Rapid Response: Paramedics stealing narcotics happens with distressing regularity

Narcotic theft, often by the people entrusted to secure and administer those drugs, is damaging to providers, agencies and communities

What Happened: We regularly share news about medics caught stealing narcotics from their agency, patients, hospitals or other facilities that store and distribute narcotics. This week was no different, with two separate incidents.

In Missouri an EMT and a casino security guard were caught on film removing hydrocodone from a locked cabinet in the casino's EMT room. A Florida medic was charged with multiple counts of theft and possession for removing fentanyl, presumably from vials, and replacing it with an unknown liquid. It is not clear from the reporting if the vials had already been opened for administration to patients and the medic was stealing the remainder or if the vials were put back into stock for potential administration to patients.

Why it’s Significant: Reports of narcotics theft are damaging on many levels. First, the career, livelihood and future ambitions of these medics have been destroyed by their theft, presumably driven by an addiction.

Second, the alleged thefts erode the public's trust. EMS providers enter the homes of the sick and injured. For EMS to succeed, the citizens we serve need to trust us to enter their private spaces and potentially have access to their most treasured belongings and valuables.  

Third, systems for securing narcotics are vulnerable to an addict who is willing to take great risk to obtain something of great value. The ubiquity of cameras in a casino should be well understood by an EMT and a security guard in that workplace.

Top Takeaways: Anywhere there is the administration and storage of narcotics the risk of theft is significant. We may worry about the unknown criminal breaking and entering to obtain narcotics or a thief lifting a med bag from the ambulance while a crew is on scene, but the real risk is from the people entrusted with those drugs.

These are my top takeaways about the most recent news of medics caught stealing narcotics:

1. Control, limit and monitor access to narcotics

The safeguards that are currently in place – locked cabinets, two-person access, tamper-proof containers – are not adequate to the risk medics are willing to take to access narcotics.

2. Act on your hunches and suspicions

When a drug-diversion is exposed and reported there are almost always co-workers that come forward to say they were suspicious, had a hunch or saw some clues that something was amiss with their now arrested and terminated co-worker. Workplaces need to have systems to report suspicions, but in a way that does not lead to reprisal if the suspicions turn out to be unfounded. But when something seems to be amiss it is almost always amiss. Trust your instincts.

3. Make it safe for Paramedics to acknowledge and treat the addiction

A medic is likely to be praised if they share in the day room that they are entering a tobacco cessation program or attending "meetings" about drinking. But if that medic were to report they are getting help for their narcotics addiction they would likely be put on the fast-path to suspension and termination. For treatments and interventions to succeed through employee-assistance programs medics need to be safe to access those programs without fear of reprisal.

What’s Next: How do medics become addicts?

I want to understand what is leading medics to become addicted to narcotics. I read news that some narcotics addicts were healthy and employed professionals before an illness or injury. And when the pain pills are cut off or no longer available those addicts turn to theft or illegal narcotics, like heroin, to satiate their addiction.

I also, like many of you, know medics that are off the job because of back injuries from patient lifting and movement. We have an obligation to help prevent lifting-related injuries and to see our colleagues through appropriate treatment, which may include narcotic pain management, and to a successful return to work.

Is there a clear line that can be drawn from a lifting-related back injury to narcotics theft? I don't know, but it sure would be worth investigating because if we can prevent the back injury we might also be preventing a cascade of other terrible outcomes for our providers, our agencies and the patients we serve.

Further Reading:

Why EMS managers must plan for narcotic thefts

Police: Ambulance employee stole prescription pads to buy drugs

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