Infectious Disease Expert Works with HealthcareDiversion.org to Combat Opioid Epidemic

Infectious Disease Expert Works with HealthcareDiversion.org to Combat Opioid Epidemic

Recently, we talked with Dr. Matthew Crist, Medical Officer with the Centers for Disease Control and Prevention (CDC). Matt works in the Division of Healthcare Quality Promotion, which leads the CDC’s work to combat healthcare-associated infections and respond to outbreaks in healthcare settings.

Dr. Crist is also an advisor for the HealthcareDiversion.org network, a nationwide not-for-profit that helps track drug diversion, any crime involving a prescription medication, which includes drug-seeking behaviors, corrupt prescribing practices and the theft of drugs by healthcare workers.

Some might wonder where infectious disease and theft of opioids in hospitals cross paths. Crist and other experts see the costs of drug diversion from the perspective of patient risk, a growing and frightening trend that has been blamed for outbreaks of Hepatitis C and other infectious diseases. There is also concern for healthcare workers who are impaired while treating patients and the breath-taking hard costs of opioid overdose and abuse, estimated to be billions of dollars.¹ Crist says his team at the CDC hopes to work with state health departments, clinicians and local law enforcement to curb drug diversion and its threats to public health.

“The opioid epidemic is large and encompasses so many issues,” says Crist. “We want healthcare institutions, law enforcement and state officials to know they can rely on the CDC to help improve collaboration, increase awareness and help them emphasize reporting.”

In addition, Crist says the CDC can assist with epidemiologic investigations and case finding, performing patient notifications and helping organizations to frame messaging.

A Platform for Reporting Drug Diversion

The CDC’s goals also help explain Crist’s interest in the HealthcareDiverson.org national network where local organizations can report drug diversion investigations and convictions. Crist believes that reporting is one of the key elements often missing in efforts to stop drug theft in healthcare facilities. “We need healthcare organizations to feel comfortable reporting issues instead of allowing healthcare workers who divert to quietly leave and go somewhere else to start all over again.”

Multiple stories have been reported by the media where healthcare workers are fired or leave a facility where they have been guilty of drug theft and abuse, only to move to another hospital or nursing home and continue the pattern. One of the most notorious cases reported in the Newsweek expose, “When Drug Addicts Work in Hospitals, No One is Safe,” chronicled David Kwiatkowski, a contract radiology technologist who worked at eighteen hospitals in seven states and was accused of infecting at least 45 people with hepatitis C along the way.

Crist says this ability for abusers to slip through the cracks in the current system is one of the biggest obstacles to halting drug diversion. “We need a balanced approach that secures medications with the potential for abuse to prevent unauthorized access and also quickly detects and responds when healthcare workers who do have access to these medications utilize them inappropriately."

That’s where HealthcareDiversion.org comes in. The non-profit’s goal is to provide a platform where managers, investigators and others can report diversion cases in their community and provide a source for employers and others to check for drug diversion incidents. Tom Knight, founder and chairman says HealthcareDiversion.org hopes to educate, create awareness and deter diversion while helping create best practices for investigating and reporting drug diversion incidents. “We want to help healthcare organizations lead the charge against the opioid epidemic,” says Knight.

Plugging Leaky Supply Chains

Crist believes that the work being done by the CDC Division of Healthcare Quality Promotion team and organizations like HealthcareDiversion.org can help healthcare facilities put security first and prevent unauthorized access to medications. Crist also points out that a focus on just healthcare facilities where controlled substances end their journey isn’t enough.

“We need to monitor the entire supply chain,” he says. “It’s important that we pursue diversion all along the pathway of drugs from the manufacturer to administration to patients by healthcare workers. Crist says a leaky supply chain and anything that creates a risk for drug diversion along the way is a public health concern. “Anything that we can do to help increase transparency and awareness can help us better protect patients and their families.”

1. "The Economic Burden of Prescription Opioid Overdose, Abuse and Dependence in the United States.” National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA. October, 2016.

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