As a result, some of these providers turn to drug diversion, which refers to the transfer of prescription drugs from a legal to an illegal channel. Staff may divert to sustain their substance use disorder, sell medication for additional income, or obtain costly medications that would be otherwise unaffordable to treat themselves or family members. No matter the underlying motive for diversion, organizations should be prepared to identify, investigate, and address diversion at each step of the process.
Here are four ways that health systems can develop a comprehensive, efficient diversion management process.
1) Invest upfront resources in drug diversion prevention and management before it is too late.
Most health systems wait to invest in comprehensive drug diversion prevention and management until a major diversion event occurs at their organization—at which point they are likely to face serious consequences.
Given the growing opioid epidemic, systems should put resources (i.e., staff, data analysis, security enhancements) in place now to get ahead of diversion, avoid costly consequences, and support their employees' health.
2) Take a multidisciplinary approach (e.g., pharmacy, nursing, HR) to increase process efficiency and effectiveness.
Too often diversion management is solely the responsibility of the pharmacy leader. Though pharmacy leaders are responsible for medications within the health system, effective diversion prevention requires a multidisciplinary approach.
Nursing and pharmacy should be partners in steering the system's drug diversion management efforts. Their leadership should be supported by contributions from physician leaders, HR, quality and safety, security, and the legal department, among others.
3) Reduce the auditing time burden with dedicated staff and technology.
One of the top challenges of drug diversion management is the time burden of monitoring and addressing each point of the drug's life cycle. Digging in to ADC outlier data and patient charts to identify potential diversion takes hours on a daily, weekly, and monthly basis.
Organizations with dedicated resources, such as diversion analysts and vendor software platforms, are able to more easily identify and respond to suspected diversion, mitigating the effect of the event on the institution.
4) Revise and reinforce diversion prevention and management procedures on an ongoing basis.
As processes and technologies change, and potential diverters discover new vulnerabilities in medication systems, health system leaders must constantly revise their diversion prevention and management tactics.
Instituting multiple mechanisms for continuous learning and improvement helps ensure that procedures stay up to date and minimize risk to the health system.