July 2022
The following are several drug diversion news stories that have captured our industry’s attention.
Nurse leader at hospital where 7 gallons of fentanyl went missing has license reinstated
The New Hampshire Board of Nursing reinstated the license of Amy Matthews, the chief nursing officer at Cheshire Medical Center in Keene, N.H. She previously had her license suspended after an investigation found over seven gallons of fentanyl went missing under her watch. The suspension came as regulators investigated how 583 bags of fentanyl solution went unaccounted for within a four month period. Matthews was not found to be involved in the theft, but her role as the supervisor was questioned after the death of one of her nurses in March following the theft of at least 200 bags of fentanyl solution.
Measures in place at Vermont hospitals to prevent misuse of fentanyl
Following the loss of more than 500 bags of liquid fentanyl at Cheshire Medical Center in New Hampshire, hospital leaders in neighboring Vermont are assuring their constituents that they have measures in place to prevent the painkiller’s misuse. This led Southern Vermont Medical Center to announce a barcoding system in place to track all medications, as well as a hospital committee to review all prescribing practices in the facility regularly. Other hospitals in the state also committed to rigid record-keeping systems, among other tools, to avoid further drug theft.
Massachusetts woman sentenced for painkiller theft from veterinary office
Melissa Paradise was sentenced to 24 hours in prison and one year of unsupervised release after admitting to stealing hydrocodone from a veterinary office where she was employed. Federal investigators had noticed a large amount of the painkiller ordered by Paradise’s office. An ensuing audit in 2019 found her responsible for the office’s record-keeping. She later admitted to forging signatures to place the orders and take the excess medications for her own use.
Pittsfield nurse practitioner pleads guilty to siphoning fentanyl from patient’s IV
A Massachusetts nurse practitioner at Berkshire Medical Center pleaded guilty to charges of acquiring a controlled substance through fraud. Jessica Lotto admitted to withdrawing fentanyl from a patient’s IV while the patient was unconscious in 2019. She was discovered in the act by the hospital’s critical care unit director, who was warned to “keep an eye” on Lotto after suspicions of diversion arose as early as 2018. Lotto admitted to having a substance abuse problem and is currently in treatment until her sentencing in early 2023.
School nurse allegedly stole Virginia students’ medicine
The Fairfax County Police Department is investigating the theft of students’ medication by the school nurse at Greenbriar East Elementary School in Fairfax, Va. Jennifer Carpenter allegedly stole students’ prescription drugs like Adderall or Ritalin and replaced them with generic antihistamines. The parents were alerted only after an internal investigation from the Health Department began. Parents allege that information on the investigation has been limited as the school has not provided “audit documentation” of the issue.
North Carolina pharmacy ordered to take steps to prevent drug abuse
A federal court prohibited North Carolina pharmacy Asheboro Drug Company and its pharmacists from dispensing controlled substances until it took steps to address neglectful drug diversion prevention policies. The pharmacy allegedly dispensed prescription opioids for dangerous combinations of drugs sought by drug abusers and significantly increased the risk of overdose” and ignored prescriptions from doctors who repeatedly wrote suspect prescriptions. In addition, the pharmacy was ordered to pay $300,000 in civil penalties.
Department of Justice forms a strike force to stop opioid risks in three New England States
The Department of the Justice’s Criminal Division recently announced the formation of the New England Prescription Opioid (NEPO) Strike Force, which will primarily target criminal conduct by physicians, pharmacists, and other health medical professionals focused on both healthcare fraud and drug diversion offenses. The three northern new England states that make up the NEPO Strike Force are: New Hampshire, Maine, and Vermont. This Strike Force builds on the success of another group, which has successfully charged 111 dependents responsible for over 115 million controlled substance pills.
A National Tracking System for Nonfatal Drug Overdoses
The White House recently released the National Drug Control Strategy (NDCS) to reduce deaths from drug overdoses. It calls for expanding access to evidence-based prevention reduction, treatment, and recovery support services. It also calls for creating the Drug Data Interagency Working Group by collaborating with other federal agencies. A national system would help better assess the needs of underserved communities across the country, as well as provide better predictions and trends to help public health systems respond to overdoses more quickly.
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How a focus on education can shine a light on drug diversion
Drug diversion is not a topic that healthcare executives bring up in meetings. In fact, it’s rarely mentioned. According to a study published in the American Journal of Health-System Pharmacy, a large majority of drug diversion goes undetected. Unfortunately, most health systems executives only hear about the negative news when it’s too late – when a nurse is found unconscious in a closet or a patient complains of unrelenting pain despite receiving a controlled pain medication.
“Drug diversion is hard to detect because it isn’t discernable all the time, but rather, it often occurs behind the scenes,” said James DePoy, CEO of PharmID, a drug verification company that utilizes a cutting-edge device to validate medication purity. “Because it’s underreported — for a variety of reasons — most hospital executives are more likely to believe the issue occurs elsewhere.”
PharmID’s technology provides accurate verification of medications in seconds, enabling facilities to make intelligent and quick decisions on potential diversion events. Applying the product to hospitals could help improve efficiencies, minimize risks, and potentially save lives. But until recently, the use of their device for preventing drug diversion was not in great demand.
“Because many healthcare systems believe that diversion doesn’t occur in their facilities, going to them about this issue requires a shift in thinking,” noted DePoy. “Our approach is to educate. We explain how to look for the ‘unseen’ and how ultimately, it is about protecting the patients, the healthcare providers, and the organization.”
The educational approach requires a holistic view of how healthcare operates. This includes understanding the complexities in different areas of care and the number of medication transactions occurring throughout the day. Comprehending that process was a priority for DePoy when he joined PharmID in early 2020.
“When you come from the outside of healthcare looking in, it’s a matter of working with the healthcare professionals to sympathize with the problems they may be facing,” said DePoy. “It’s understanding their standard operating procedures and using technology to fill in the gaps to achieve the ultimate objective, which is to effectively stop drug diversion.”
His newfound goal has borne fruit, as many facilities now utilize PharmID’s technology and are looking for different ways to stop diversion from occurring beyond testing medication waste. However, he admits that despite the number of facilities in the country, the pharmacy industry is small – and word of mouth gets around quickly.
“I think testimonials are always very good because what we see is that it’s a fairly small world when it comes to hospital pharmacy,” said DePoy. “The more they learn about how drug diversion events occur, the more likely they will understand how to utilize solutions that have successful and see its value. Then they can help spread the word and tell their colleagues across the country.”
Beyond the technology, DePoy sees this word of mouth as an effective way to influence change and to approach drug diversion, not just testing.
“Diversion isn’t going to be solved just by simply updating standard operating procedures, such as telling diverters they shouldn’t divert,” he added. “It’s changing perspectives to understand that diversion is everywhere and that we must be proactive in preventing it. Bringing technology to the forefront is a very important step in detecting problems that are not visible – and mitigating potential harm.”
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