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Our view: State needs better monitoring of missing pills

Every year, some 20 million pills — mostly opioids — go missing from the nation’s hospitals.

Where those pills end up is anyone’s guess. Also unknown to the general public is which hospitals “lose” the most pills, what pills are most often “diverted” (a euphemism for stealing) and which employees do the diverting. That has to change.

The fact is, while the nation is in the midst of an opioid epidemic that is killing tens of thousands of Americans a year, there is no federal database that tracks opioid pill thefts from hospitals, pharmacies and nursing homes. Massachusetts doesn’t have one either.

That leaves the public in the dark about a major contributor to the opioid epidemic. And it leaves officials clueless about whether the steps they’re taking to stem the abuse of prescription narcotics are having a real effect. How can you know if your solutions are working if you don’t know the true extent of the problem?

“How much is going on that we don’t know about?” asked Salem state Rep. Paul Tucker, a former police chief and detective. “This really points out a huge gap in knowledge.”

That gap was made clear in a special report from The Salem News’ Julie Manganis, who used public records requests to track down statistics on drug thefts from hospitals in the state over the past decade. The requests came after a Beverly Hospital worker was charged with stealing nearly 18,000 pills — mostly OxyContin and Percocets — over the course of several months.

Manganis learned the Beverly diversion was the largest in the state’s history, topping a 16,000-pill theft from Massachusetts General Hospital in 2013. While the big-number thefts garnered the most attention, Manganis learned there were plenty of thefts happening on a smaller scale. The News had to modify its original request for diversions of more than 100 pills after officials said they had turned up enough reports to fill two banker’s boxes.

We’re guessing that is information most people would want to know in the midst of any epidemic. How can health professionals manage an outbreak of the flu or measles, for example, if they don’t know how many cases there are, where the cases are originating and how they’re spreading?

Much of the problem can be attributed to a patchwork of reporting requirements from state to state and across the country. In Massachusetts, hospitals, nursing homes and pharmacies must report thefts to the Department of Public Health Drug Control Program, as well as to any licensing authorities overseeing medical and pharmacy professionals. Federal regulations require pharmacies to report lost medications that are on the list of controlled substances to the Drug Enforcement Administration.

But the DEA doesn’t readily share that information with the states. The states don’t talk to each other. And places like Massachusetts don’t take their information out of banker boxes and put it before lawmakers and the general public, where it belongs.

The information gap is especially concerning in Massachusetts, which has prided itself on addressing the impact of prescription drugs on the opioid epidemic.

Gov. Charlie Baker signed legislation in 2016 that limits initial opioid prescriptions to a seven-day supply, created a program to dispose of unneeded prescription drugs and required physicians and other prescribers to check the state’s prescription monitoring program before prescribing drugs that have relatively high potential for abuse.

Given those successes, creating a database of drug diversions shouldn’t be a tall order.

Tucker said he’s not sure if that will require legislative action or if the Department of Public Health should be required to update its policies to better track and share information on pill thefts.

This is clearly a bipartisan issue.

“There’s got to be a way to get the feds, state, hospitals, the drug manufacturers, wholesalers and retailers on the same page,” said state Rep. Lenny Mirra, a West Newbury Republican. “This stuff is killing thousands of people.”

Mirra’s right. The question is, who is going to step up and lead the way?