An Inside Job: Drug Diversion in the Pharmacy?Part 1

Among the issues in drug diversion is the theft of prescription drugs from inside the pharmacy. The perpetrator, of course, can be anyone employed by the pharmacy or someone who is allowed access to the pharmacy, whether it is appropriate or not.

When diversion occurs in the pharmacy, there can be a very small group or a large group of potential suspects, depending on the pharmacy policy, state administrative rules, or the duty manager?s personnel policies.

Good pharmacy managers restrict any unnecessary personnel from behind the counter. In rare instances, when a person needs access behind the counter for legitimate purposes (eg, pharmacy maintenance, computer or telephone installation), he or she should be under supervision, and these visits should be kept to a minimum.

No occupations are exempt from having their employees involved in drug diversion. The computer technician or the telephone repairperson, as mentioned, or people remodeling the store could be involved. There is usually no reason for law enforcement personnel to enter the pharmacy work area, except in unusual circumstances (emergency situations, medical need, investigating a crime scene due to burglary or robbery). In those cases, the officers should be supervised as well.

In 1 instance, a pharmaceutical representative regularly visited an independent pharmacy to check on the stock. The male pharmacist routinely allowed her behind the counter with no supervision. While behind the counter, she would steal entire bottles of phenter-mine and hydrocodone for her habit. After the owner had become suspicious of another pharmacist, the surveillance cameras the police set up finally revealed the individual responsible. When officers stopped her from leaving on her last trip, she had more than 600 dosage units in her possession.

In another store, where the pharmacy and the grocery store were combined, the grocery manager routinely came into the pharmacy. He would gladly empty the trash bags, sweep, or engage in general conversation with the pharmacy staff. Law enforcement officers discovered (through a tip from a pharmacy employee) that the manager was stealing significant amounts of hydrocodone from the shelves.

The most common form of diversion from within the pharmacy, however, is the theft of prescription drugs by those who have legitimate access to the area: pharmacists, interns, and technicians. Although class 2 (CII) drugs may initially appear to be the likely target, this usually is not the case.

Because CII drugs are monitored much more closely, many with a perpetual inventory, pharmacy employees diverting drugs typically will remove class 3 and class 4 substances. These drugs generally are not inventoried for months or years, and are easier to take without apparent detection.

When losses are detected, the time frame may produce many potential suspects, some of whom may no longer work at the pharmacy. In chain pharmacies, the "floater" pharmacist must be added to the number of people who had access to the pharmacy.

Most of the pharmacy thefts encountered by law enforcement occur because employees are addicted to prescription drugs and are trying to satisfy their habits. This is a bit of good news, if trafficking is not the main issue, but employees may be impaired while they are working and driving to and from the pharmacy.

Next month, I will discuss some of the cases of prescription drug theft by pharmacy personnel. I will look at what can be done about it and what preventive measures can be taken, as well as some options for the drug-addicted employee.

John Burke, director of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 32-year veteran of law enforcement.For information, he can be reached by e-mail at burke@choice.net, by phone at 513-336-0070, or via the Web site www.rxdiversion.com.