One of my colleagues recently reminded me that in 2011 I wrote about drug abuse in the workplace and promised a follow-up
article. Apparently I forgot to write that second missive. (Possibly due to some brownies I ate on my last trip to Fort Collins?)
Nevertheless, based on calls and e-mails we receive at my law office, the subject keeps expanding, so I will opine further
on the topic.
When I field inquiries from veterinarians and technicians around the country with concerns about possible workplace controlled
substance abuse, the worried caller is almost never the person perpetrating the abuse—at least that's what they say. Rather,
what usually happens is that a staff member notices consistent irregularities in the process of ordering, cataloguing, dispensing
or recording the use of one or more substances controlled by state or federal law. While these workers are nervous about the
impact of drug improprieties on the practice, what they're more concerned about is the possibility of becoming involved in
an investigation of the problem.
Enforcing the law
The laws concerning the oversight of a controlled substance once it arrives at a legal wholesale purchaser, such as a medical
clinic or pharmacy, are all over the place depending on the jurisdiction. In some states the recordkeeping laws are very strict,
but enforcement of those rules is so lax that a doctor can go a lifetime without fielding a single inquiry about who ends
up with the controlled products.
Other states are basically providing a free service to the federal Drug Enforcement Administration (DEA) by conducting spot-checks
at veterinary hospitals to make sure they're complying with state veterinary practice laws. While state inspectors are carrying
out a clinic visit to make sure the facility is clean and that all veterinarians wear gloves while performing surgery, they
also peek at the phenobarbital and hydrocodone records to be sure they're up to snuff. In this way, states bolster the DEA's
woefully underfunded compliance efforts.
Regardless of how pharmaceutical records are policed in your state, what veterinarians and technicians really need and want
to know is how they can protect themselves when discovering—or even just suspecting—that controlled medications are leaving
the clinic in a way that violates the law.
And the concern is certainly legitimate. Every year private medical, dental and veterinary practices are sanctioned for prescription
drug law violations. I'm reminded of this fact every time I renew my license to practice veterinary medicine in Florida. That
state is so concerned about pharmaceutical abuse that it requires a mandatory continuing education class on the topic as a
prerequisite to actually renewing a license.
Signs of trouble
Veterinary staff members who've never witnessed a potential drug abuse problem in the workplace are usually surprised when
the indications do show up. They may not realize that these signs indicate anything more than sloppy inventory management
or haphazard recordkeeping.
Here's a brief list of some red flags that a genuine problem exists:
> Pages missing from the controlled substance manifest
> A claim that a bottle of a controlled substance has been "lost," "destroyed" or "thrown away by mistake," especially
if this occurs with suspicious frequency
> A doctor or technician insisting that he always log in certain pharmaceutical deliveries when it's not one of his usual
> Refusal by management to upgrade, or even initiate, a controlled substance log
> Missing prescription pads
> Associates or partners who hold veterinary distributor accounts with delivery addresses other than the veterinary practice