Jessica Gerstein

Wolcott ENC1102
Literature Review

The Problem of Drug Diversion: What can we do?

Drug Diversion means the transfer of a controlled substance from a lawful to an

unlawful channel of distribution or use. (Berge.) Within hospitals and health-related
facilities is a prominent issue that is unknown to those outside of this field. The many
ways that nurses attempt and steal these drugs for illegal and personal purposes, and
every article written about drug diversion establishes that this behavior is illegal and
should be treated as such. Nurses lose their licenses and even face time in prison because
this is an unauthorized use of their license. State programs established to help these
nurses that face these issues are available because mental health is taken seriously, just as
addiction is as well. In addition to state programs available, drug testing within the
medical field would be beneficial in preventing the problem of drug diversion. This
literature review tries to represent selected documentation from a wide range of sources,
including books and articles from the web. All publications of this literature review range
from the past three decades and all publications within are in English. This was written
with the intended audience of nursing students, workers in the medical field, or those
interested in the topic of drug diversion. This literature review was written to prove an

overall understanding of the horrific problem of drug diversion within the hospitals and
clinics in this United States.

Due to drug diversion being such a commonality, there should be a yearly, or

biyearly meeting in which the employers set up awareness for drug diversion. (Berge,
Dillon, Thomas) Preventing this in the workplace should be crucial information to spread.
Educating employees on signs to watch out for and what the consequences would be
would help spread awareness and hopefully put an end to the high amount of drug
diversion in the healthcare workplace. The Office of Diversion Control is an enforcement
agency where their main goal is to investigate and prevent drug diversion all over the
nation. Hospitals are able to register for this agency to visit and present to their hospital
or healthcare facility to prevent drug diversion actions, and raise awareness.

A topic that was touched on that states should offer rehabilitation for nurses who
struggle with addiction in addition to stealing the medications. Trying to help these nurses
get their life back on track starting with taking care of themselves, because drug addiction
is a mental health disorder. (Laferney, Levinson, Thomas) These nurses at one point in
their life worked hard to receive their nursing license and certifications and it is hard for
employers to see them ruin their careers.

In all of my research that I have been sorting through on drug diversion, close to
nothing has been done to require drug tests. These tests would have unfolded these
situations before they became an even bigger problem within the establishment. (Berge,

Tanga) If drug tests were done routinely on these professionals then consequences
wouldnt be as severe for the negligence resulting in patients not receiving the proper
medications and care. Either scheduling drug testing or even random testing should be a
priority in the health-care workplaces. (Creighton) Even if drug testing wasnt done
routinely and were picked randomly and scheduled randomly without warning would be
beneficial to the overall problem of drug diversion within hospitals and healthcare
facilities. (Levinson) This gap within the research done to prevent drug diversion has
been focusing on how to deal with this matter after the fact, but what needs to be done is
prior attention to the before problem. While the individual is affected more than the
nurse from this diversion of illicit medications, it needs to be a bigger priority to prevent
this rather than to handle the situation before it is too late.(Warner) Either scheduling
drug testing or even random testing should be a higher priority in the health-care
workplaces.

Drug testing should be performed within the workplace before a problem arises. Florida
alone has been a popular state where drug diversion has been the center of their attention
lately within hospitals. Drug testing within hospitals would prevent not only the whole
problem of drug diversion affecting more than the patient, but affecting the wellbeing of
the hospital. How to begin this experiment would include surveying, results of drug
testing, and how many employees were caught before it became an even bigger problem.
Rather than just fixing the problem, perhaps by removing the employee from harms way,
drug testing will give the employees enough time to stop the problem from resulting in an
even bigger liability. In a research proposal, surveying hospitals where drug diversion has

been possible and surveying whether or not they drug test their employees. This survey
would reveal whether or not drug testing would prevent the whole process of illegally
taking medications from patients. The results of drug testing and if the test had exposed
employees of taking such drugs and where they have gotten those drugs. If there was
proof of certain toxins within their blood stream, an investigation would then be put forth
to discover where it was found. If employees were caught, what legal action was taken to
get them fired and make it visible for other employers to know of their previous
background.

The results of this study indicate that drug testing employees, either randomly or
scheduled, would prevent an issue involving the company and the individual. Before a
drug diversion case has been discovered and taken into more serious hands, there should
be a system that prevents such behavior among staff. Along with drug testing, a main
focus has been dealing with the aftermath of a drug diversion situation is to rehabilitate
these individuals that are dealing with the illness of addiction.

Berge, Keith H., Kevin R. Dillon, Karen M. Sikkink, Timothy K. Taylor, and
William L. Lanier. "Diversion of Drugs Within Health Care Facilities, a Multiple-Victim
Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention." Mayo
Clinic
Proceedings. Mayo Foundation, 12 July 2012. Web. 11 Oct. 2015.

Cole, B. Eliot. "Recognizing and Preventing Medication Diversion." - Family

Practice Management. N.p., 08 Oct. 2001. Web. 23 Oct. 2015.

Eichenwald, Kurt. "When Drug Addicts Work in Hospitals, No One Is

Safe."Http://www.newsweek.com/2015/06/26/traveler-one-junkies-harrowing-journeyacross-america-344125.html. NewsWeek, 18 June 2015. Web. 23 Oct. 2015.

Laferney, Michael C. "Dealing with Drug

Diversion."Http://www.reflectionsonnursingleadership.org/Pages/Vol36_2_Col_LaFerney
.aspx. N.p., 20 Aug. 2010. Web.

Levinson, Daniel. "Why Aren't Doctors Drug

Tested."Http://oig.hhs.gov/newsroom/news-releases/2014/drug-tested.asp. N.p., 12 Mar.
2014. Web. 15 Nov. 2015. <http://oig.hhs.gov/newsroom/news-releases/2014/drugtested.asp>.

Tanga, Hazel. (2011) Nurse Drug Diversion and Nursing Leaders

Responsibilities. JONAS

Thomas, Cynthia M. "The Impaired Nurse: Would You Know What to Do If You
Suspected Substance Abuse?" American Nurse Today. N.p., 11 Aug. 2011. Web. 20 Oct.
2015.

Warner, David O. "Substance Use Disorder Among Anesthesiology Residents."

Http://jama.jamanetwork.com/article.aspx?articleid=1787405&resultClick=1. JAMA, 04
Dec. 2013. Web. 23 Oct 2015.