When you look at drug diversion, sometimes it can be hard to see everyone that is affected by it.

Mayo Clinic even went to the point of calling drug diversion a “multiple-victim crime” in their article Diversion of Drugs Within Health Care Facilities, a Multiple-Victim Crime: Patterns of Diversion, Scope, Consequences, Detection, and Prevention. They went on to say that the victims are patients, healthcare workers and the actual hospital/clinic can be harmed, both directly and indirectly, by drug diversion. I am also going to add two more “victims” to that list, the insurers and the general public that purchases health insurance.

Below is a mix of a bulleted summary of the risks to each victim group highlighted in the article, along with some of my thoughts and additional risks. We will explore each of these sections in further detail in future blog posts.

Patient safety is the number one concern for hospitals, yet diversion puts patients in the direct line of risk. There are multiple ways that drug diversion can put the patient at risk:

  • Patients can receive substandard care from the addicted caregiver, assuming that they are working under the influence of a controlled substance
  • The patient may not have been given the drug that they need resulting in increased discomfort
  • The patient may have been given a diluted form of the drug, and may not be getting enough of the drug for comfort
  • Drug may have been switched out and patient may be getting another drug that they are allergic to
  • There have been cases where patients have contracted Hepatitis C and other illnesses from drug diverters
  • Risk of blood borne and other types of infections due to needle sticks with used and contaminated syringes
  • There have been cases of death to patients from infections contracted from drug diverters

Healthcare workers are also at risk of being harmed by drug diverters:

  • Risk of blood borne and other types of infections due to needle sticks by used and contaminated syringes
  • Risk of blood borne and other types of infections due to accidental touching of broken glass vials
  • Injury from either broken glass vials or used syringes
  • Shared patient care responsibilities resulting in adverse patient outcomes, putting all team members at risk for legal liability

Hospital/Clinics are at risk:

  • Loss of revenue from diverted drugs
  • Medicare/Medicaid program jeopardy
  • Fraudulent insurance billing
  • Poor work quality
  • More absenteeism leading to staff shortages
  • Civil liability risks
  • Costly investigations to confirm or refute diversion
  • Mandatory reporting causes diversion to become public
    • Devastating effect on morale of employees
    • Disappointed or mistrustful patients may seek medical care elsewhere
  • Financial loss from loss patients

Insurers are at risk:

  • Paying for diverted drugs that patient never received
  • Paying for other procedures that patient may have had because “pain” wasn’t decreasing
  • Paying for additional meds because “pain” wasn’t going away
  • Paying for longer stays because “pain” not decreasing
  • Paying for longer stays because of additional infection or issues associated with used and contaminated syringes and medication

Risks to everyone because of the drug diversion, even if you don’t ever go to the hospital:

  • Increased insurance premiums (see risks to insurers, they are not in business to lose money)
  • Risk of becoming a patient and being treated by drug diverter or having drugs diverted from you

The drug diverter themselves:

  • Risk to loss of life – overdose
  • Infection from reusing needles and medication
  • Unsanitary injection techniques
  • Blood to blood transmission of pathogens from patient to diverter
  • Criminal prosecution
  • Civil malpractice
  • Actions against medical license
  • Billing and insurance fraud charges