The illegal diversion of prescription drugs in health care facilities is nothing new and continues to be problematic not only in the United States but also around the world. Those who work in hospitals, nursing homes, and other long-term-care facilities often have easy access to controlled substances.  

When I was with the Cincinnati Police Department and our squad worked full-time on drug diversion issues, we arrested a health care facility employee an average of once a week for stealing medication. This resulted in 50 nurses per year being caught and offered treatment through the courts. Most of these individuals successfully completed the treatment programs and had their criminal records wiped clean. A sizable number were able to continue their nursing profession and reclaim their lives. 

I got tired of the media’s asking me how big the problem was in the country, especially because there was a lack of reporting. So I used 9 years’ worth of statistics, and considering Cincinnati’s population, it came out to 102 of these cases per day. But nowhere near that number is addressed annually. It is not because they are not discovered; rather, facilities choose to either allow the people to quit or fire them. This violates regulatory and often criminal mandates to report these offenses. 

Of course, some of these health professionals move on to other facilities and continue to struggle with addiction without getting help and in turn endanger patients. Some of the same health care facilities that have failed to report the offenses can also become victims of this practice when they unknowingly hire someone from another facility who also left because of an addiction incident that was not properly addressed. 

In the past decade, some of the most egregious health care facility diversions have been caused by technicians, not nurses. Radiology technician  David Kwiatkowski is likely the best example, as he diverted medication from various operating rooms around the country. He removed fentanyl syringes from unattended supplies and injected himself in the bathroom. Kwiatkowski then filled the syringes with water and placed them back for the unsuspecting health professional in the operating room to use, not knowing that they had been compromised. The especially horrific part of this is that Kwiatkowski had hepatitis C, and he ultimately infected dozens of innocent patients across the United States. He worked in radiology and had access to these drugs only because they were left unattended in the operating room. 

I am part of the International Health Facility Diversion Association (IHFDA), a 501(c)(3) organization that has worked for decades to encourage health care facilities to strengthen their reporting of these offenses. The IHFDA’s only purpose is to educate and encourage networking related to the problem of diverting medication inside health care facilities. 

The IHFDA’s goal is to protect innocent patients first but also to require offenders to address their addiction early on, not after they have been allowed to quit or fired several times. Addressing their addiction may very well save their lives. 

Although the IHFDA is in its infancy, its membership and conference participation are growing rapidly. Members can network with hundreds of other professionals who face the same problems in their institutions daily. This networking takes place on the organization’s very active list server and, of course, at its annual conference each year. Members also have access to webinars and a large volume of articles and prior presentations on the topic by experts around the world. 

A first-time regional conference was held in Cincinnati, Ohio, this year, with more to come later in 2018 or 2019. The annual conference will be held in Dallas,Texas, from October 22 to 24, 2018, and it already has an exciting agenda. Initial registrations indicate it will easily surpass the 250 attendees at 2017 annual conference. Visit to learn more about this one-of-a-kind conference. 

 Cmdr. John Burke is a 40-year veteran of law enforcement, the past president of the National Association of Drug Diversion Investigators, and the president and cofounder of the International Health Facility Diversion Association. He can be reached by email at burke@rxdiversion.comor via