keep your facility, your patients and your staff safe.  No one in the industry has the ability or experience to address this significant issue on the same scope or scale as Parkdale’s staff.  Give us a call today to find out more about our Diversion Prevention Program.  Let us help your facility identify gaps in practice, perform risk management as it relates to diversion and implement changes to protect your facility as a whole.  We can help.