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Opioid addiction is hard, and that is especially true for people who work in the health care industry in hospitals and in clinics where they are surrounded by highly addictive medications. New studies suggest more American doctors and nurses are stealing and abusing drugs on the job. That puts them and their patients in danger. NPR addiction correspondent Brian Mann reports.
BRIAN MANN, BYLINE: Kristin Waite-Labott is a nurse in Wisconsin. Early in her career, she began taking opioid pills to ease stress. She started getting high on the job. She eventually stole fentanyl from her hospital's medical supply cabinets.
KRISTIN WAITE-LABOTT: Taking it one time, I instantly - I mean, I craved more. It's so powerful and deadly.
MANN: She found it was relatively easy for her to steal small amounts of fentanyl or morphine supposed to be used for patients in pain.
WAITE-LABOTT: I would just say, oh, gosh, I just wasted this morphine. Could you please co-sign for me? And they would do it. They trusted me. Unfortunately, I was taking advantage of that trust, and that happens all the time.
MANN: Waite-Labott eventually lost her job and spent time in jail before entering recovery. She's still haunted by the thought of patients she might have harmed.
WAITE-LABOTT: I don't know that I made any errors, but I can't be certain of that because I was under the influence at work.
MANN: The federal government says roughly 1 in 10 health professionals struggle with some kind of substance use disorder. Kim New, a national expert on drug theft, says many of those workers face constant temptation.
KIM NEW: Any facility that's using controlled substances is certainly going to have diversion occurring. It's extremely common, and the consequences can be very, very grave.
MANN: In extreme cases, health care workers steal so much medication, patients wind up suffering.
NEW: Patients will be left to linger in pain and not receive the doses that they were supposed to receive because the diverter has progressed to the point where they're no longer willing to share with the patient.
MANN: Studies have also found health care workers who steal drugs tamper with medications, leaving them contaminated.
NEW: I go and take a fentanyl vial. I administer the entire vial to myself, and I refill that vial with water, seal it back up, put it back for use on patients. That's a very common scenario. And unfortunately, many patients have been infected with bloodborne pathogens as a result of this type of diversion.
MANN: A study by the Mayo Clinic found more than 28,000 hospital patients were put at risk of contracting hepatitis C over a 10-year period because of this kind of drug theft tampering. How often this diversion happens is hard to say. The U.S. Drug Enforcement Agency investigated roughly 3,000 cases of drug theft at health care facilities over the last five years. But the DEA's Tim McDermott says their attention is mostly focused elsewhere.
TIM MCDERMOTT: We don't spend a lot of time targeting hospital employees or clinic employees. That is not where our biggest problem is in the United States right now.
MANN: He says overdoses from illegal street fentanyl pose a far deadlier risk than fentanyl misused in hospitals. But McDermott acknowledges the DEA can't say with confidence how big this problem is. That's because the DEA only knows about drug thefts that health care facilities detect and report.
MCDERMOTT: It limits the ability of us as an agency to see diversion that's being done, whether it's at a clinic, whether it's at a hospital.
MANN: But critics say many hospitals aren't equipped to catch drug theft. This summer, a company called Kit Check that monitors drug inventories at hospitals issued a report showing tens of thousands of cases where high-risk medications had gone missing and couldn't be accounted for.
MARK FAN: There's probably a lot of under-detection.
MANN: Mark Fan is a researcher at North York General Hospital in Toronto. His study in the Journal of Hospital Medicine found drug theft in U.S. hospitals appears to be accelerating, in part because security systems often break down.
FAN: We know that staff are really overworked. They're under a lot of time pressure. It's not uncommon for people to let things slide.
MANN: The consequences can be devastating. Two years ago, Denise Keller got a call from UT Southwestern Medical Center, a hospital in Dallas where her daughter Iyesha worked as a nurse.
DENISE KELLER: When I first heard from the hospital, they were like, there was an accident. She died on the floor in the bathroom at her hospital.
MANN: Iyesha Keller was 36 years old when she overdosed on a variety of drugs, including fentanyl, likely stolen from her hospital.
KELLER: She is so good with people. She loves her patients. If all this was in her system, how did she do her job?
MANN: Iyesha Keller was the second nurse to die at UT Southwestern from a fentanyl overdose over a two-year period. Experts interviewed by NPR say stigma and the fear of being fired or arrested prevent many health care workers from coming forward and asking for help with their addiction until it's too late for themselves or their patients.
Brian Mann, NPR News.
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