Should drug diverters be prosecuted?

KatieMI, BSN, MSN, RN · Feb 28, 2017

Drug diverters should be criminally prosecuted, IMHO. But I really doubt it will deter anyone from doing so. Humankind had some 10000+ years to make sure that the most horrific executions don't do that to any notable degree; it is unlikely that fear of theoretical possibility of spending some years in modern jail would overcome the incredible power of addiction, money or both of them.

RNperdiem, RN · Feb 28, 2017

For a harsher punishment to deter anyone, a person has to be future oriented enough to think before doing. A person also needs to get over "I will never get caught mindset". I briefly knew a girl in high school who shoplifted for a hobby. She honestly believed she would never get caught. Consequences are never an issue if you don't believe it will happen to you.

Extra Pickles · Feb 28, 2017

theft from an employer is theft regardless of what it is that is being stolen so yes they should be prosecuted, but it's up to the employer to want to pursue it. Most don't.

Harsher consequences don't deter anyone, states that have a death penalty in place or life sentences for certain crimes has never been a deterrent to committing the crimes in the first place. People who commit crimes that have stiff penalties commit them regardless. The lure of the crime is always greater than the threat of punishment. For those who see it the other way around, that the penalty isn't worth the satisfaction from the crime, they weren't the ones who were at risk for committing the crimes anyway!

That Guy, BSN, RN, EMT-B · Feb 28, 2017

If some lay person stole those from an outpatient pharmacy they would be charged. Why should someone doing it at work be treated any different?

MrNurse(x2), ADN · Feb 28, 2017

Healthcare workers are in a unique environment where they are constantly around opioids and yet can not be prescribed them, lest they be found out by the BON and be reprimanded. Those who may have pain issues are the only stories I have heard of in my long career. One nurse with renal CA and another with traumatic knee injury that was being misdiagnosed. Those Percocet was what made their shifts physically bearable. Really doesn't matter what you think about prn opioid use, it is illegal, read your nurse practice act, that is in never, not when you are off, when you leave your shift, never. Put that up against what happens to your profession when caught, it is arguably worse to go before the board. Repeat offenders should probably be prosecuted, but first time offenders should probably be given a pass.

Archerlpvn, LPN, LVN · Feb 28, 2017

Healthcare workers are in a unique environment where they are constantly around opioids and yet can not be prescribed them, lest they be found out by the BON and be reprimanded. Those who may have pain issues are the only stories I have heard of in my long career. One nurse with renal CA and another with traumatic knee injury that was being misdiagnosed. Those Percocet was what made their shifts physically bearable. Really doesn't matter what you think about prn opioid use, it is illegal, read your nurse practice act, that is in never, not when you are off, when you leave your shift, never. Put that up against what happens to your profession when caught, it is arguably worse to go before the board. Repeat offenders should probably be prosecuted, but first time offenders should probably be given a pass.

im going to read my nurse practice act more closely. I have never heard of a nurse not being Able to take a prn opioid when he or she is off the clock if it is prescribed and indicated. I know that a nurse mustn't be under the influence of any mind/judgment altering substance while he or she is working under their license and caring for patients. For example- if a nurse has his/ her wisdom teeth removed, she can take ibuprofen and acetaminophen while at work, but when she is home, why shouldn't she be able to control her pain more with an opioid if it is prescribed to her and is indicated? Maybe I misread your post.

MrNurse(x2), ADN · Feb 28, 2017

Call your BON, they told me that most states operate this way.

Here.I.Stand, BSN, RN · Feb 28, 2017

Hmm I've been prescribed Percocet for corneal erosions (no longer get those, thanks to my amazing ophthalmologist), dental infection which went down to my jawbone, and for postpartum pain. It was CNMs who Rx'ed for the postpartum pain, and RNs administering them while in the hospital.

I have administered IV fentanyl to RNs who have been my patients... um forcing someone WHO IS NOT AT WORK to go without pain control after getting their pelvis broken or burned 50% of their body (I float to the burn unit sometimes) is unconscionable.

Actually come to think about it I used to work with an RN who had been through our state's monitoring program. There was a form she had to have her physician submit to the program, in the event that opioids were medically necessary such as after surgery or other legit need. So if she was able to get clearance while in a monitoring program, I highly doubt that a nurse who hasn't abused will get in trouble for continued appropriate use.

Working impaired obviously is another issue.

Now for the OP: I don't think all situations are equal. Sticking waste in one's pocket vs. the sink is not at all the same as allowing that man to go into surgery after administering NS, while documenting that he had fentanyl. If someone has a substance abuse problem (a brain disease, which we're expected to de-stigmatize in non-healthcare people) but hasn't harmed anyone, for them I tend to agree with stipulations, monitoring, etc. Those people in the article were clearly harmed, even life threatened in the case of the CA pt who became septic from a contaminated line. Those should absolutely be tried for not only the drug offense but the disregard for human life. And I know if that were myself or my family, I would be outraged if those were not prosecuted.

morte, LPN, LVN · Mar 1, 2017

Call your BON, they told me that most states operate this way.

i am thinking your BON lied to you, or you misunderstood. I think Florida comes close..

elkpark · Mar 1, 2017

Healthcare workers are in a unique environment where they are constantly around opioids and yet can not be prescribed them, lest they be found out by the BON and be reprimanded. Those who may have pain issues are the only stories I have heard of in my long career. One nurse with renal CA and another with traumatic knee injury that was being misdiagnosed. Those Percocet was what made their shifts physically bearable. Really doesn't matter what you think about prn opioid use, it is illegal, read your nurse practice act, that is in never, not when you are off, when you leave your shift, never. Put that up against what happens to your profession when caught, it is arguably worse to go before the board. Repeat offenders should probably be prosecuted, but first time offenders should probably be given a pass.

I'm now practicing in the fifth state of my career, and I've never heard anyone in any of those states suggest that there was a problem with nurses being legitimately prescribed opioids, or any other controlled substance, for a legitimate medical need. Obviously, working impaired is always an issue, regardless of the legitimacy of the rx.

Just now, out of curiosity, I skimmed over the NPA and the BON regulations for my current state and the state I consider my permanent "home" state (where I have spent most of my career), and see no mention at all of anything about nurses and prescribed medications other than lengthy sections about nurses with substance dependency issues. The closest thing I found was a statement in my home state's NPA that the Board can discipline or revoke the license of any nurse who "uses any drug to a degree that interferes with his or her fitness to practice nursing" (without differentiating whether the medication is legitimately rx'd vs. being used illicitly).

I've been prescribed opioids a few times over the years for short-term use after surgical procedures or injuries, and no one has ever suggested that that might conflict with my licensure.

I have heard people comment on this site that Florida, specifically, has a rule against any opioids for nurses, ever (although I have no first hand knowledge of that). I've never heard of that being the case in any other state.

And what is your logic for "first time offenders should probably be given a pass"? As someone else noted, if a person on the street stole a controlled substance from a pharmacy, that person would be prosecuted. Why should it be any different for healthcare professionals?

Libby1987 · Mar 1, 2017

Healthcare workers are in a unique environment where they are constantly around opioids and yet can not be prescribed them, lest they be found out by the BON and be reprimanded. Those who may have pain issues are the only stories I have heard of in my long career. One nurse with renal CA and another with traumatic knee injury that was being misdiagnosed. Those Percocet was what made their shifts physically bearable. Really doesn't matter what you think about prn opioid use, it is illegal, read your nurse practice act, that is in never, not when you are off, when you leave your shift, never. Put that up against what happens to your profession when caught, it is arguably worse to go before the board. Repeat offenders should probably be prosecuted, but first time offenders should probably be given a pass.

This is from from the CA Nurse Practice Act for those under a treatment plan:

http://www.rn.ca.gov/pdfs/enforcement/discguide.pdf

(16) ABSTAIN FROM USE OF PSYCHOTROPIC (MOOD-ALTERING) DRUGS -

Respondent shall completely abstain from the possession, injection or consumption by any route ofall psychotropic (mood altering) drugs, including alcohol, except when the same are ordered by ahealth care professional legally authorized to do so as part of documented medical treatment.Respondent shall have sent to the Board, in writing and within fourteen (14) days, by the prescribinghealth professional, a report identifying the medication, dosage, the date the medication wasprescribed, the respondent's prognosis, the date the medication will no longer be required, and theeffect on the recovery plan, if appropriate.