A Novel Approach to Monitoring the Diversion of Controlled Substances: The Role of the Pharmacy Compliance Officer

Abstract

Purpose The true extent of drug diversion practices in acute health care settings is unknown. Drug abuse by professional staff may result in jeopardized patient safety discredited organizational reputations, compromised financial outcomes, and endangered community trust. Yet, limitations in reporting drug diversion behaviors by health care professionals precludes quantification of the scope of these practices in nurses, physicians, and pharmacists. This manuscript describes one institution's efforts to monitor drug diversion with the implementation of a novel pharmacy-based role, the Pharmacy Compliance Officer (PCO). Methods Nearly 5 years of PCO experience will be identified and organizational drug diversion methods will be delineated. Common profiles of professional drug diverters in acute care will be depicted with a review of the literature on pharmacist, nurse, and physician drug dependency characteristics. The collaborative process between the PCO and Nursing Directors will be described with particular emphasis on options for validating drug diversion and confronting employees with evidence. Exemplars of drug diversion by professional staff will be highlighted with the use of two case studies. Cost implications will be discussed as well. Results The PCO has assisted with the identification of staff at risk, and responsible for, drug diversion. Implementation of this novel role has facilitated the early recognition of staff with active substance abuse disorders. Our relationship with the State Boards of Pharmacy and Nursing has been enhanced due to this proactive approach to recognizing drug diversion practices in professional staff. Conclusion This contemporary strategy has the potential for replication, particularly in large, diverse, urban, acute care settings, where drug volume is high, information systems are frequently complex; hence, identification of drug-diverting professionals is circuitous.