Drug Diversion Prevention with Proper Prescription Drug Disposal

Industry experts believe there is a link between diversion and proper waste stream management practices for pharmaceuticals.
   

What is Drug Diversion?

Drug Diversion is when physicians and other healthcare professionals divert or use drugs intended for patients. Hospital and health system leaders can minimize this risk by not overlooking the security and proper disposal of controlled substances - an important, waste stream for them.
   

Common Causes of Drug Diversion

Easy access to medications, overcrowded ERs and the 24/7 pace of patient care, can make it easy for diversion to occur. An array of regional newspapers from Virginia to Florida, Arkansas, Iowa and California, show nurses, pharmacists and other healthcare workers charged with this crime, which significantly dents hospital reputations and bottom lines.
   

Federal Regulations for Controlled Substances  

In 2014, the Drug Enforcement Administration (DEA) issued new regulations that “controlled substances be rendered irretrievable and unusable after disposal.” The DEA requires that health care professionals wasting a controlled substance have an independent witness who documents and verifies the amount wasted matches what the user documented while also observing the substances being disposed.
   
Don Albaugh, formerly with the Louis Stokes Cleveland VA Medical Center, piloted different options after the DEA regulations took effect. Ultimately, he chose the Stericycle’s CsRx^® Controlled Substance Waste^TM Service as other programs were “costly and there was a lot of maintenance involved…”. “We have a 1-gallon container on each medication cart right next to the drug-dispensing machines, so you don’t have to walk to the medication room to waste, and a 3-gallon container in each OR. People aren’t going to do this unless you make it easy.”
 
Taking steps to manage controlled substance includes making sure that expired or unused controlled substances can never go into sharps containers - one of many ways a determined person can divert.
   

Drug Diversion Prevention 

Stericycle’s Controlled Substance Disposal Program can help your organization prevent drug diversion. The containers have lockable wall­-mount brackets and one-way lids, preventing hands, sharps, vials or ampules from entering. Once inside, the carbon deactivates pills, patches or liquids.  Before shipping for disposal, a solidifier is used as a final security measure.  Stericycle technicians will fill containers with water, exchange when full, and handle the disposal of the full containers.  For hospitals without a technician, a simple self-service system is available.
 
Brian O’Neal, PharmD, the Senior Director of Pharmacy and Biomedical Engineering at Children’s Mercy Hospital, in Kansas City, Mo., describes. “While the DEA has not endorsed any (products)… it would be difficult for hospitals to set up a compliant, in-house solution.”
 
In the article, Stericycle’s Gerry van Domelen adds to “The 10 Best Practices for Waste Management” as he highlights the need for secure sharps and pharmaceutical waste containers, and educating staff on proper procedures. His recommendations are here with new guidelines by the American Society of Health Pharmacists and the Institute for Safe Medication practices.