Tracking Diversion During COVID-19

Pharmacy Practice News –

New Orleans—Drug diversion may be an unrecognized offshoot of the ongoing COVID-19 pandemic.

Security experts cite several high-profile examples, including a pharmacy technician who was charged with the theft of more than 700 hydroxychloroquine tablets and azithromycin from Harbor-UCLA Medical Center in West Carson, Calif., and several other cases of diverted morphine, ventilators, personal protective equipment (PPE) and other key items that are crucial to patient care during the pandemic.

The uptick in diversion can be traced to the pressures of caring for patients during a pandemic, according to Charlie Cichon, the executive director of the National Association of Drug Diversion Investigators (NADDI), which trains law enforcement, state licensing board members and hospital staff each year. Indeed, hospitals spending more energy on COVID-19 instead of diversion are more vulnerable, Mr. Cichon noted.

“Has diversion stopped? Absolutely not,” he said. “Until a hospital sets up a team diversion program involving pharmacy, nursing, physicians, human resources and a team investigator, they’ll unfortunately find there’s more going on.”

At Upstate University Hospital, in Syracuse, N.Y., the 800-bed health system tracks opioids, COVID-19 medications and PPE, and “treats them all as controlled substances,” said clinical informatics pharmacist Derek Empey, RPh. “We review electronic documentation and fluctuations in patients’ pain scores [an indication of possible painkiller diversion], and speak with nurses about what they’ve seen.”

Mr. Empey urged alertness to “even minor blips on your diversion radar for proper vetting and follow-up” because COVID-19 can lower a hospital’s daily census by up to 40% due to lack of elective surgeries. By default, he added, “this will lower total removals of controlled substances and potentially mask diversion patterns that would otherwise be more apparent via reporting and analytics.”

Security teams have another tool for keeping one step ahead of diverters—reporting them to, headed by chairman Tom Knight, who said the site is reviewing dozens of COVID-19–related diversion claims to date. He said the reports will be posted to the site in the next few months, after he verifies them with public information from law enforcement and other sources. Health care facilities will be able to learn about diversion details from the posts and avoid similar thefts at their own institutions.

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