Home' Australian Pharmacist : Australian Pharmacist April 2014 Contents How pharmacists divert
The Chair of the Pharmacy Board of
Australia (PBA), Stephen Marty, says an
attitudinal change in the pharmacy
profession has facilitated the diversion
of drugs by people who are impaired
‘In the past 10 years or so there has been
an attitudinal change and I look around
Australia at the number of incidents
involving Schedule 8 drugs,’ he said.
‘One of the big issues is poor control and
as more Schedule 8s are held in stock
the pharmacy runs out of room so they
may fail to keep them in the safe, which
is a statutory criminal offence.
‘ Those who want to access these drugs
exploit weaknesses in the system.
‘I think of a hospital pharmacist who was
diverting for his own use from medicines
returned from wards so there were poor
controls in place.
‘ There have been instances of
pharmacists who have used from
returns from nursing homes or
‘If they think no one is going to know
they are kidding themselves because
they are all headed in the one direction
and that’s downwards,’ Mr Marty said.
Lack of accountability provides
opportunities for drug diversion which
can be almost impossible to trace,
Kay Dunkley, says.
‘Returned medicines being diverted by
pharmacists who have a problem is not
uncommon. They are not accounted
for before being disposed of in RUM
(Return of Unused Medicines) bins so a
pharmacist with a problem can divert.
There is no accountability for how many
are returned,’ she said.
‘Obviously for drugs that are kept
locked up in a safe the pharmacist has
to keep records of how many come in,
how many go out and so on and that
makes it a bit trickier. Of course there
are ways and a pharmacist may place
orders and not record them in the drugs
Stephen Marty recalls
‘I remember an intensive care
specialist who wrote some brilliant
protocols for ICU, did in‐house
training at the hospital where he
worked but he developed a habit
and was suspended for diverting and
stealing ampoules of midazolam.
When he died he was on his knees,
with a sandwich in his hand. And he
just obviously succumbed and rolled
over sideways. So he was still in
this kneeling position, on his side,
sandwich in his hand – deceased.
‘And I think of a nurse who stole what
she though was the remains of a
pethidine ampule but it was succinyl
choline and she was bolt upright,
dead, in the female toilets near the
operating theatre. That would have
been horrific as she would have been
fully conscious but she was paralysed
in her breathing. She would have
known what was happening but
unable to do anything about it.
‘Some years ago we had a pharmacist
who had a cocaine problem and he
was suspended and then came back
to work under imposed conditions
but as soon as those conditions
were lifted he started using again.
The message out of that is that you
don’t solve these problems in the
short term and the consensus among
medical consultants is that after three
years of non‐use you can generally
start to feel confident they won’t
re‐use. I asked him what happened
and he said that he was doing well
but when those conditions were
lifted it was a case of: ‘Wow here I am,
in the candy store.’
Electronic medical records
The advent of electronic medical
records (EMRs) has seen a correlating
rise in impairment among some
health professionals, according to a
Philip Hemphill, Director of the
Professional Enhancement Program
at Mississippi’s Pine Grove Behavioral
Health and Addiction Services,
told Australian Pharmacist that the
introduction of electronic medical
records (EMRs) have caused an
increase in healthcare professionals
experiencing burnout and even
‘EMRs bring significant stressors
during preparation, implementation,
and monitoring that are necessary,’
Dr Hemphill said.
‘Fear seems to be the main response
because of the ‘unknown’ factor
and some respond destructively.
The learning curve can bring
confidence and empowerment
Dr Hemphill has also said EMRs
essentially removed ‘the art,
the creative part of healthcare,
which allows a story to be told.
EMRs make the work much more
restricted than it was in the past’.
Australian Pharmacist April 2014 I ©Pharmaceutical Society of Australia Ltd.
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