Description and Comparison of Drug Diversion in Pharmacies by Pharmacists, Interns, and Pharmacy Technicians
Objective: The purpose of this study is to describe reported drug diversion within the practice of pharmacy. Methods: There is limited research that examines the nature and extent of drug diversion within the practice of pharmacy. If drug diversion is reported, state boards of pharmacy examine cases involving registered pharmacy personnel. To describe the problem of diversion, a sample of state board records were examined. First, states were classified, using U.S. Census classifications, into regions and divisions to provide a representative sample. States that did not have minutes posted online or that did not register technicians were excluded. If more than 1 state remained in a division, then a state was randomly chosen for analysis. Meeting minutes were obtained from May 2008 to May 2013. The following items were obtained for each case of drug diversion: (1) category of pharmacy employee (pharmacist, technician, intern), (2) type of substance (controlled, non-controlled, both); (3) use of diverted substance (sale, personal use, both, unknown); and (4) action taken by the board. An a priori sample size was calculated (alpha = 0.05, effect size = 0.3, n = 253 cases). Descriptive statistics were performed for all data in SPSS v.21, and chi-square tests were used to assess categorical differences. Results: A total of 811 drug diversion cases in 9 states were identified and used. Most cases were involving a pharmacy technician (71.4%), controlled substances only (94.2%), diverted for personal use (46.6%), and resulted in license revocation/surrendering (62.5%). When examining drug diversion use by type of substance, there were significant differences by pharmacy employee type (sale use P = 0.003; personal use P = 0.032; unknown use P<0.001). Conclusion: Drug diversion is prevalent, as indicated by the 811 cases examined by state boards, and many cases may be unreported. Technicians represent nearly three-fourths of diversions. It is essential that the practice of pharmacy identifies and assesses strategies to reduce drug diversion.