Minnesota Hospital Association

Patient Safety

Drug Diversion Prevention

Hospitals, health care providers, state government and law enforcement have joined together to create a set of best practices that hospitals and health care facilities can use to enhance security for controlled substances, including narcotics and other powerful prescription medications.

The Controlled Substance Diversion Coalition, convened by the Minnesota Department of Health and the Minnesota Hospital Association, came together in May 2011 to prevent theft of prescription drugs by health care workers, patients, families, and visitors, and to raise awareness about the issue within health care settings. The coalition is an effort of a broad-based stakeholder group, including hospitals, long-term care facilities, home care and hospice.

The Drug Enforcement Agency requires hospitals and other health care facilities to report the theft or loss of controlled substances. In Minnesota from 2005 to 2011, there were 250 reports of theft or loss of controlled substances. Reports increased from 16 in 2006 to 52 in 2010, a 325 percent increase. (Retail pharmacy thefts are not included in these numbers.)

Overall the prescription drug problem is the fastest growing drug problem in the nation, according to the Office of National Drug Control Policy. The public has more access to these drugs today than in previous times. The number of opiate prescriptions dispensed by U.S. retail pharmacies increased from 76 million in 1991 to 210 million in 2010 – triple the number. The number of prescriptions for stimulants increased from 5 million in 1991 to 45 million in 2010.

Drug Diversion Prevention Road Map

The coalition has created a road map and tool kit that will improve health care providers’ controlled substance storage and security, procurement, prescribing, preparation and dispensing. The road map includes training materials, sample policies and procedures, and a flow chart of reporting guidelines and requirements that providers can use when they suspect a drug diversion has occurred.

The road map is a collection of about 100 best practices for preventing and responding to controlled substance diversions. Some examples include camera surveillance in high risk areas, keeping prescription pads in locked locations, implementing a clearly defined process for controlling and accounting for keys, rules against sharing pass codes, utilizing bar codes for tracking, deploying secure and locked delivery carts, and using tamper resistant packaging.

Tool Kit

Safety teams/organizational structure

Access to information, accurate reporting, monitoring, surveillance, detection system

Facility expectations

Educate staff (and patients)

Clinical Bundle

Additional Links/Resources