Diversion in the Operating Room

The operating room (OR) is a high-risk setting for diversion of controlled substances, primarily due to the large quantities of these medications that change hands each day. It is the responsibility of the pharmacy to design a distribution system that will limit this risk and detect diversion before a problem escalates. Unfortunately, diversion in the OR appears to be an increasing problem. A 1999 survey of certified registered nurse anesthetists (CRNAs) established the prevalence of controlled substance abuse at 9.8% (167 of 1,709 respondents). Considering that this study required a CRNA to self-report his or her own substance abuse experience, the actual prevalence may be significantly higher.