ASHP Guidelines on Preventing Diversion of Controlled Substances

Prevention of drug diversion and substance use disorders among anesthesiologists: a narrative review

“…The American Society of Health-System Pharmacists guidelines suggest that in high-risk areas or when high-risk controlled substances (fentanyl) are wasted that an authorized healthcare worker witness and that the amount initially obtained match that documented as administered plus that wasted. 2 Several weak points exist in this process ( Table 3 ). 60 The provider may simply document that a substance was used and take the substance for personal use.…”

“…Health-system pharmacies maintain primary responsibility for substance procurement, prescribing, preparation and dispensing, and wastage. 2 The importance of involvement of pharmacy leadership in prevention of diversion is critical for success. An all-inclusive Controlled Substances Diversion Prevention Program (CSDPP) focuses on the safety of patients and providers while assuring adherence to federal laws, state regulations, and accrediting agency guidelines.…”

“…The American Society of Health-Systems Pharmacists have developed Guidelines on Preventing Diversion of Controlled Substances. 2 These guidelines address core elements such as legal and regulatory requirements. System-level controls include human resources, technology and monitoring and surveillance, and investigations into suspected diversion.…”

“…1 Areas considered among the highest risk include the central hospital pharmacy, procedural areas, emergency departments, surgical centers, and remote care locations. 2 The perioperative environment is a significant source of diversion of highly potent substances. Such action by anesthesia team members and other healthcare workers may result in substance use disorders by the individual diverting substances, inadequate pain management for the patient from whom substances were diverted, or even a direct threat to the health and life of the patient under the care of individuals who are impaired by substances via the impact on performance or through transmission of communicable diseases.…”

Closing the Loop for Controlled Substances Surveillance: A Field Study of the Usability and User Experience of an Integrated Electronic Narcotic Consumption

“…Diversion of controlled substances (CSs) in healthcare poses a risk of harm for patients by exposing them to insufficient pain management, incorrect medications and their documentation, possible risk of infection from contaminated needles, and healthcare personnel incapacitated by narcotics misuse [1]. In the USA, it has been estimated that 1% of healthcare workers divert drugs [2], which underscores the necessity to strictly monitor and control the use of these substances.…”