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Review
. 2023 Nov-Dec;73(6):810-818.
doi: 10.1016/j.bjane.2023.07.008. Epub 2023 Jul 28.

Prevention of drug diversion and substance use disorders among anesthesiologists: a narrative review

Michael G Fitzsimons  1 , Gabriel Soares de Sousa  2 , Arpine Galstyan  1 , Vinícius Caldeira Quintão  3 , Cláudia Marquez Simões  4
Affiliations
Review

Prevention of drug diversion and substance use disorders among anesthesiologists: a narrative review

Michael G Fitzsimons et al. Braz J Anesthesiol. 2023 Nov-Dec.

Abstract

Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions. Healthcare systems are placed in jeopardy by the legal impact associated with illegal routes of drug release including sanction and financial liability and loss of public trust. Healthcare institutions have implemented many measures to reduce diversion from the perioperative area. These efforts include education, medical record surveillance, automated medication dispensing systems, urine drug testing, substance waste management systems, and drug diversion prevention teams. This narrative review evaluates strengths, weaknesses, and effectiveness of these systems and provides recommendations for leaders and care providers.

Keywords: Anesthesiology; Drug diversion; Drug testing; Healthcare professionals; Substance abuse; Substance use disorders.

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Conflict of interest statement

Declaration of Competing Interest The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The vulnerable chain of drug diversion.
See this image and copyright information in PMC

References

    1. Department of Health & Human Services Centers for Medicare & Medicaid Services. Drug Diversion in the Medicaid Program. State Strategies for Reducing Prescription Drug Diversion in Medicaid. 2012. Available fromhttps://www.cms.gov/medicare-medicaid-coordination/fraud-prevention/medi... (accessed January 13 2022).
    1. Clark J, Fera T, Fortier C, et al. ASHP Guidelines on preventing diversion of controlled substances. Am J Health Syst Pharm. 2022;79:2279–2306. - PubMed
    1. Berge KH, Dillon KR, Sikkink KM, Taylor TK, Lanier WL. Diversion of drugs within health care facilities, a multiple-victim crime: patterns of diversion, scope, consequences, detection, and prevention. Mayo Clin Proc. 2012;87:674–682. - PMC - PubMed
    1. de Vries M, Fan M, Tscheng D, Hamilton M, Trbovich P. Vulnerabilities for drug diversion in the handling, data entry, and verification tasks of 2 inpatient hospital pharmacies: clinical observations and healthcare failure mode and effect analysis. J Patient Saf. 2022;18:e227–ee35. - PMC - PubMed
    1. Merlo LJ, Cummings SM, Cottler LB. Prescription drug diversion among substance-impaired pharmacists. Am J Addict. 2014;23:123–128. - PMC - PubMed