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Tag: drug diversion

  • Inside Seattle's Progressive Approach To Drug Policy

    Inside Seattle's Progressive Approach To Drug Policy

    Instead of ramping up criminal penalties for non-violent, minor drug offenses, Seattle is providing a chance to get help.

    Seattle is a beacon of progressive drug policy—a model for helping, not criminalizing, drug use.

    According to a New York Times op-ed by columnist Nicholas Kristof, the city has rejected the age-old “war on drugs” and has instead taken a different approach—one that relies “less on the criminal justice toolbox to deal with hard drugs and more on the public health toolbox.”

    Instead of ramping up criminal penalties for non-violent, minor drug offenses, Seattle is providing a chance to get help.

    The Birth Of LEAD 

    In 2011, the Law Enforcement Assisted Diversion (LEAD) program was created in the city.

    Under the program, non-violent people arrested for “law violations driven by unmet behavioral health needs”—e.g. drugs—are diverted to a “trauma-informed intensive case-management program” that may include transitional or permanent housing or treatment, according to the LEAD website. This way, they bypass the criminal justice system, which is often said to only exacerbate their issues.

    “People are hurting inside. That’s why they’re using in the first place,” said Chian Jennings, a 45-year-old woman with a history of drug abuse who was referred to LEAD.

    She told Kristof, “It was probably the best thing that happened to me. It saved my life.”

    Encouraged by its success, 59 municipalities across the U.S. also offer, or will offer, the LEAD program.

    According to a 2017 study, LEAD participants were 58% less likely to be arrested again and 46% more likely to have a job or get job training.

    Drug Prosecutions

    Last September, King County (in which Seattle resides) stopped prosecuting cases involving possession of less than one gram of drugs including heroin and cocaine.

    Dan Satterberg, the prosecuting attorney for King County, shared with Kristof that while some may not be happy with the humane treatment of people who use drugs, it’s better than the alternative: locking up people who are already struggling.

    Satterberg is guilty of perpetuating this drug war strategy himself—but as he told Kristof, he would see firsthand why that strategy was not working.

    His younger sister, Shelley Kay Satterberg, passed away last year of a urinary tract infection. She was 51. Her cause of death was the culmination of years of drug and alcohol abuse, Satterberg said.

    Kristof seems to have a lot of faith in the direction Seattle is going in, in terms of drug policy. “Seattle is undertaking what feels like the beginning of a historic course correction, with other cities discussing how to follow,” Kristof writes.

    He added, “If the experiment in Seattle succeeds, we’ll have a chance to rescue America from our own failed policies.”

    View the original article at thefix.com

  • Marijuana Theft Grows Rampant In Washington

    Marijuana Theft Grows Rampant In Washington

    The state’s attempt at keeping the industry transparent may be helping thieves stake out a “laundry list of targets.”

    Marijuana theft is a problem in Washington state.

    Recreational marijuana was approved in 2012 by Washington voters, and the legal marijuana industry was built on the promise of transparency.

    Washington marijuana producers are required to report on every step of the process. “We plant a seed, we report it. You take a cutting, you report it. How long you dry. What the final weight was. How soon did it go out [the] door? What did you sell, who did you sell it to, for how much? What did they mark it up to? Easily 25% of our time is given over to tracking,” Regina Liszanckie, a producer-processor in Seattle, told Politico.

    All of this information is posted online and available to the public.

    The Targets

    Some suspect that the state’s attempt at keeping the budding industry transparent may be leading thieves to businesses, by providing a “veritable laundry list of targets,” according to one Seattle cannabis grower who has lost $200,000 worth of marijuana to multiple burglaries last summer.

    They came to suspect that the availability of the public record was causing the repeat burglaries, upon analyzing the pattern of burglaries among marijuana growers in the Seattle area.

    They noticed a similar pattern in each case. The businesses tended to be smaller and less likely to afford the surveillance and security tools to protect against thefts. They would also somehow be hit at peak inventory and robbed of thousands—“even tens and hundreds of thousands”—of dollars worth of product.

    Now faced with a burglary problem, marijuana businesses say they are suffering for the sake of industry transparency. What’s worse, the state does not properly track marijuana thefts.

    “It’s a huge risk for us to have that out in the public domain,” said Spencer Shrote of Royal Tree Gardens in Tacoma. “It puts a target on our backs. It makes things less safe.”

    Despite the state taking steps to clamp down on cannabis diversion to the illegal market, Shrote does not have much hope that the problem will be resolved any time soon. “We’ve just accepted it’s going to happen,” he told Politico, “because of the state of industry and the amount of public data that’s available.”

    View the original article at thefix.com

  • Doctors Turn Detectives To Find Out Who Stole Narcotics From Cancer Center

    Doctors Turn Detectives To Find Out Who Stole Narcotics From Cancer Center

    The doctors shared their experience with a medical journal with the hopes of helping others in similar situations.

    A rash of bloodstream infections at a cancer center spurred clinicians to turn into amateur sleuths, which in turn revealed that a former nurse had allegedly caused the outbreak by replacing intravenous painkiller medication with tap water.

    Federal charges were file against Kelsey A. Mulvey, 27, who faces 10 years in prison and a $250,000 fine for allegedly obtaining controlled substances by fraud, tampering, and a violation of the Health Insurance Portability and Accountability Act (HIPAA).

    The clinicians shared their experience in a letter to the New England Journal of Medicine in the hopes that it would help other medical professionals with similar cases.

    An article on Medpage Today detailed the circumstances of the case, which began in June of 2018 at the Roswell Park Comprehensive Cancer Center in Buffalo, New York.

    Mysterious Infections

    Six patients developed bloodstream infections from sphingomonas paucimobilis, a bacterium found in soil and drinking water that can take root in distilled water tanks, respirators and dialysis machines. Patients with chronic conditions are particularly susceptible to it, and infection can result in sepsis, peritonitis and pulmonary embolisms.

    However, the bacteria rarely causes bloodstream infections, which drew the attention of Jillianna Wasiura, RN, Brahm Segal, MD and Katherine Mullin, MD, all clinicians at the Roswell Park facility. They checked a number of possible sources, including regional microbiology labs and pharmaceutical vendors, before finding the source of the bacteria: compounded syringes with the prescription opioid painkiller hydromorphone.

    Four of seven syringes stored in a Pyxis MedStation, an automated medication-dispensing system, tested positive for sphingomonas, as well as other waterborne bacteria. Further analysis revealed that the syringes had been diluted with tap water from a single source, which contaminated the medication.

    A criminal complaint led to an investigation by federal agents, including representatives from the Food and Drug Administration, the Federal Bureau of Investigation, and the New York State Attorney General’s Office.

    In a statement issued by the U.S. Attorney’s Office for the Western District of New York, former Roswell Park nurse Kelsey Mulvey was charged with removing the medication from the Pyxis machine, which she had access to through her position at the center.

    How She Did It

    According to the statement, Mulvey not only removed the hydromorphone syringes, but also methadone, oxycodone, and lorazepam. The center became suspicious of Mulvey’s actions in June of 2018 when a large number of transactions on the Pyxis machines registered as “cancelled removed,” which meant that the machine drawer with certain medications was accessed but the transaction was subsequently cancelled.

    The statement also alleged that Mulvey removed medication from floors and wings of the center where she did not have patients, and accessed them during her regular shifts as well as on her days off and three days of scheduled vacation. Mulvey resigned from the center on July 13, 2018 to avoid termination. Though charged with the aforementioned violations, Mulvey is presumed innocent until, and unless, proven guilty.

    As Medpage noted, none of the six patients died as a result of the infections, though two subsequently passed away as a result of the cancers.

    U.S. Attorney James P. Kennedy Jr. alluded in the statement to the “destructive power of opioid addiction,” which appeared to suggest that Mulvey’s actions were motivated by drug dependency.

    “In this case, however, the harm caused by the defendant’s actions resulted in not only harm to herself but in harm to some of the most compromised and vulnerable individuals in our community—those members of our community receiving cancer treatments.”

    View the original article at thefix.com

  • Nurse Accused Of Stealing Hydromorphone, Possibly Infecting Patients With HIV

    Nurse Accused Of Stealing Hydromorphone, Possibly Infecting Patients With HIV

    Investigators say they found video footage of the HIV-positive nurse stealing the drugs.

    A nurse may have infected patients with the HIV virus by injecting himself with hydromorphone intended for patients, say authorities in the San Antonio area.

    Kyle Evans, 29, was arrested last Thursday (June 13) for stealing vials of hydromorphone, an opioid painkiller, while he was on the job. He allegedly injected himself with the drug, then would place the vials back where he found them after refilling them with saline solution. He is now facing multiple felony charges—tampering with a consumer product and drug diversion.

    Evans was working as a registered nurse at Northeast Methodist Hospital outside of San Antonio when he stole the drugs, My San Antonio reported.

    His activity first came to light in February after he was “caught stealing five vials of hydromorphone” from the hospital. According to My San Antonio, he later admitted to stealing the drugs, triggering a DEA investigation. Investigators say they found video footage of Evans in the act.

    In May, during questioning by Live Oak Police Department investigators, Evans allegedly confessed to stealing the drugs, injecting himself with them, and returning the vials after he’d filled them with saline solution and glued the lids shut to hide the fact that they were tampered with. (Instead of saline solution, authorities found that in one vial Evans had replaced the hydromorphone with lidocaine, a local anesthetic. The test results of two other vials are pending.)

    Authorities voiced concern over the fact that Evans is HIV positive, and may have exposed patients to the virus if he used the same syringes to refill the vials before putting them back.

    Hospital officials addressed the concern in a statement: “Upon learning the former employee was diagnosed with HIV, we took several precautions including consulting with third-party infectious disease experts who concluded that there was virtually no risk of exposure to others, most notably due to the virus being below detectable levels in the employee’s blood,” said Paul Hancock, MD, Chief Medical Officer of Methodist Healthcare System.

    Though so far authorities were “not able to determine” if Evans did share the contaminated needles, it would not be the first time patients have been infected by hospital workers doing the same thing.

    In 2013, a former hospital worker was sentenced to 39 years in prison for possibly infecting hundreds of patients with hepatitis C. David Kwiatkowski was working as an itinerant (traveling) cardiac technologist while he injected himself with drugs—primarily fentanyl—stolen from hospitals across the U.S.

    Another nurse, Cora Weberg, contributed to a hepatitis C “outbreak” at Good Samaritan Hospital in Puyallup, Washington in recent years, according to the CDC.

    View the original article at thefix.com

  • Recovery of a Real-Life "Nurse Jackie"

    Recovery of a Real-Life "Nurse Jackie"

    Before I ever stole a pill from work, before I was ever a daily drinker and habitual pill-popper, I was just a burned-out nurse, exhausted and in pain.

    Nurses are often referred to as “angels in scrubs.” It certainly fits. 

    Who else but an angelic being can provide unconditional comfort in the throes of tragedy, hold your hands through unspeakable heartbreak, and save your loved one’s life all while cleaning up an array of bodily fluids?

    Nurses do it with a smile.

    Florence Nightingale left her predecessors with big shoes to fill. Nurses must function as caregivers under extraordinary pressure, possess superhuman resilience, scrupulous morals, exceptional coping skills and be immune to afflictions that trouble the general population. Nurses need to be available to care, comfort and to cure. There’s no time to be ill or emotionally fragile. 

    By striving to live up to Nightingale’s standards, we’ve earned the #1 spot on Forbes list of trusted professionals, but we’re also the most susceptible to job burnout. We’re brimming with intelligence and compassion, but far from celestial beings. Nurses are 100% human and just as likely, if not more so, to employ unhealthy coping mechanisms. 

    A Registered Nurse for over 14 years, I can attest to this. I mismanaged work stress and job burnout in the worst way possible: by turning to drugs and alcohol. 

    It’s estimated that around one in 10 nurses struggle with substance use disorder. That’s no small statistic, considering there are around 3 million nurses in the US.

    Alcohol, opiates and benzodiazepines are an all-too-accessible source of fuel to get through the work day. They’re also excellent numbing agents to sleep off the stress of a shift. It’s not uncommon to hear a nurse exclaim “This shift calls for wine!” or to joke about the necessity of drugs to wash away the day.

    Nurses readily encourage drinking as a coping skill, use of anti-anxiety medicine is socially approved of and sleeping pills are shared between friends. But admitting one has lost control of one or more of these highly addictive substances is absolutely taboo. 

    It was eight years into my career at the hospital that I became physically and psychologically dependent on Vicodin. Migraines interfered with my ability to work and be a mother. My doctor prescribed an opiate, and I experienced blissful relief as the migraine melted away and euphoric energy filled the void. 

    The progression of my addiction was insidious but certain. Since graduation from nursing school, I could count on one hand how many hangovers I’d woken up with. Recreational drugs, including smoking pot, was out of the question. Yet when all the factors fell into place – a legit prescription, disengaged from my work, overwhelmed at home and sleep deprived working nights – my fate seemed inevitable.

    Slowly and steadily I transformed from a Florence Nightingale prodigy – working overtime, volunteering, climbing the ladder to nursing success – into a real-life Nurse Jackie. 

    Eventually I became tolerant and my personal prescription wasn’t enough. I engaged in behavior I’d previously considered appalling and unthinkable. I stole from my employer. Compulsion to use and desperation to avoid withdrawal won over any rational thought process. Opiates had become a cure-all for the physical and emotional exhaustion that consumed me.

    Like so many other nurses, when I realized the line had been crossed from medical and occasional recreational use to abuse and dependence, I felt trapped. I couldn’t just tell my manager. I couldn’t even tell a friend. Too much was at stake. Drowning in opiate addiction, (and drinking heavily to boost the effects or stave off withdrawal) I saw no safe shore to swim to. 

    Washington State, along with most states in the US, offers an “alternative to discipline” program due to the high incidence of substance abuse in healthcare professionals. But since the problem isn’t talked about, the solution isn’t either. The organizations are spoken of in whispers, as are the nurses who “ended up in the program.”

    I wasn’t ignorant to the existence of these resources, but I was completely misguided as to their intention and function. 

    I’d heard rumors of nurses who were caught “diverting” – the fancy term we use for stealing the leftover or extra amounts of drugs that are supposed to be “wasted” at work in the proper receptacle.

    According to gossip, they were escorted off campus by security or police as the state program was notified. At worst they were forced to relinquish their license. At best, job opportunities were limited to grueling shifts at nursing homes earning half the pay they deserved. 

    It was a living nightmare. Imprisoned by addiction, paralyzed by fear. Terrified of being recognized, I refused to attend any type of peer-support group meeting. Finally, out of desperation I contacted a private counselor. She declined to treat me based on duty to report.

    “Oh, you’re a nurse? I can’t treat you. Too much liability. But good luck I’m sure you’ll find someone.” 

    Fortunately, I found rock bottom. Not in the form of an overdose, which I was dangerously close to many times, but in being caught by my employer. Someone had informed them of my suspicious behavior. I was required to give a urine sample, and when it came back glowing dirty with the truth of my drug use, I was given a choice according to my state’s department of health policy: Enter into treatment or face criminal charges and potential loss of my license.

    Both options felt like professional suicide. For the next two weeks as I contemplated the decision, I also contemplated actual suicide. With the support of one family member I felt I could confide in, I made my way to treatment; sick with shame and certain I’d destroyed my reputation, my dignity and life as I knew it. 

    Out of work as a nurse, but intentionally working on recovery, my outlook began to change. One month of sobriety turned into multiple, and the chemical fog began to clear. I made connections with nurses who had or were recovering. I began practicing mindfulness, cultivating resilience and digging deep to understand what had transpired. 

    As I researched, I discovered my story isn’t unique. Being an excellent nurse and having an addiction are not mutually exclusive. In fact, they often go hand-in-hand. The highest functioning, hardest working, most in-depth critical thinkers end up stealing and ingesting drugs from work. Numerous factors play into this, the most basic of which is drugs and alcohol offer instant relief from a mind that won’t shut off, and they are physically addictive. Nurses in particular feel invincible as the caregivers – “it’s others who are sick.”

    Our comprehensive knowledge of medications and how to ingest or inject “safely” gives us a false sense of security. And 75-80% of nurses are adult children of alcoholics, including me. We’re essentially predisposed and then enter into a pressure cooker of a career. 

    My research also uncovered that sober, recovering and/or “graduated” from an alternative to discipline program nurses still don’t disclose this part of their lives. This is a tragedy in itself. When nurses keep their recovery in their dark, still-suffering nurses keep their active addictions in the dark. 

    Healthcare as an occupation does a disservice to professionals who enter into it by neglecting to educate, advocate and adequately treat. 

    Nursing schools should provide courses in mindfulness and self-awareness, encouraging nurses to uncover the sometimes-hidden nature of addictive tendencies and teaching strategies to manage them. This should be done long before ever exposing them to the workforce and giving access to a plethora of pills and injectables. 

    Educational institutions and employers should offer free education, confidential counseling and allow time off work for treatment. Lunch breaks should be mandatory and enforced; employees should be trained in self-care. 

    Instead of shaming nurses who are under suspicion or undergoing treatment by posting names and license numbers on public lists, the department of health should be involved in the development of peer- support groups.

    Trauma-informed rehabilitation programs need to be implemented for nurses and first responders who have been repeatedly subject to high stress and high stakes patient care. 

    Asking for help shouldn’t be a trauma itself. We need to change the narrative from “being reported” to being “given an opportunity to receive treatment and protect your license.” Treatment providers need to change the verbiage from “You can’t tell me anything, I have a duty to report.” To “This is an opportunity for honesty, to find you the best treatment possible so you can achieve health and well-being again.”

    I never wanted to be known as a real-life Nurse Jackie. It would have been easier to quietly complete my time in treatment and live out my career with a well-kept secret. But I know that there are many more angels in scrubs still suffering. Neglecting themselves while striving to meet the needs of their patients, too afraid to ask for help and too sick to overcome addiction on their own. 

    Before I ever stole a pill from work, before I was ever a daily drinker and habitual pill-popper, I was just a burned-out nurse, exhausted and in pain. I needed a safe place to admit I was hurting and an outlet to vent the pressure. I needed somewhere to take off my scrubs, shed the angel wings, and become vulnerable without being made to feel inferior. I needed to know I wasn’t alone, and that treatment was not the end of my career; only the end of my addiction. My career would have a chance to flourish.

    Stigma must be eradicated for recovery to be possible. Prevention, early intervention, and treatment must be advocated for fiercely in order for nursing to be filled with thriving, healthy individuals. I live sober out loud because I believe this change is possible.

    Tiffany Swedeen, RN, BSN, CPC/CPRC is a certified life and recovery coach, She Recovers Designated Coach, and a registered nurse in recovery herself from opioids and alcohol. Tiffany lives “sober out loud,” proudly sharing her story through advocacy and blogging and is passionate about helping others do the same. Her goal is to eradicate shame and empower all to live a life of radical self-love.

    You can contact Tiffany through her website Recover and Rise, read her blog www.scrubbedcleanrn.com and follow her @scrubbedcleanrn. 

    View the original article at thefix.com

  • Prescription Opioid Theft Spikes Among Medical Staff

    Prescription Opioid Theft Spikes Among Medical Staff

    The new report found that 67% of prescription opioid thefts are by doctors and nurses.

    A new report found a 126% increase in the theft of opioid prescriptions by doctors and other medical professionals from 2017 to 2018, according to CBS News.

    This problem has directly harmed patients who were prescribed opioid painkillers following surgery or injury, and the report’s authors are warning that their findings are merely the “tip of the iceberg.”

    Lauren Lollini told CBS News about contracting hepatitis C from syringes contaminated by a hospital technician who used them to take the opioids prescribed to Lollini. The tech then refilled the syringes with saline and left them for the patient to use.

    As a result, Lollini went home from her kidney surgery with a liver infection and 10 years later is unable to work due to chronic fatigue.

    “I really was angry at the broken system,” she said. “The hospital that hired her—unbeknownst to them that she had been let go from other jobs.”

    The technician is currently serving a 30-year prison sentence for her crimes.

    The report also found that 67% of these thefts are by doctors and nurses. Dr. Stephen Loyd of Tennessee described how he got hooked on the opioid pills that were incredibly easy for him to steal.

    “There was no requirements on what happened to those pills. They could go down the toilet or they could go in my pocket,” he said. This went on for three-and-a-half years.

    When diverted drugs could be identified, it was found that the most commonly stolen drug was oxycodone, followed by hydrocodone (Vicodin) and fentanyl. Overall, 47 million opioid doses were stolen in 2018 alone. 

    A report published in Drug Diversion Digest in September 2018 by the same analytics company found that healthcare employee theft of prescription medications in general cost healthcare organizations $162 million in the space of six months, with nearly 95% of cases involving at least one type of opioid.

    This report also expressed that their findings were only the tip of the iceberg due to the fact that they were only able to research cases where the thefts were discovered.

    Dr. Loyd, who now runs a rehab center, believes that the high rate of opioid diversion is largely due to the high stress of medical professions. That plus easy access to the drugs create a recipe for drug misuse and addiction.

    “They’ve got high stress jobs. A lot of them, like myself, have workaholism. And not only that, you have access,” Loyd explained.

    View the original article at thefix.com