Special articleDiversion of Drugs Within Health Care Facilities, a Multiple-Victim Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention
Section snippets
Illustrative Vignettes
There are many patterns of drug diversion in the health care facility workplace environment, involving personnel from diverse backgrounds engaged in diversions in a variety of practice locations. The heterogeneity of drug diversion practices is exemplified in the following vignettes, all based on cases detected at Mayo Clinic medical centers during 2010 and 2011. These vignettes represent only a portion of the instances of diversion that were detected during that time. For reasons of
Potential Harm Arising From Drug Diversion
Addiction is sometimes viewed as a victimless crime. When the addiction is supported by drug diversion within the health care facility workplace environment, it becomes, in most situations, a multiple-victim crime in which patients, health care workers, and employers can be harmed directly or indirectly.
General Concepts of Prevention and Detection
Many HCWs are unaware that drug diversion is a serious problem in the workplace. Thus, broad-based educational efforts must be instituted that focus on the nature and scope of the problem, signs and symptoms of possible diversion and addiction, and proper ways to respond if diversion is suspected. The entire workforce, not only those with ready access to CSs, should be informed of the threats to life and career presented by drug diversion. Orientation of new employees should include such
Department of Anesthesiology
Anesthesiologists and nurse anesthetists are health care providers in whom psychotropic drug use and addiction is considered an occupational hazard.6, 13, 16 Mayo Clinic is no exception in this regard; thus, it is not surprising that concerted efforts to detect drug diversion began in the Department of Anesthesiology. Detection has often been precipitated by personnel underperformance or behavioral changes at work, frequent unexplained work absences, patients who seem to be undermedicated in
Conclusion
Diversion of drugs from legitimate to illicit use is being recognized with increasing frequency in the United States. Although the full extent of diversion from health care facilities is unknown and probably unknowable, our experience makes clear that it is a considerable and ongoing problem. Addicted HCWs who are diverting drugs from the health care facility workplace pose a risk to their patients, their employers, their co-workers, and themselves. It is essential that all health care
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