Drug Diversion in Healthcare is a National Problem, but Recent Survey Shows a Promising Path Forward

Clinicians who divert drugs using patients’ clean needles to inject medications have been known to transmit hepatitis C, while hospitals found culpable in drug diversion cases face steep legal and financial repercussions as well, which can add up to tens of millions of dollars.

According to Invistics’ fourth-annual survey of health professionals, 98% agree drug diversion is happening in hospitals, and that most of it goes undetected. According to the survey, 79% of respondents agree or strongly agree that “most” drug diversion goes undetected, which is a notable increase since the 2017, 2019, and 2021 surveys.

So, it’s good news that investment in drug diversion technologies at healthcare organizations has reached an all-time high. But with opioid overdoses and clinical burnout still at epidemic proportions, we must learn what is working and what needs to improve. By taking a closer look at survey data, we can see clearly what most hospitals need to strengthen.

Progress, by the Numbers

In 2023, healthcare organizations appear to have returned to similar levels of investigations as reported in 2019. More than 9 in 10 survey respondents said their facility investigated at least one incident of suspected drug diversion, compared with 82% in 2021.

Additionally, 20% of respondents said that more than half of drug diversion investigations resulted in a confirmed diversion, up from 13% of respondents in 2021, underscoring the effectiveness of a tech-driven approach. These data align with the finding that healthcare organizations had the same number of full-time employees dedicated to drug diversion programs and investigations in 2019, with 58% reporting at least one dedicated full-time employee, up from 45% in 2021.

However, more investigations don’t mean more success in uncovering suspected diversion. In fact, according to the Invistics survey, 44% of investigations at health systems lead to 10% or fewer confirmed cases, down from 48% in 2021. These data suggest a few things.

First, we may be relying on technology systems that aren’t sufficient in tracking incidents that would raise a red flag. Second, many health systems could be woefully understaffed. Or perhaps, perpetrators are getting better at hiding their tracks.

Either way, the call to action is the same: Although healthcare organizations can’t always control staffing levels, they need technology capable of accurately isolating meaningful evidence that warrants investigation.

Smarter Investments, Better Detection

Healthcare organizations can lower their risk of drug diversion by strengthening staffing, employee training, and technology:

• Staffing. While more healthcare facilities surveyed said they employ at least one dedicated full-time employee to drug diversion mitigation efforts, this should be a universal practice. A dedicated expert in drug policy and healthcare diversion can ensure that an organization’s drug policies and technology investments are in the right areas—for example, that staff is complying with Joint Commission guidelines for reporting diversion among colleagues to clinical managers or law enforcement.
• Training. Equipping staff and managers with the skills to recognize and respond to drug diversion is the most important aspect of prevention. At a minimum, health systems should provide annual training on current trends, common red flags associated with drug diversion, and where to find resources for additional information and guidance.
• Technology. Machine learning technologies and artificial intelligence have advanced significantly over the past few years. This is good news: As a February 2022 study published by the American Journal of Health-System Pharmacy noted, advanced analytics and machine learning technologies detected known diversion cases an average of 160 days faster than existing, non-machine learning detection methods, and with 96.3% accuracy. One promising trend the survey found that the use of AI and machine learning software has doubled since 2017. Invest in a platform with a proven track record of culling information from multiple IT systems—EHRs, practice management systems, timecards, medication-dispensing cabinets and wholesaler purchasing records—that will result in speedier follow-up investigations.

While no single strategy can eliminate the risk of drug diversion altogether, strengthening staffing, training, and technology can improve overall safety. With patients’ lives and clinicians’ careers at stake, amid the continuing opioid epidemic, it’s never been a more important area of focus.

About the Author

Tom Knight is the founder of Invistics, now part of Wolters Kluwer.