An Inside Job: Drug Diversion in the Pharmacy?Part 2
The theft of prescription drugs by pharmacy personnel is often the result of an addiction problem on the part of an employee. There are notable exceptions, including the theft and diversion of very expensive prescription drugs and street trafficking, which will be discussed in future articles.
The usual theft within the pharmacy seems to follow the same pattern as prescription drugs abused on the street. Certainly hydrocodone will tend to lead the list of drugs diverted?not surprisingly, because it is the number-1 diverted prescription drug in this country. The benzodiazepines and stimulants also are common targets of those diverting from behind the pharmacy counter.
A scarier instance of pharmacy diversion, however, revolved around car-isoprodol. A pharmacist had been diverting the drug for several months at a chain pharmacy, and he had reached an almost 20-tablet-a-day habit. He was inventing fictitious patients to document dispensing carisoprodol, but at the same time he was paying for the drug out of his own pocket. He rationalized that he was not stealing the drugs because he was paying for them!
This same diverting pharmacist was discovered when he left work in the afternoon, after consuming several of the pills, and drove the wrong way on a local interstate highway. Fortunately it was a Sunday, and traffic was relatively light, when he was finally pulled over by local police. Uniformed officers noticed his impairment and found bottles of carisoprodol on the front seat of his vehicle.
The worst example of diversion in the pharmacy involved an addicted pharmacist who was also providing drugs to a friend. When we approached him leaving the pharmacy, he quickly confessed to the diversions. He had several pills on his person. He agreed to allow us to accompany him to his home to retrieve additional dosage units that he had previously stolen.
Because of his cooperation and some pressing family responsibilities, we allowed him to meet us the following day for his surrender and the processing of additional paperwork. When he failed to show up the next day for his appointment, the officers went to his home, only to find that he had deliberately overdosed on pharmaceuticals and had died.
This prompted me to find out about our Ohio recovery organization, and to meet Charlie Broussard, RPh, from the Pharmacists Rehabilitation Organization (PRO). Charlie provided me with valuable information that included pamphlets and emergency phone numbers that could be given to pharmacists we encountered in these situations. My investigators made sure that each pharmacist was given this information before the contact was finished.
The theft of prescription drugs by pharmacy personnel is a criminal offense. Law enforcement has a job to do when it comes to investigating and prosecuting those responsible. Although we have no legal mandate, we certainly have a moral responsibility as well to attempt to ensure that addicted pharmacy personnel have the opportunity to seek help for their problem.
If you know of a coworker who is having a problem, do something now! If the affected person refuses to admit his or her problem and to seek help, then it is important that you notify supervisors, law enforcement, or a bona fide recovery agency that can offer suggestions.
My good friend, David Marley, PharmD, RAS, executive director of the North Carolina Pharmacist Recovery Network Inc, directed me to the Am-erican Pharmacists Association Web site for more information. Interested readers can go to www.aphanet.org and click on "Professional Development" and then "Pharmacy Recovery Program." While at this link, click on "Directory of State Pharmacy Recovery Programs" to find the program in your part of the country.
If we are to best serve our communities, this societal problem requires not just arrest and conviction. Follow-up and quality rehabilitation opportunities are mandatory if we have any hope of adequately addressing this problem.
John Burke, director of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 32-year veteran of law enforcement.For information, he can be reached by e-mail at firstname.lastname@example.org, by phone at 513-336-0070, or via the Web site www.rxdiversion.com.