An Informative article submitted by Stericyle written by Kim New an expert in the field on the topic of drug diversion
Understanding how to Properly Waste Controlled Substances: A facility-wide solution minimizes your risk
Experts like Kim New, J.D., BSN, founder of the International Health Facilities Diversion Association, weekly visits U.S. hospital leaders to explain solutions to a growing crisis – drug diversion by healthcare workers.
She describes institutional drug diversion as stealing medications, including excess waste, for personal or unauthorized use. Anyone who has legitimate access to drugs delivered during patient care has the opportunity to divert. Developing and tightening controlled substance waste processes are a necessity for protecting patients and staff.
Kim New describes common scenes: fentanyl waste left on a cabinet between OR cases; an ER patient pulls a sharps container off the wall for access; or diversion by family visitors and imposters posing as healthcare providers. All can gain access to controlled substances if procedures are not standardized.
Preventing diversion of controlled substance when it needs to be wasted can be problematic. New describes the steps to take to improve your security in this webinar: “Proper Disposal of Controlled Substance Waste.”
New describes all health facilities as vulnerable and mentions it’s a matter of when, not if, diversion happens. A hospital team’s ability to detect it quickly is the key to what can be a multi-victim crime that poses a significant risk to patients and staff safety. For this reason, clinicians and administrators should treat diversion similar to other patient and staff safety initiatives.
New highlights the bigger picture and contributing factors: drug abuse occurs at the same levels as community abuse. Healthcare workers have a stressful, physically demanding job that can bring injury or chronic back problems that often lead to taking painkillers that can become addicting.
She dispels myths: clinicians often describe becoming desensitized and supervising staff say a person of this crime is “the last person I’d expect.” Equally puzzling, diverting drugs from sharps containers is one of the last places one would expect someone with healthcare knowledge to go. Yet diversion from sharps containers is very common.
Diversion consequences include: providing patient care in an impaired state at work or while driving home; withholding medications from patients in need; and transmitting blood borne pathogens after removing the contents and replacing the opioid with saline or water to match the former volume and then using the same syringe on the patient.
Individuals waste controlled substances into sinks, toilets and sharps containers. HCWs are asked to witness and document or attest that the wasting occurred. No matter the place and timing of disposal, there can be diversion. Surveyors now question hospitals’ wasting processes as part of safety and examining waste in sharps containers.
New describes seeing hospital policies that outdate DEA, EPA, state and local requirements. The Joint Commission medication management standards are being revised to include waste so New strongly advises hospitals to address waste in written policies to minimize risk.
Current practices vary from hospital to hospital and department to department. Formal controlled substances disposal services can help including at outpatient clinics which often unaware of how to properly dispose of controlled substance waste. No matter which healthcare facility, New recommends dedicated controlled substance waste containers that deactivate, bind or both, so the substances prevent diversion. She cautions that the sink is not a good policy for wasting due to environmental reasons.
Where to Learn More
Learn more about minimizing risk and what a consistent and practical approach for hospitals looks like. Safely and securely dispose of controlled substances with a full-service solution such as the CsRx™ Service by Stericycle.
Why have a formal controlled substance disposal initiative? New makes it clear: “These type of efforts save lives.”