By Cara Simaga
Drug diversion, a term that is used to describe when prescription drugs are taken by an individual who they are not specifically prescribed for, has become a significant problem in America. Particularly with the rise of the opioid epidemic, we’re seeing drug diversion continue to be problematic both in the home and in healthcare facilities. In 2017, $301 million worth of drugs were lost.
Unfortunately, the problem has only increased in the past few years. In 2018, $454 million worth of drugs were lost to drug diversion, and 94% of those incidents involved opioids. While that’s still a large number, the increase from year-to-year is even more alarming. Drug diversion also does not appear to be slowing, and it’s impacting some of our more vulnerable communities.
A recent study from the University of Minnesota School of Nursing found that 5,917 pills were stolen from residents of assisted living facilities in Minnesota over the last five years. That means that 131 residents of assisted living facilities were impacted, and the average resident lost about 45 doses of medicine. For seniors with a serious condition, that number of doses can mean life or death. This is an alarming reality for both seniors living in assisted living facilities around the country, as well as their families who want to ensure their loved ones are being taken care of.
Let’s explore why this issue exists at assisted living facilities and how seniors and their families can help prevent the continuation of drug diversion in this community.
Why drug diversion is a problem at assisted living facilities
Older adults, particularly those who are living in assisted living facilities are sadly one of the most vulnerable targets of drug diversion. Most older Americans, roughly 80 percent, take at least one prescription drug every day, and although they account for just over 10 percent of the U.S. population, this group receives about a third (34%) of all of the prescription drugs given out in America. Additionally, nearly a third of older adults have been prescribed an opioid for pain management.
Due to the combination of the number of prescription drugs, including opioids, that are prescribed and therefore available at assisted living facilities on a daily basis, as well as the presence of senior residents, who some would think of as a vulnerable group, there is a heightened rate of drug diversion within these communities.
But it’s not other residents causing this problem. According to Protenus data, 18.7M pills were lost due to healthcare employee misuse and theft. Sadly in the healthcare field, with so much access to prescription drugs, addiction is not as uncommon as one might think. According to the National Center for Biotechnology Information, 10 to 15 percent of healthcare workers misuse drugs and alcohol at some point in their career.
Signs seniors can look for to help prevent and recognize drug diversion
For residents at assisted living facilities there are a few ways to ensure that medications are not being diverted. First, for those able to store medications in their rooms or apartments, it’s important to keep track of medications. This may mean counting the number of pills left in a bottle and keeping a log each day to ensure no pills go missing. Additionally, seniors should only keep medicines that they are using – don’t let unused prescription medications sit in a medicine closet or on a bathroom counter. Dispose of unused prescriptions properly through drop off kiosks or through mail-back envelopes, which ensure that the medications don’t fall into the wrong hands. For residents who need help with medication management it can be a bit more difficult. Monitoring their own levels of pain or symptoms for changes is an important factor in detecting drug diversion.
How families can ensure their loved ones are getting the medicines they need
For families with grandparents, loved ones or friends living in assisted living facilities, it’s important to look out for the signs of drug diversion as well. This begins with asking the right questions before placing your loved one in a community. For example, how does the facility administer drugs? Will it always be the same nurse or assistant delivering the drugs? What is the process for vetting employees? How does the facility manage medication overall? How does the facility dispose of unused drugs?
Families should ensure that the facility has policies for medication management and that they are disposing of used prescriptions in a safe way. Additionally, families should come to an agreement with the facility on the updates they’ll receive about their loved ones condition, and their medications. By addressing the potential problems surrounding drug diversion from the start of your loved one’s time at an assisted living facility, and raising the right questions, you can help prevent drug diversion.
Cara Simaga is Director of Regulatory Affairs at Stericycle.