In this interview, FedHealthIT’s President, Susan Sharer, discusses drug diversion, prevention and education, and how it impacts the entire Healthcare industry with the Centers for Disease Control and Prevention’s Medical Officer, Matthew Crist and Tom Knight, Chairman of HealthcareDiversion.org.
What is Drug Diversion?
The term drug diversion refers to crime involving a prescription medication, which includes drug-seeking behaviors, corrupt prescribing practices and the theft of drugs by Healthcare workers.
What is HealthcareDiversion.org?
HealthcareDiversion.org is a 501(c)(3) non-profit organization focused on reducing drug diversion in Healthcare.
What do you Hope to Achieve with HealthcareDiversion.org and What Steps are you Taking to Reach Those Goals?
Knight says the site aims to foster public-private partnership, to bring together Federal, State and private stakeholders to reduce incidents of diversion and to establish best practices focused on prevention. “We’re focused on bringing together education and awareness, and best practices. By sharing information and resources on our website, we hope to spread the message that this is a national issue that requires a concerted focus.”
What is the CDC’s Role in Drug Diversion Detection and Prevention?
The CDC focuses primarily on prevention, that includes increasing awareness, and providing education to Healthcare workers. We want to increase the industry’s understanding of the harm to patients and Healthcare workers created by diversion. Education can also include things to look for and how to communicate suspected incidents.
The other side of the work is related to response, supporting State and local health departments when diversion occurs. We can assist with investigations and case finding, performing patient notifications and helping to frame messaging.
There are a number of States that require facilities to report diversion to the health department. This helps trigger timely investigation and might prevent the provider from relocating to another area and attempting the same kind of activity where they would then put others at risk.
How is Drug Diversion Affecting the Federal Health Industry?
Events of diversion can be very detrimental to the industry. Where incidents occur or are suspected, it requires a lot of resources to investigate, and perform notifications. It is far more cost-effective to prevent incidents than to have to go through investigations but sometimes it takes one to motivate the other.
What are the Biggest Concerns that Federal Health Leaders have about Drug Diversion?
The risk to patients is the biggest concern – patients not getting the medication they should be or not getting the proper amount which leaves their pain untreated, and medication tampering that puts them at risk of infection or illness. There is also a risk though to others on the care team who may be working with an impaired colleague, and to the facility and providers who are at risk because of the liability involved.
What can Leaders do to Address the Issues Associated with Drug Diversion?
Transparency is critical. There must be better communication across jurisdictions. While there have been improvements, there is still a long way to go in ensuring diversion in one place isn’t handled quietly, allowing that person to go elsewhere.
Appropriate reporting, investigations and communication are key to understanding how prevalent the issue truly is.
What are the Legal Ramifications/Issues Associated with Drug Diversion?
Of utmost importance are the ramifications to patients who may not be receiving proper care. Beyond that there is liability on the part of the facility, perhaps for not providing appropriate security measures, and on the part of the individual, they could be charged with theft, tampering, or even more serious charges related to distribution.
Is this Solely a CDC Focus?
Not at all. The CDC is taking a leading position and is very interested in reducing drug diversion but so too are other agencies. The FDA’s Office of Criminal Investigations looks at tampering and is very interested in Healthcare worker substitution. The VA has been a real leader in preventing diversion at VA medical centers. HHS, through CMS is also working hard to reduce incidents of fraud, and of course, the DEA is investigating and prosecuting incidents of diversion.
How are you Connecting/ Getting the Word Out?
We are actively engaged at a lot of national meetings and speak at events that bring together stakeholders focused on diversion, whether that be investigators, lawmakers, or regulators. We are always looking to broaden the scope of stakeholders, to gain insight into prevention methods from those with experience and expertise.
About Dr. Matthew Crist
Dr. Matthew Crist serves as a Medical Officer on the Response Team in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention. Dr. Crist serves as a subject matter expert on drug diversion and provides consultation to state and local health departments conducting epidemiologic investigations of drug diversion events. Before joining CDC in August 2015 Dr. Crist worked at the Tennessee Department of Health in the HAI and Antibiotic Stewardship Program, and then served as the Director of the HAI and Respiratory Disease Unit at the Georgia Department of Public Health, and subsequently as the HAI Section Director at the South Carolina Department of Health and Environmental Control.
About Tom Knight 
Tom Knight is the Chairman of HealthcareDiversion.org, a 501(c)(3) non-profit organization focused on reducing drug diversion in healthcare.
