The Opioid Crisis in Hospitals – What You May Not Know

It’s no secret that the opioid crisis has taken hold across the country. We continually see news reports and stories that highlight its serious repercussions. Earlier this summer, the federal government even went so far as to declare this crisis a national emergency.

Headlines addressing this crisis on a national scale mostly shed light on the problems outside of the hospital—namely what happens after a patient receives a prescription for an opioid and becomes addicted.

What many neglect to report on is the prevalence of addiction that occurs within a health system’s own ecosystem. In recent years, healthcare providers suffering from opioid addictions have created countless patient safety issues, in some instances, even spreading potentially fatal blood-borne illnesses like Hepatitis C.

The Crisis in Hospitals

According to the Mayo Clinic, up to 15 percent of healthcare workers have addictions to drugs or alcohol, compared to 8 percent of the general population. Attributed to many factors, this alarmingly high number may result from stressful work environments and relatively easy, more regular access to controlled substances.

Many healthcare workers develop and feed their addictions through drug diversion—the transfer of any legally prescribed, controlled substance from the individual for whom it was prescribed to another person for any illicit use—which threatens patient safety.

Often, when healthcare providers are diverting drugs, such as pain medications, they are stealing a prescribed medication for a patient and replacing it with some type of placebo, leaving the patient in pain.

Reported cases on the spread of blood-borne illnesses indicate that syringes have become infected after diverters used them on themselves and then on a patient. One especially high-profile diversion case found 45 patients infected with a deadly disease, with a diverter then sentenced to 39 years in prison.

In addition to patient safety concerns, hospitals that are not actively monitoring for drug diversion are at risk for severe financial implications. One leading academic facility received a fine for $2.3 million after an investigation by the DEA led to allegations that the facility’s lax oversight enabled employees to divert controlled substances. Ruth Carter, a spokesperson for the DEA, said in a statement:

“It is extremely important that pharmacies be prepared to meet this challenge by focusing closer attention on prescriptions dispensed, ensuring that hiring policies and accountability policies and procedures are sufficient to detect, discover, and respond to recent opioid drug crisis, as well as identify impaired health care workers and assist them in seeking appropriate programs for recover.”

As the opioid crisis continues to escalate, how are hospitals combating this issue within their own walls?

Health IT’s Role

Many hospitals are leaning on health IT as a means to deter and detect diversion in their facilities. Analytics software solutions and secure automated dispensing cabinets (ADCs) can work in unison to catch diversions, as they happen in near real-time.

Secure ADCs not only physically help protect controlled substances, but smart cabinets can detect miscounts in pills and drawer tampering, and connect them to an employee’s unique identification number.

Analytics monitor transactions at all of a health system’s ADCs and immediately report discrepancies. Analytics tools also have insight into which drugs an employee is dispensing at any given time, which is a key component to catch diverters.

Beyond Health IT

Health IT solutions have helped many hospitals actively catch and prevent drug diversion. However, technology alone isn’t enough to combat this problem. Some health systems are taking additional measures to address diversion in their ecosystem.

After a substantial fine from the DEA, one leading academic facility created a drug diversion team that uses a collaborative approach across all departments to address suspicious activity and suspected diverters.

The facility also hired a drug diversion compliance officer, a full-time position to actively track, pursue, and address diversion within the facility. Despite this facility’s troubled past, they are now regarded as an industry leader in publicly speaking out against drug diversion and looked to by other facilities for their expertise about addressing this issue.

Looking Ahead

The national dialogue around drug diversion in hospitals has changed in many ways due to the advancements in health IT. However, many hospitals still fail to recognize that drug diversion is a problem within their own facilities. Leading drug diversion experts believe that if a health system has controlled substances, a 100 percent chance exists for drug diversion. For successful control of the opioid crisis, widespread use and national adoption of health IT and other diversion prevention practices offer solutions.

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