Hydrocodone

There are many documented cases of pharmacists, nurses and doctors diverting drugs for their own use — specifically hydrocodone.

Here is a case where a pharmacy technician in Christiansburg admitted to diverting some 30 doses of hydrocodone. But after examining at records for the year that Jennifer Hines was employed, the pharmacist in charge at Davidson’s Pharmacy ended up filing a DEA report for loss of controlled substances for some 288 dosage units of hydrocodone.

Hines had her license indefinitely suspended by the board.

Hydrocodone is a popular drug for diversion. It is habit forming and used to treat pain. I know people who have used left over doses from an injury to alleviate the effects of a hangover.

According to the U.S. Department of Justice:

“Hydrocodone diversion and abuse has been escalating in recent years. In 2006, hydrocodone was the most frequently encountered opioid pharmaceutical in drug evidence submitted to the National Forensic Laboratory Information System… In the 2005 Drug Abuse Warning Network combination products were associated with more emergency room visits than any other pharmaceutical opioid with an estimated 51,225 emergency room visits. Poison control data, medical examiners’ reports, and treatment center data all indicate that the abuse of hydrocodone is associated with significant public health risks, including a substantial number of deaths.”

More information on the drug can be found here.

Pharmacy tech helps herself to 11,612 pills in three months

Jessica Brashear, a licensed pharmacy technician at a Walgreens in Portsmouth, Va., admitted in a consent order that she diverted medication and lost her job over it. The state revoked her license Sept. 11.

Diverting drugs means taking them for yourself or somebody else. We could fill this blog with stories about drug diversion, because a small but steady number of medical workers help themselves to the drugs they are entrusted to give to patients. Many of them get caught and fired, according to filings you can look up here. Here’s another example in case you’d like more proof that employee drug diversion is a big challenge in health care. And another. And another. And another.

Here’s what Brashear took from Dec. 17, 2006, to March 27, 2007:

-11,342 units of Vicodin

-200 units of Lortab

-60 units of Viagra

-10 units of an antibiotic

Weight loss meds

Ryszard Zebrak, a doctor from Spotsylvania, used the name of a dead relative to write prescriptions for himself.

The order says that on 33 occasions from Jan. ’06 to Jan. ’07, Zebrak wrote prescriptions for Bontril and Adipex-P in the name of family member who had died Sept. 16, 2006. It is unclear if the family member used the prescriptions before their death.

Zebrak admitted to the board that he used the prescriptions to get approximately 1,080 doses of the Bontril and 570 doses of Adipex-P. The drugs are used for weight loss. He denied giving the medicine to anyone else and said that he does not abuse legal or illegal drugs.

In January, after a call from a pharmacist, Zebrak stopped writing the prescriptions and stopped taking the meds. He said he had no withdrawal symptoms.

Zebrak said he was sorry and told the board that he struggles with his weight and was too embarrassed to talk to his primary care physician about weight loss medication. A search reveals that a Ryszard Zebrak, 34 from Fredericksburg, is in fact a psychiatrist.

Zebrak was also in trouble for prescribing the same medicine he was taking to five other patients without performing a comprehensive weight analysis.

Zebrak was reprimanded. A psychiatric evaluation in March cleared Zebrak of the possibility of addictive behavior. The doctor agreed to outpatient therapy.

In addition to the therapy, Zebrak has to take some continuing education classes in record keeping and prescribing drugs.

Roanoke pharmacist gives it up

Lori Rings just couldn’t get it right.

Rings, a pharmacist near Roanoke, was placed on probation in 2004 for drug diversion, substance abuse and mental health issues.

The most recent order contains Ring’s violations as a pharmacist at a CVS in Troutville. Rings took Stadol for her own personal use between Dec. ’06 and Jan. ’07. A Stadol injection is sometimes used as preoperative or preanesthetic medication for pain relief during labor. The nasal spray can be used for the relief of pain as well.

Rings also failed to inform the board of a change in her employment, worked at different CVS stores, worked more hours than she was allowed and filled prescriptions for herself, all violations of terms imposed from her earlier order.

In May, Rings voluntarily gave her license up to the board. Good for you, Rings. The board put her license on indefinite suspension, which means she might be able to seek reinstatement down the road.

Is it just me, or should a pharmacist who diverts drug for personal use even have the option of working as a pharmacist again? Talk about temptation.

What medicine for schizophrenia can do to you

I wonder how often this happens…

Glendale Pharmacy in Newport News, VA gave the wrong medication to a patient. Apparently, the patient was supposed to receive Macrobid (a drug for urinary tract infections) and instead received Clozaril – a medicine for schizophrenia!

Yowsers, that has got to be a shock to the system.

The patient who got the Clozaril experienced a loss of consciousness,  slurred speech and lethargy and had to take a trip to the ER.

The pharmacy was fined $500, which leads me to believe this might happen more often than not.

Pharmacist diverts drugs

Ronald Malsam, a pharmacist in Fairfax City, had his license suspended and lost his job, according to an order from the Department of Health Professionals. The suspension was ordered in February.

The order does not state the reason why the license was suspended, but a notice dated the same day alleged that Malsam, over the course of a year-and-a-half, diverted 621 tablets of hydrocodone, alprazolam, acetaminophen and Lipitor, among other drugs, for his personal use.