Should drug diverters be prosecuted?

3ringnursing, BSN · Mar 5, 2017

If there are going to be diversion programs for nurses, then there should be diversion programs for the general public.

I couldn't agree more. Drug addiction is an illness. Treating it like a crime seems to me to be a circumvented approach to addressing the problem. I advocate equal help for all.

blondenurse12, MSN, NP · Mar 5, 2017

This is an interesting topic. I suppose I am of the thought that nurses who divert should not be prosecuted. I am mostly speaking from the experience of being an ICU nurse but I am sure there are similarities with nurses on other units. ICU nurses have very high rates of PTSD but I've never known a nurse who was actually treated for it in regards to work. It's sort of one of those "well, you chose this job, so suck it up cupcake". There are also lots of on the job injuries/abuse by patients. I've never diverted but I suppose I can see why it happens. You have bags full of fentanyl/morphine/versed, you're not hurting the patient by pulling off a syringe or 2. You just order up another bag from pharmacy. I'm assuming that's what they think?

Three co-workers I had ended up diverting. Two ended up going through the diversion program and came back to work. One had been using at work and he ended up failing, he diverted again and lost his license. The other did very well and the third decided to work at a different facility with no access to narcotics. I think the addiction needs to be treated and criminalizing people is futile in this type of situation.

1jewel, ADN · Mar 5, 2017

You obviously know nothing about the disease of addiction!

Ruby Vee, BSN · Mar 6, 2017

You obviously know nothing about the disease of addiction!

Please use the quote function so we can tell to whom you are being dismissive.

JustKeepDriving · Mar 6, 2017

Honestly, and this is probably going to be a particularly unpopular opinion, but I'm getting tired of treating addiction like a criminal issue and not a public health issue. I live in a state where we have good diversion programs for non-nursing offenders (and have done work and research within these programs) where offenders do an amount of time in recovery and the charges get dropped. The fact is that once you hit someone up with a license violation, put them through a diversion course - it can make maintaining a livelihood ridiculously difficult. Now to slap a criminal charge on top of it? Well then finding work in any field, even a McDonald's job becomes almost impossible. We have to protect the public from impaired nurses but I'm also a firm believer that rehabilitation is always a better route than punishment.

Angry LPN · Mar 6, 2017

I try to be forgiving and reserve judgment, but how despicable that is to take away someone's pain meds when they in severe pain or dying. Prosecuted, yes, but not persecuted. Give them the option of seeking rehab. I used to like to drink a few dozen beers when I got off work, never drove or came into work under the influence. When I realized that it was a habit and not particularly good for a type II diabetic I just simply quit and haven't had a drop in 5 years now. People can reform themselves without having their careers and thus their lives ruined.

IrishCMSRN, BSN, RN · Mar 7, 2017

You know it's a really tough question. I know nurses who would never have diverted/stolen if not in the grips of their addiction. Addiction is a disease, so do we punish for acts triggered by a disease? (I mean within reason) I think a lot of the issue is that we do not respect the meds we handle. You work day in day out handling narcotics in AMPLE amounts, they just stop being respected. Its almost like water. Your surrounded by it and its everywhere. It just is. So taking home some morphine that's going to be flushed anyway just seems fine in an addicts brain. Now I am over-simplifying here but those are my thoughts. Do we punish Yes, but not criminally. Community outreach or service. Don't potentially destroy a career that can get back on track.

DiplomaNurseRN · Mar 7, 2017

I had a dear friend who got herself addicted to trammadol and worked nursing homes on occasion to pilfer or outright steal blister packs of the medication. She played that game once too many and was caught. The PA BON reviewed and gave her sanctions to continue her practice but she failed to comply and lost her license indefinitely. This wonderful Penn State SON honors grad (top in her class) and the best nurse I ever was blessed to work beside, was out forever of the profession she truly loved. Sad, very sad.

RiskManager · Mar 7, 2017

You know it's a really tough question. I know nurses who would never have diverted/stolen if not in the grips of their addiction. Addiction is a disease, so do we punish for acts triggered by a disease? (I mean within reason)

This is a timely post for me insofar as I was at a deposition today of one of my providers. The provider was being deposed in a civil personal injury case regarding a DUI resulting in severe bodily injury. Our patient was the DUI driver and the plaintiff is the crash victim. We provided primary care for some years to the patient, including making referrals for her alcoholism treatment. She had a few stays in inpatient treatment and outpatient treatment as well and has had some relapses along the way. I am assuming she was in one of the relapse periods when she had the crash. The deposition of the patient was held last month at the prison in which she is serving her sentence. So that is a situation in which the patient has an addiction and is being held accountable for acts arising out of that addiction. I bet the patient never would have gotten ensnared in the criminal justice system if not for the crash. I would imagine that the decision to prosecute a nurse diverting depends in part if someone was injured as a result of the diversion.

I have had somewhat similar cases in which our patients have been prosecuted for causing auto accidents and bodily injury when they were diabetic and did not take their meds or had a seizure disorder and did not take their meds and that was the proximate cause of the accident. I have given testimony in those cases after I wrote letters to the patient specifically instructing them not to drive, and they did so nonetheless.

subee, MSN, CRNA · Mar 7, 2017

I have taken opioid pain medications while working. I had an extraction done and was taking Vicodin and called off work that evening. The House Sup told me that I could take Vicodin and work as long as I had a legal prescription for it. I also informed my charge when I came on duty and she had no problem with it.

All three of you were wrong.

subee, MSN, CRNA · Mar 7, 2017

I can't speak for anyone else here, but, for myself, I'm not advocating that nurses should be criminally charged and prosecuted, just that they should not be treated any differently than the general public. If it would be considered a crime if someone on the street did it, I think it should be considered a crime if a nurse does it. If there are going to be diversion programs for nurses, then there should be diversion programs for the general public.

It's called drug court.

Irish_Mist, BSN, RN · Mar 7, 2017

Honestly, I think it depends on the circumstances. If someone is diverting drugs for sale, absolutely prosecute him/her. If someone is diverting drugs for their own use, offer them help first. HOWEVER, I think this should be a one chance and you're out kind of thing. If you get caught diverting drugs for your own use, are offered help, go through the proper channels to get clean and then turn around and do it again, you don't deserve your nursing license. I am also not opposed to prosecuting someone in this situation. Yes, people with addictions need help but people must be held accountable for their actions. A tremendous amount of trust is placed on us as nurses to not do this sort of thing and it needs to be dealt with.