Description and comparison of medication diversion in pharmacies by pharmacists, interns, and pharmacy technicians

Objectives: 1) To describe reported medication diversion within the practice of pharmacy; and 2) to compare diversion by employee type. Design: Retrospective study. Setting: A sample of state board of pharmacy records was examined from 9 states. Disciplinary actions were obtained from the records for the time period of May 2008 to May 2013. Participants: Pharmacy employees (pharmacist, technician, interns). Intervention: Not applicable. Main outcome measures: When a diversion case was identified, the following items were obtained for each case of medication diversion: 1) category of pharmacy employee (pharmacist, technician, intern); 2) type of substance (control, noncontrol, both); 3) use of diverted substance (sale, personal use, both, undetermined); and 4) action taken by the board. Results: A total of 811 medication diversion cases in 9 states were identified. Most cases involved a pharmacy technician (71.4%), controlled substances only (94.2%), and diversion for personal use (46.6%) and resulted in license or registration revocation or surrender (62.5%). When examining medication diversion use by purpose for diversion, there were significant differences by pharmacy employee type (sale use: P=0.003; personal use: P=0.032; unknown use: P<0.001). Conclusion: Medication diversion is a pressing problem. There were 811 cases examined by 9 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 medication diversion. (C) 2018 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.