Understanding and Addressing Drug Diversion

Understanding and Addressing Drug Diversion

Drug diversion, or the illegal transfer of prescription medications, is a pervasive, ongoing problem for health care organizations across the country. According to the U.S. Department of Justice National Drug Intelligence Center (NDIC), drug diversion costs the health care industry over $70 billion per year. Here, we provide an overview of this issue and discuss how to prevent and address it.

What is Drug Diversion?

Drug diversion is a medical and legal term describing the illegal transfer of prescription medications, typically for illicit use. Drug diversion has garnered increased attention in recent years and has been called “health care’s hidden epidemic.”

There are several ways that drug diversion can occur in a health care setting. In some cases, a care provider may steal prescription medications from a hospital pharmacy or dispenser. In others, providers may give a patient less medication than was prescribed, or less in combination with a placebo, and pocket the rest. The “diverted” medication is typically then used for personal consumption or sold for illicit purposes.

What are the Impacts of Drug Diversion?

Drug diversion has far-reaching implications. Notable impacts include:

  • Worsened patient care. If medication is diverted from a patient in need, quality of care is diminished and a patient may have improper pain relief or become exposed to infection. Additionally, if a provider steals medication for personal use, patients may be treated by impaired providers.
  • Reputational damage. Changes to quality of care or worker impairment can impact a health care organization’s reputation and expose them to liability. 
  • Financial impact. Prescription medications are costly, so lost inventory can impact an organization’s bottom line. In addition, hospitals often have to pay for internal investigations, follow-up care for affected patients, and massive fines for failure to prevent drug diversion in the first place. For example, in 2017, a hospital was fined over $500,000 after a pharmacist was convicted of diverting drugs.
  • Health care worker impairment. If drug diverters are using drugs, they are at risk of impairment, overdose, or even death.

What Causes Drug Diversion?

Drug diverters are typically motivated by financial pressure or personal stress. For health care workers who are stealing medication for personal use, controlled substances can provide relief; for those enduring financial hardship, these medications can lead to lucrative profits on the black market.

Personal stress is unfortunately common in health care workers. In a recent survey from Mental Health America, 93% of health care workers reported experiencing stress, 86% reported experiencing anxiety, 77% reported frustration, 76% reported exhaustion and burnout, and 75% said they were overwhelmed. 

Additionally, according to the U.S. Substance Abuse and Mental Health Services Administration, at least 100,000 medical professionals struggle with substance abuse. Further research has found that approximately 10-15% of U.S. physicians will develop a chemical dependence in their lifetime.

One way that health care organizations can mitigate the risk of drug diversion is by offering robust mental health resources and providing employees with financial planning and substance abuse prevention training.

How is Drug Diversion Addressed?

There are several strategies that health care organizations can and do implement to prevent and address drug diversion. One effective strategy is establishing a drug diversion program. These programs include safeguards to prevent diversion, systems for identifying diversion, and policies for assisting employees struggling with prescription drug abuse. 

Developing an effective drug diversion program can be done by reviewing best practices from a variety of organizations, such as the American Society of Health-System Pharmacists (ASHP), and consulting with experts. This is particularly important since research indicates that approximately 40% of providers have not received formal drug diversion training.

Another strategy is protecting prescriptions and pharmacies. This can include limiting access to prescription pads, comprehensively charting medications dispensed to patients, and including security measures in pharmacies. Developing a working relationship with local area pharmacies and alerting them to standard practices for prescriptions can improve the detection of drug diversion.

In addition to implementing these measures, health care organizations should also seek to provide employees with comprehensive, low-cost mental health resources. This can include offering mental health training, providing counseling or other resources, offering time off for mental health concerns, and taking steps to reduce the stigma.

Addressing Drug Diversion

Drug diversion is a costly and dangerous problem for health care organizations. To ensure employee and patient safety and success, it is important to develop prevention strategies. This includes establishing a drug diversion program, protecting medications and prescription pads, and providing access to mental health resources.

Since drug diversion is typically noticed by the diverter’s coworkers, it’s also important to ensure that employees have an easy, effective means of reporting suspicious or concerning behavior for both themselves and their coworkers. This can include missing medications, mental health concerns, substance abuse suspicions, and more. In addition to mitigating the risk of drug diversion, anonymous tip reporting can help prevent and address a variety of other concerns.

To learn more about the threats facing healthcare workers and how risk intelligence can help, download our free guide, Protecting Health Care Workers with Risk Intelligence. Visit the LiveSafe website to learn more about implementing LiveSafe into your health care organization’s prevention strategy.


Alexandra Brunjes has a B.S. in Neurobiology from Georgetown University in Washington, D.C. with minors in Creative Writing and French. She is a published journalist and experienced health and science writer. Her expertise includes risk intelligence, healthcare and neuroscience, and technology.

Jeff Dalto, Senior Learning & Performance Improvement Manager
Jeff is a learning designer and performance improvement specialist with more than 20 years in learning and development, 15+ of which have been spent working in manufacturing, industrial, and architecture, engineering & construction training. Jeff has worked side-by-side with more than 50 companies as they implemented online training. Jeff is an advocate for using evidence-based training practices and is currently completing a Masters degree in Organizational Performance and Workplace Learning from Boise State University. He writes the Vector Solutions | Convergence Training blog and invites you to connect with him on LinkedIn.

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