Drug diversion risks in physician offices

Most physician offices don’t store or use large quantities of controlled substances, but even if controlled substances are used infrequently, there is always a risk of theft. Assessing processes in physician offices will make certain that diversion risk is minimized.

The controlled substance risks primarily associated with physicians’ offices include the following:

• Controlled substance security and accountability
• Samples
• Medications that patients want to discard
• Prescriptions
• Verification of orders

Some physicians’ offices use controlled substances as a regular part of business. Allergy clinics, for example, often use controlled substances when testing patients who have a prior history of an abnormal medication reaction. Cocaine may be used in ENT offices that do procedures, and cocaine eye drops are sometimes used in ophthalmology practice settings. Testosterone is used in many internal medicine practices, and benzodiazepines may be used in conjunction with procedures done at gynecology offices.

Staff at many of these offices admit that they have never used the medication and that they usually end up having to waste it because it expires. In these situations, it is important to reconsider the value of keeping a divertable drug on the premises and requiring staff to count it regularly. If the drug must be kept, it can be placed in a mounted lock box with a serialized lock on the opening. That way, staff can verify the lock number each day instead of having to handle the medication. Once a month, the lock can be broken to inspect the medication and ensure that it isn’t expired.

Editor’s note: This is an excerpt from Drug Diversion Prevention in Healthcare, Second Edition. Platinum members can read the e-book for free here.