The announcement last week of the sentencing of a former Camas WA Fire Captain to 27 months in prison for product tampering, brings the subject of Narcotic Diversion and Narcotic Tampering back into the news.  We, the collective prehospital industry should take this opportunity to review our moral, ethical and legal responsibilities concerning the controlled substances we carry. 

 

In the grand scheme, the purpose of all the drugs we carry is to alleviate and mitigate pain and discomfort.   In the grand scheme, our purpose is to give a sense of security to the public we serve, a sense that a professional will be there to provide aid when they or their environment is beyond their control.  We are at our best when we deliver what is expected of us.  We are at our worst when we are unable to do so, be it because of lack of training, focus, or other form of impairment. 

 

Being a paramedic and having access to drugs is a great responsibility, one which some may take too lightly.  These drugs will be ingested, inhaled or injected into the body of another, and anything more or less than the appropriate drug or amount is tantamount to assault, assault on another human being.  

 

Sure, practicing medicine is just that; practice. We are only human and everyone makes mistakes.   For our own psyche we may hide behind the idea that we ARE the good guys.  We didn’t cause their illness; we didn’t cause the accident.  Routine may make us callous to our own moral compass.

 

We know it is wrong to steal, it is wrong to take from the public and wrong to take from the company.  We know it is wrong to knowingly allow another to take that which is not theirs.  We know it is wrong to by action or inaction allow harm to come to others. We know it is wrong to replace narcotics with saline, tap water or worse.  Do we need to be reminded of this?  Yes!  Just as we need to review our compression ratios, we need to review right and wrong.  Lest we be lulled by a sense of complacency regarding the accuracy of our moral compass.   

 

If we were so perfect, would we need laws and regulations to protect ourselves from each other?  This brings me to Code of Federal Regulation 1301.91

 

It reads

 

Section 1301.91 Employee responsibility to report drug diversion.

Reports of drug diversion by fellow employees is not only a necessary part of an overall employee security program but also serves the public interest at large. It is, therefore, the position of DEA that an employee who has knowledge of drug diversion from his employer by a fellow employee has an obligation to report such information to a responsible security official of the employer. The employer shall treat such information as confidential and shall take all reasonable steps to protect the confidentiality of the information and the identity of the employee furnishing information. A failure to report information of drug diversion will be considered in determining the feasibility of continuing to allow an employee to work in a drug security area. The employer shall inform all employees concerning this policy.

 

The first sentence says the why, “…serves the public interest at large.”

The second sentence says the what, “…obligation to report such information to a responsible security official…”

The third sentence gives protection, “…employer shall treat such information as confidential…”

The fourth sentence gives a warning, “...failure to report…will be considered in determining feasibility of continuing to allow an employee to work…”

The final sentence gives a sense of urgency, “The employer shall inform all employees concerning this policy.” 

 

Were you made aware of this CFR?  Have you informed your employees of their responsibilities?  If not, it is time to remind them of the difference between right and wrong.  Hopefully we’ll remember them as well, if not better than our compression ratios.