What is drug diversion?

We define drug diversion as the act of diverting, or misappropriating, medication from its intended destination. It is any illegal action involving a legal medication, mainly the theft of legal medication, either for personal use, or for sale/distribution to others. Healthcare diversion may also include the adulteration or substitution of medications that cause adverse healthcare events to innocent victims.

How widespread is drug diversion?

Drug diversion is difficult to measure, but it’s estimated as many as 10 percent to 15 percent of all healthcare workers divert drugs at least once. In recent years, the rise of the opioid epidemic has led to an increase in reported incidents of drug diversion within hospitals and other healthcare settings.

Why is visibility into drug diversion so important?

Awareness of drug diversion is the first, and most important, step in stopping drug diversion by healthcare workers. Reporting tools such as HealthCareDiversion.org help healthcare organizations and law enforcement workers have greater visibility into real-time incidents of drug diversion. The sooner a pattern of diversion is detected, the sooner organizations can intervene to mitigate future incidences of diversion.

How is drug diversion impacting patients and others?

When healthcare workers divert drugs, they are putting everyone at risk: themselves, their patients (e.g., through the spread of disease via shared needles), and their peers in the medical system.

As the Centers for Disease Control and Prevention (CDC) noted in their research on drug diversion by healthcare providers, since 1983, drug diversion has led to dozens of outbreaks of Hepatitis C and other bloodborne infections (with a higher concentration of outbreaks between 2004 and 2013). And that’s only the diversion they know about. Hundreds, if not thousands, of incidents of diversion go undetected – oftentimes until it’s too late.

Drug diversion has financial consequences, too. For healthcare systems, incidents such as the Rose Medical Center 2009 outbreak in Denver, which was linked to a single healthcare worker infecting 18 patients, had legal and financial implications.

I suspect my doctor/nurse/healthcare provider is diverting drugs. What should I do?

If you suspect someone is diverting drugs, it is your responsibility to report your suspicion to their supervisor or employer, who in turn is responsible for investigating the suspected diversion.

After you have reported to their supervisor or employer, please report the incident to HealthCareDiversion.org through our online reporting tool at this link: https://healthcarediversion.org/report/. HealthCareDiversion.org accepts submission of all types of incidents: incidents of suspected diversion, criminal cases, licensure discipline, etc. You may submit your report anonymously, if you would like. When you report an incident, we will ask for you to provide as many details as possible, including a short description as well as facility and location information. Each incident will be evaluated by HealthCareDiversion.org staff, who will determine the appropriate next steps (e.g., publishing the report in our database).

See our page How to Report Diversion (and Why It Matters) for further details, including a list of law enforcement and regulatory agencies to whom different types of suspected diversion should be reported.

Why should diversion be reported to HealthCareDiversion.org, in addition to reporting it to law enforcement and/or regulatory agencies?

Our primary purpose at HealthCareDiversion.org is to collect drug diversion data for the purposes of stopping diversion altogether. By reporting a suspected drug diversion incident to HealthCareDiversion.org, you will be helping drug diversion professionals (including law enforcement workers, healthcare leaders, etc.) not only to document that single incident, but also to understand the size and scope of diversion across the nation.

Who may submit an incident report through HealthCareDiversion.org?

Anyone may submit an incident, including:

• Licensure boards (e.g., state boards of nursing, boards of pharmacy, medical boards);
• Regulatory and law enforcement agencies (local law enforcement, local/county/state public health agencies, and federal regulators);
• Healthcare facilities (providers, nurses, pharmacists and anyone else working in a healthcare facility has a unique role to play in drug diversion);
• The general public (patients, families and others)

Our hope is to provide these healthcare workers with a safe place to submit concerns and upload data in an unidentified way, in compliance with the Health Insurance Portability and Accountability Act (HIPAA). Individuals can report a suspected incident of diversion online here: healthcarediversion.org/report.

How will information I report to you be used?

When someone reports an incident to us, we add that data into our database, along with all other diversion incidents.

Having information on drug-diversion incidents helps us to better track diversion across the country.

The more data we have, the more accurate we can be in detecting trends, such as a surge in drug-diversion incidents in one community or region.

If I report an incident, does that mean the person will get arrested, or that organization will get in trouble?

Reporting an incident to HealthCareDiversion.org is just a single step, which adds the incident to our national database. It doesn’t necessarily mean someone will be arrested for drug diversion, fired or otherwise implicated.

Reporting an incident to law enforcement or regulators is also essential, as the sooner those groups can be made aware of diversion, the more quickly they can respond to the incident, to properly investigate if diversion has occurred – and prevent a catastrophic outcome, such as the spread of a life-threatening infection. The sooner authorities are made aware of healthcare diversion within the system, the more quickly they can help.

For individuals who are unsure of how to report drug diversion to law enforcement or regulators, HealthCareDiversion.org can provide contact information and next steps.

Will HealthCareDiversion.org forward reported diversion incidents to law enforcement or regulators?

HealthCareDiversion.org forwards reported diversion incidents or “tips” to law enforcement or regulators in cases of tampering in Arkansas, Colorado, Iowa, Illinois, Indiana, Kansas, Michigan, Minnesota, Missouri, Nebraska, New Mexico, North Dakota, Oklahoma, South Dakota, Texas, Utah, Wisconsin, and Wyoming.

We encourage you to report to law enforcement and/or regulatory agencies, and provide appropriate contact information for reporting the incident to local law enforcement, state licensure boards, and/or federal agencies such as the Drug Enforcement Administration (DEA), Food and Drug Administration (FDA) or the Centers for Disease Control and Prevention (CDC).

Our goals are to protect patients and their families, and help addicted healthcare workers get the help they need.

On a larger scale, we hope to strengthen communities (e.g., preventing overdoses and the resale of stolen drugs), and help healthcare facilities lead the fight against drug diversion.

Is reporting anonymous?

Yes, reporting is anonymous. HealthCareDiversion.org or its affiliates will not share your contact information with outside parties.

How will incident reports be edited?

HealthCareDiversion.org may edit an incident as needed to comply with its policies.

Duplicate incidents (multiple incidents have been submitted by different people about the same diversion incident) will be consolidated together into a single record.

Cases might also be edited following independent confirmation, e.g., by including additional publicly available information such as court records or disciplinary actions of state licensure boards, or by deleting any Patient Identifiable Information (PII).

Names of individuals who have not already been identified in publicly available information, such as a grand jury indictment, will be de-identified to protect the privacy and reputation of individuals who have been accused of diversion but not yet convicted in a court of law or by a licensure board.

What is the purpose of HealthCareDiversion.org?

HealthCareDiversion.org was created to bring awareness to the issue of drug diversion by healthcare workers, which is a growing problem in the United States that affects thousands of patients and their families, providers and healthcare organizations. The Drug Enforcement Agency (DEA) estimates that drug diversion is a $25-billion-per-year problem.

How does HealthCareDiversion.org verify the accuracy of incidents? How will it protect people against false accusations?

HealthCareDiversion.org will attempt to verify the accuracy of all reported incidents by searching for publically available new sources such as court records.

We will delete an incident if a court of law or a state licensure board requests its deletion.

We will also accept and review rebuttal and retraction requests for possible incident editing and/or deletion.

Is there a telephone tip line?

No, HealthCareDiversion.org does not utilize a telephone tip line at this time, but we hope to have one in the near future.

Does HealthCareDiversion.org partner with addiction treatment groups for people with Substance Use Disorder (SUD) to seek help and recovery?

Yes, HealthCareDiversion.org partners with addiction treatment groups for people with Substance Use Disorder (SUD).

One of the primary reasons we are committed to stopping drug diversion is to prevent individuals from becoming addicted, either as a result of their personal use of stolen drugs, or as a result of those stolen drugs being resold and used within their communities.

In cases where addiction has already occured as the result of diversion, we’re also committed to helping people with Substance Use Disorder (SUD) get the help they need.

Is HealthCareDiversion.org secure?

HealthCareDiversion.org utilizes some of the strongest security technology available to protect against data breaches and is in compliance with all relevant healthcare privacy/security regulations.