What You Should Know:
– Despite increased investments in detection programs, drug diversion—the illegal obtaining of prescription drugs by healthcare staff—continues to be a significant and often underreported issue within U.S. hospitals and health systems, according to the fifth edition of the “State of Drug Diversion” report released by Wolters Kluwer Health.
– The comprehensive survey of nurse leaders, pharmacists, risk managers, and drug diversion program leaders reveals that while awareness and resources have grown, critical gaps in technology adoption, departmental alignment, and program confidence remain.
– The accessibility of controlled substances with significant street value poses an ongoing challenge, threatening patient safety when vital medications are stolen or substituted, and impacting team performance and workplace safety.
The “Elephant in the Hospital Room”: An Underestimated and Underreported Risk
The report starkly highlights that drug diversion is a sensitive topic, often an “elephant in the room” that healthcare organizations struggle to address openly and effectively. Four out of five (81%) healthcare leaders surveyed believe drug diversion continues to occur within their organizations, with many of these incidents likely remaining unreported. This persistent risk exists even as organizations invest more in personnel and training to combat it.
“Drug diversion is a sensitive topic, often making it the elephant in the room that no one wants to talk about. It remains a persistent and underestimated risk in healthcare, yet many hospitals and health systems still lack unified strategies to detect and address these behaviors effectively,” said Karen Kobelski, Vice President and General Manager of Clinical Surveillance Compliance & Data Solutions at Wolters Kluwer Health. “The survey data highlights notable gaps in departmental alignment and the adoption of innovative technologies like artificial intelligence (AI). Our hope is that, with these findings in hand, stakeholders can educate and foster dialogue within leadership and across the organization to adopt a more proactive approach to drug diversion detection”.
Key Survey Findings: Persistent Challenges Despite Investments
The fifth edition of the report illuminates several critical areas requiring attention:
- Enforcement Gaps Despite Policy Updates: While nearly all respondents have updated their drug diversion policies to meet evolving regulations, significant gaps in the enforcement of these policies remain.
- Low Confidence in Program Effectiveness: Only a third (33%) of respondents reported being “very confident” in the effectiveness of their current drug diversion detection programs. This lack of confidence is compounded by the belief held by 81% that incidents continue to be underreported.
- Underutilization of Technology, High Interest in AI: Current drug diversion programs often rely on traditional, frequently manual, audits, which can leave significant room for diversion to go undetected. While only 40% of respondents are currently using AI tools, a substantial 76% expressed a desire to incorporate advanced analytics for better oversight and detection capabilities.
- Lack of Cross-Departmental Ownership: Effective diversion prevention requires a unified strategy, yet key departments like anesthesiology and human resources (HR) remain underrepresented in these programs. For instance, only about a third of respondents indicated that anesthesiology is represented in their drug diversion programs, despite it being recognized as a major risk area.
- Increased Staffing but Vigilance Still Key: Commitment of Full-Time Employees (FTEs) to diversion programs has grown significantly, with most respondents now dedicating three FTEs in 2025, compared to just 0.25 FTEs reported in 2023. However, the report stresses the need for continued vigilance.
“If your diversion detection program isn’t turning up any suspicious cases or behavior, you may be missing something,” Kobelski continued. “With constantly changing behaviors and opportunities for diversion of high-risk medications to go undetected, organizations must stay vigilant and ensure they have the resources in place to extend beyond the limits of manual monitoring”.
Report Background/Methodology
The fifth edition of the State of Drug Diversion survey included 200 respondents who are U.S. adults, 18 and older, working in a hospital and/or large healthcare system. Respondents were at least at the director level and work in risk management, drug diversion programs, pharmacy, or are a Chief Nursing Officer or nurse manager, with at least some influence on drug diversion programs at their organization. The survey was conducted online between February 27 and March 10, 2025.
