EMS Personnel and Narcotics* Tampering Awareness & Prevention West Region EMS Conference - February 25, 2011

Transcription

1 EMS Personnel and Narcotics* Tampering Awareness & Prevention West Region EMS Conference - February 25, 2011 Lecture by Aimin S. Alton, BA, MICP Program Director Alton & Associates and StopNarcoticTampering.org CSFA EMS Committee, Emergency Responder Substance Abuse Task Force Ventura County Fire Protection District contact: aalton@alton-associates.com Definitions *Narcotic - Originally this term referred medically to any psychoactive compound with sleepinducing properties. I have associated this term with opioids, such as morphine and their derivatives like fentanyl. I must admit that this term is imprecise and carries with it some negative connotations. We could say Medication Tampering to recognize that not all medications subject to theft and tampering are narcotics, such as benzodiazepines like midazolam and diazepam. In the end I choose to continue to use the term Narcotic not because it is accurate, but because it is attention getting. Diversion means different things to different people Diversion - People Skills - There are those that are skilled at diverting attention away from themselves and their failings, be they competency or moral. They do this via finger pointing, nit picking, manipulation, slight of hand, misdirection. This isn t what we re talking about today, but those that divert drugs, often utilize these skills. Diversion - Law Enforcement - The misappropriation of DEA Scheduled medications from approved and/or legitimate patient usage, through doctor shopping, prescription forgery, outright theft or substitution. Diversion - Diversion Program or Wellness Program - A systematic approach by which a professional gets assistance in overcoming their alcohol or drug addition; they enter into a contract where they are to maintain their sobriety while maintaining their employment. The better systems utilize proven medical models and inpatient services (when needed) for the initial stages followed by regular counseling sessions and continual drug and alcohol screening. Tampering - The diversion of medications done in such a way that makes it look like it was never stolen. To be left in the system, to be used by an unsuspecting health care professional (Paramedic, RN, RT, MD) on an unsuspecting patient Alton & Associates. v.1.1 Page 1 of 7

2 1. Blanco, Texas Who - Paramedic/EMS Director What - Improperly dispensed fentanyl 237 times to his wife. Why? According to the DEA, the percentage of state and local drug cases involving Fentanyl have increased significantly over the past seven years, rising from 37 (cases) in 2001 to 1,412 cases in Sacramento, California 2007 Who - Flight Paramedic What - Stole powerful narcotics from his company s drug cabinet and medications left over from patient treatments, and injecting them hourly while on duty. Why? This (name deleted) case marks the second time since 2001 that a (company name deleted) license was revoked for a morphine theft Sacramento, California 2005 Who - Paramedic What - Stole $6,100 cash from a patient. Why? Three days after stealing (name deleted) money, (he) showed up for duty reeking of alcohol and his employer, (company name deleted) called police to give him a Breathalyzer test. (results were almost 2x the legal limit). Instead of being arrested or put on leave, (he) was sent to a hotel for the night 2011 Alton & Associates. v.1.1 Page 2 of 7

3 4. Big Bear, California Who - Paramedic and Fire Department EMS Chief What - Officially - stole at least 350 vials of morphine from his department s safe. Why? Chief Rolston advocates random drug and alcohol testing of paramedics and annual training in managing stress and preventing substance abuse. He also wants the state to tighten narcotics control requirements for ambulance companies, cities and counties. 5. Las Vegas, Nevada 200? Who - Paramedic and Fire Firefighter What - Broke into fire stations, apparatus and ambulances to steal their controlled substances. Why? Was found passed-out on his fathers driveway after stealing drugs from a fire station. 6. New Jersey Who - Operations Coordinator at a Hospital Based Ambulance Company What - Stole at least 10,521 milligrams of morphine and 500 milligrams of diazepam. Why? Obtained drugs from the pharmacy and failed to place them on the ambulances Alton & Associates. v.1.1 Page 3 of 7

4 7. Ventura County, California Who - Paramedic, Clinical Education Specialist & Field Supervisor. What - Stole drugs, a lot of drugs Why? (He) admitted (to) forging documents and stealing drugs from his ambulance company for a year in what may be the largest case of its kind in California history. 1. Self - Addiction or Pain 2. For another - Friend or Family Motivations for Diversion 3. Profit - Sale or Exchange for goods or services 4. Mental Illness - Kleptomania or Impulse Disorder 5. Revenge - Anger or Spite towards authority Common Denominator is, is not Gender Age Experience Rank Access? What is the REAL common denominator in these stories? Notes: The stories made the PRESS 2011 Alton & Associates. v.1.1 Page 4 of 7

5 Understand this happens We have to confront these attitudes Attitude: We don t hire drug addicts. Reality - The pre-employment drug screening is essentially an intelligence test AND our industry makes drug addicts via, PTSD, Injury + prescriptions. Attitude: My agency is too high performing to have this happen. Reality - Sure your Class 1 dept may have some of the best people in the world, but they are still PEOPLE and people with weaknesses, type A personalities, many with predispositions towards addictive personalities. Attitude: Our comprehensive drug control system is the same one used everywhere. Reality - The current industry standard for CS handling is in the opinion of the speaker, substandard. Attitude: We don t have enough of - or the right kind of - drugs that anyone would want. Reality - Addicts will take what is easily available to them. Risk vs. Gain. If it s easier to take from the employer than risk arrest from a street buy they ll take from the employer. And since the addict wants to maintain their access to their fix, they ll do all they can to keep the thefts and addiction secret Alton & Associates. v.1.1 Page 5 of 7

6 These stories and more are found at under Awareness, then Diversion Articles from Pre Hospital Care Wisconsin - Fake Fire Distracts Firefighters; Thief Steals Drugs Minnesota - Firefighter-paramedic admits stealing painkillers North Carolina - Paramedic charged with stealing morphine syringes Alberta - EMS union head hopes charges not laid in tampering case Washington - Camas FD Employee Charged with Misappropriation of Narcotics New York - Officials: FDNY Captain Attempted to Fill Phony Vicodin Prescription Massachusetts - Brockton firefighter in drug treatment after larceny charge Kentucky - Former paramedic indicted Texas, Santa Fe - Medics Faked 911 Call to Steal West Virginia - Hidden camera aids in arrest California - Paramedic Arrested for Stealing Prescription Medication Australia - Last Word - Sham Drug Shame Oklahoma - Narcotics stolen from ambulance service Michigan - Investigators: Paramedic stole potent pain relievers on the job Idaho - Former Canyon County paramedic who was crushed by door made fake 911 call Louisiana - Paramedic arrested for stealing medications from blind man Iowa - Eagle Grove paramedic accused of drug theft Louisiana - Paramedic arrested in drugs theft Florida - Paramedic Arrested New York - Ambulance attendant stole pills Kentucky - Barren-Metcalfe Co. Paramedic Arrested South Carolina - Horry County paramedic arrested, charged wtih taking patient s drugs Some EMTs use position to molest patients, steal drugs Firefighter Deaths from Prescription Medications: Two Case Studies Ventura Co., CA - Employee allegedly stole drugs from ambulance company Nebraska - Police: Lincoln Firefighter Took Narcotics From Ambulance Texas - Health department: Blanco paramedic didn t prevent drug theft Texas - Blanco Ambulance Corps director faces judge Wednesday West Virginia - Paramedic Arrested for Stealing Drugs Las Vegas - Burglaries: Firefighter faces charges Illinois - Former paramedic sentenced for stealing morphine Spokane, WA- Paramedic switched drugs with saline Colorado - EMS worker at center of drug probe Sacramento - Paramedic loses license in drug case Special report: Some rescuers pose threat Sacramento Fire Truck Narcotics Tampered With Texas - Paramedic not indicted in theft Florida - Paramedics kept shoddy narcotics logs Florida - Veteran medic accused of stealing drug Santa Barbara, CA - Paramedic arrested in morphine theft South Carolina - Four EMTs charged in drug thefts 2011 Alton & Associates. v.1.1 Page 6 of 7

7 under Awareness, then Diversion Articles from Clinical Settings St. Cloud Hospital suspends nurse after 23 inadvertently infected Pennsylvania - Nurse charged with stealing drugs from hospital Obstetrics Manager Convicted of Tampering with Patient's Narcotics Medicines at White Salmon Hospital Information about Drug Diversion by Surgical Nurse Colorado surgery tech who infected 3 dozen patients with Hep C gets 30 years in prison Temp firms a magnet for unfit nurses High on the Job: Drug Abuse Among Surgical Staff Narcotic Use and Diversion in Nursing Problem nurses stay on the job as patients suffer Kentucky - Theft of Controlled Substance Arrest in Livingston County Drug-Addicted Nurses Narcotic Theft in Nursing Substance Abuse Among Physicians: A Survey of Academic Anesthesiology Programs Serratia marcescens Bacteremia Traced to an Infused Narcotic HIV-Positive Nurse May Have Contaminated Injectable Pain Medication, Texas Hospital Administrators Warn Patients Nurse Sentenced for Drug Tampering at Indiana Hospital Nurse May Have Contaminated Drugs under Awareness, then Articles on Ethics, Etc Firefighters facing mandatory drug tests in Risk factors for alcohol and other drug use by healthcare professionals Viewpoints: State has wrong Rx for addicted doctors High on the Job: Drug Abuse Among Surgical Staff Morphine Theft Part of a Larger Problem Saying `sorry' pays off for U. of Michigan doctors Some Historical Perspective Edie Falco's Nurse Jackie a Model For Hospital Drug Use? Health staff background checks lag Pill pushers on the Net A Slow Decline Substance Abuse, Your Employer's Rights and Yours Union Urges Uniform Drug Testing Leadership Sector: Drug Abuse Scandals Narcotics Diversion: A Director s Experience Legal Consult: Are Your Employees Abusing Drugs or Alcohol? Don't Let "Bad Apples" Spoil the Basket! How to find forgiveness for the costliest of mistakes 2011 Alton & Associates. v.1.1 Page 7 of 7