Upon hearing the term “unprecedented pandemic,” one might automatically think of the current coronavirus, which—as of Aug. 12—has infected 5.2 million Americans and killed more than 160,000.
Yet, while we’re hyper-focused fighting COVID-19, our country’s opioid epidemic is growing worse.
A report released on May 13 by the Federal Office of National Drug Control Policy’s Overdose Detection Mapping Application Program (ODMAP) suggests that overdose deaths have increased (PDF) due to COVID-19. The Washington Post reported that suspected overdoses jumped 18% in March, 29% in April and 42% in May. The figures are based on data from ambulance teams, hospitals and police.
What’s not being reported is the potential threat of drug diversion within healthcare settings, which is often undetected and underreported.
Already, we’ve already seen a couple of diversion incidents that foreshadow a troubling trend. In one case, two Indianapolis women broke into an Indiana hospital in mid-April and stole morphine, personal protective equipment (PPE) and sanitizer.
According to an official statement released by the Indiana Department of Justice, one of the women had planned to sell the morphine for profit.
Most healthcare workers do not divert drugs, but it only takes a few to endanger patients and a hospital’s reputation. Incidents like these should be a wake-up call to our healthcare industry. Healthcare leaders need to redouble their efforts to mitigate, or slow, drug diversion before it’s too late.
Why drug diversion could worsen in 2020
Given the social, economic and healthcare implications of COVID-19, it’s not hard to see how drug diversion might escalate.
Recent data suggest a rise in depression and mental health disorders with the coronavirus stemming from isolation, "shelter at home" guidelines and the economic fallout of the pandemic. Healthcare providers, who are more likely to treat patients with COVID-19, may be more susceptible to mental health issues such as depression and burnout, as shown by the recent suicide of a top New York emergency physician.
Another factor that makes hospitals more vulnerable to drug diversion is the increased quantity of drugs available to steal. The Drug Enforcement Agency announced in April that it would step up production of opioids such as morphine and fentanyl as a response to the pandemic. Also, the production of new coronavirus treatment drugs such as remdesivir has already been targeted by thieves who are anticipating skyrocketing resale values.
Finally, administrative leaders and clinicians may be missing key signs of diversion happening right now in their facilities. According to a recent Porter Research survey commissioned by Invistics, 70% of respondents have said most drug diversion goes undetected. That survey was conducted before the coronavirus was on our radar.
But this summer, as hospitals in COVID-19 hot spots bring in nurses and other temporary workers to help patients, it’s possible the risks of drug diversion could be even higher due to lack of screening and oversight. Some hospitals report temporary traveling healthcare workers may be more inclined to divert than regular hospital staffers because they think they’ll be long gone by the time anyone realizes the drugs are missing.
Finding solutions amid crisis
Even if you’re not ready to implement a new drug diversion program from the ground up, now is the ideal time to consider implementing some or all of the following measures:
Refresh education. Look for ways to improve education around diversion—such as short webinars on drug diversion or even email reminders on why reporting suspected diversion can help patients and colleagues. In addition to educating staff on diversion and outlining the problems, review policies on reporting suspected drug diversion to clinical supervisors.
Extend a helping hand. The emotional load your staff is carrying is enormous, and even clinicians who haven’t diverted before may be tempted during this time. Offer to help, for example, by making clinicians aware of mental health counseling services or by encouraging them to voice concerns to their supervisors. Make sure workers know that they can speak up without fear of repercussion and that they need to not be afraid of asking for help.
Implement technology. Fortunately, drug diversion prevention, detection, investigation and reporting can be managed effectively and efficiently. But most healthcare organizations aren’t using all of the tools available to them to help with drug diversion detection. As noted by the Porter Research/Invistics survey, while nearly all healthcare organizations are using automated dispensing cabinets (89%), fewer are using advanced analytics (59%) and machine learning (29%) as part of their drug diversion program. Technologies such as advanced analytics combined with machine learning algorithms can significantly speed up detection rates so healthcare organizations can intervene more quickly before a problem escalates.
While hospitals combat rising COVID-19 cases, now is not the time to put drug diversion prevention on the back burner. A few small steps can go a long way in helping everyone, from clinicians to patients and communities, stay safe and healthy.
Tom Knight is the chairman of HealthcareDiversion.org.