A hands on review of the V-Line Narcotics Security Box model 6912-SE.

Story of Florida Firefighters being drug tested after drugs go missing.

-Alton 05-28-11

Most Effective Tool - an editorial on CFR 1301.91 for the Outpatient Surgery Industry added to the Extra’s Section.  A story about a break in at a fire station in Wisconsin added to the Paramedic Articles.  Another story about Narcotic Tampering in a Minnesota Hospital by an RN.  At least 23 patients hurt. 

Added a page to the Technology and Systems section about another Event Tracking Safe option. 

Also added a letter of compliance example from San Juan Island EMS in WA State and a Position Paper Example you can modify for use at your agency to get your organization in compliance with the DEA’s CFR 1301.91.  You can see links to these at the bottom of the Record of Compliance Template page in the Extra’s Section.

Added a PDF for a class titled Grief Following Trauma, a 14 hour CE class in Riverside towards the end of April.

-Alton 03/28/11

Dumb Safe vs. Smart Safe added tonight to the Extra’s Section.

-Alton 03/05/11

A reflection on why StopNarcoticTampering.org exists.  Some say, be professional, don’t let this be personal, don’t show others it’s personal... but it is personal.  It’s happened in my world, it can happen to yours, it probably has.

-Alton 02/28/11

Added Alhambra FD’s Policies on the PROCUREMENT AND STORAGE OF PHARMACEUTICALS in the Technology and Systems Section.  Thank you to Alhambra FD for being willing to share this with the community.

-Alton 02/18/11

Small additions to the website this evening.  Added 2 pieces of technology to the Technology & Systems section.  Revised the Past and Future Presentation lists, and added the official version of my editorial published recently on EMS1.com.  Next presentation scheduled for 2/25 in Ocean Shores, WA, then 3/15 in Riverside, CA. 

-Alton 02/15/11

Washington Fire Captain gets 27 months jail time, article here.

Washington Fire Chief gets terminated a week later, article here.

Open letter to industry here.

The research is going well at the lab, this is going to be an interesting year.

-Alton 01/28/11

The Minnesota Firefighter-Paramedic got 3 years probation.  Articles posted here today. 

In other news, the presentation Narcotic Tampering Awareness & Detection will be shown at the Paramedic Program located at the Ben Clark Public Safety Training Center in RIverside on January 19th.  On February 25 will be taking part in the Pre Conference Leadership Workshop at the West Region EMS Conference in Ocean Shores, Washington.  Contact me if you’d like this presentation at your next EMS leadership meeting or training session.

-Alton 01/03/11

Posted 3 articles involving a Minnesota Firefighter-Paramedic involved in the diversion of narcotics while transporting a patient.  See those here. Also there is a story from Pennsylvania involving a nurse that stole drugs from a hospital that specialized in addiction medicine.  Oh the irony.

-Alton 11/10/10

Several minor content updates to the site, a new article regarding the pending indictment of the Paramedic from the Ventura county case, and a draft article for KEMSA. 

-Alton 10/27/10

Uploaded to YouTube the Intro Video used in the presentation.  Added a link to it on the Awareness page.

While I may not know who visits this site, I do see their IP addresses.  I notice there’s quite a bit of activity coming from a few addresses.  Please drop me a line and let me know why you’re interested in this topic.  There’s a lot more to this than what’s posted here.  I’d especially like to hear from folks visiting us from the following areas.

Quantico, Beverly Hills, San Diego, Cupertino, Redmond, and D.C.

-Alton 06-06-10

Slight cosmetic changes to the site.  Added an analysis based on known numbers of diversion and tampering in EMS.

-Alton 05-30-10

Posted a press release from the FDA regarding an RN that tampered with morphine and fentanyl at Skyline Hospital in White Salmon, Washington.  She was the Obstetrics Manager.  How did that epidural work out for you?See that entry here.

More disturbing information coming out on our Washington Paramedic.  Tampering found in Alberta and a North Carolina Paramedic charged with stealing morphine.

Added an Open letter to colleagues in the Extra’s section.

-Alton 05-27-10

Hat’s off to Boulder Community Hospital’s PIO for putting together a page that answers questions and updates the community regarding a public case of narcotic diversion at their facility.  Good Job.

-Alton 05-19-10

EMS1.com published an edited version of my latest Extra’s entry.  See the EMS1.com version here.

Selected slides from the presentation “Narcotic Tampering Awareness & Detection” are on the site now.  You can find the slides near the bottom of the Awareness Section.

-Alton 05-18-10

Today we added in the Extra’s section a story from the Fillmore Gazette about an ex-paramedic from Ventura county, acting the fool and getting himself arrested (again!) for a DUI on Good Friday.  See my letter to the editor.

Also added in the Awareness Section under Paramedic Articles, the Press Release from the Camas PD (Washington) regarding the 22 year Firefighter/Captain who stole and tampered-with Narcotics. 

To my paramedic friends in Oregon, I’m sorry if a industry leading EMS Journal  wrongly stated this guy was from your state, this story should in no way reflect upon your state, please don’t feel singled out.  But understand, this is everyone’s problem, all industries in health care, all states, all nations. 

-Alton 05-16-10

So much has happened since our last update.  Presented the class “Narcotic Tampering Awareness & Detection” at Ontario Fire Dept., congrats to them for being the first agency to have this training given to personnel from every station on all shifts.  This class was viewed as an “ounce of prevention.”  They don’t think they have a problem there and probably don’t, but in knowing the damage than can occur if something like this happens.  They wisely decided to make all their personnel aware of this issue.  Their risk managers should be proud. 

Went to Fire-Rescue Med in Las Vegas last week and gave the presentation, though this time it was retitled “Narcotic Tampering Awareness & Prevention”.  Subtile change on the part of the conference organizers, focused on a few solutions that can be utilized by agencies to thwart diversion/tampering. 

On Tuesday I met with representatives from Implen, Inc. at CSULA with our graduate student and professors.  They demo’d their NanoPhotometer.  It holds Great promise for our industry.  More on that later.

Tomorrow will present at CFED in Palm Springs.  Interestingly, this past Monday, a 22-year Fire Capt. from Camus Fire in Washington State was arrested for suspicion of Narcotic Diversion/Tampering.  See the first articles here and here.

Also, a Colorado Medical Center and anesthesiologist  are begin sued by a patient that contracted hepatitis C from a surgery tech that had tampered-with narcotics.  If the desire to protect patients from tampered-with narcotics for the sake of doing what’s right, isn’t a good enough motivator, the fear of lawsuits should be.  Read the article here.

-Alton 05-13-10

Article published in a local newspaper about a former Fire Chief of a one station city dept.  On the surface, his story has nothing to do with Narcotic Diversion.  I question if his agency’s Narcotics were tampered-with.  Read the article and my comments to see why. 

-Alton 03-27-10

Found a webcast (since expired) self study on Narcotic Diversion provided by the makers of the Pyxis system.  MedScape recently published a Q&A with an MD.  Topic Preventing Narcotic Misuse.

Alton 03-23-10

Added another product highlight.  Ocean Optics produces a hand held Raman Analyzer that may work for the needs of our industry.  See it here.

A story from Paducah, Kentucky illustrating the changes made after someone is caught tampering with drugs. 

A story from Brockton, Massachusetts.  A 12 year firefighter, hooked on drugs, slips into a station to steal $120 from a lieutenant.  He’s sent to a drug rehab facility. 

“Implementing Systems for Detection and Prevention of Drug Diversion”, is a webcase created by Carefusion, the makers of Pyxis.  The webcast has since expired, but you can find the PDF of the slides here.

-Alton 03-18-10

Brutally honest words about diversion from an Australian RN. 

A story on Cindy McCain that shows addiction can happen to anyone.

Under the awareness section, we now have a link to a short list of regulations that EMS administrators should know.

-Alton 03-09-10

An off duty FDNY Captain is arrested for Narcotic Diversion.  In this case, she illegally obtained Vicodin thru a fraudulent prescription. 

The legislature in Colorado is trying to have healthcare facilities report, by name, techs that are fired or disciplined for irresponsible behavior.

-Alton 03-07-10

Update to the Surgery Tech from Colorado that diverted/tampered-with narcotics and infected ~ 3 dozen people with hepatitis C.  She got 30 years.

-Alton 02-26-10

3 new industry links added.  A new entry to the Technology and Systems section.  MEDTOX provides confirmation testing for the narcotics we carry.

-Alton 02-24-10

Added some thoughts by Tom O’Connor, Treasurer of San Francisco, IAFF Local 798, to our Extra section.  Wise words.  You can see read them here.

-Alton 02-23-10

This evening I became aware of a company that uses neurofeeback therapy to treat addiction.  Neurotopia is spotlighted in the Heath Program section under Prevention.  While I can’t endorse them at this point, I can say without question it is worthy of investigation.  If you try it, let me know how it goes for you.

-Alton 02-21-10

California Health & Safety Codes 11350 and 11550 are listed in the Extra section now.  11350 is the Possession of a Controlled Substance and 11550 is Using and/or Being Under the Influence of Drugs.

-Alton 02-19-10

Updated our Industry Links and added a new listing to our Resources page.  Added two articles to the Other Articles section, from Officer.com.  Pill Pushers on the ‘Net.  See Part I and Part II.  Added to the Extra section the FDA Authority granted them by the 1983 Federal Anti-Tampering Act.

-Alton 02-18-10

I’d like to recognize the good work of Outpatient Surgery Magazine’s Associate Editor Irene Tsikitas.  She wrote a piece on Narcotic Diversion that included a story about an addicted Washington State RN that repeatedly replaced Demerol with saline.  A special thank you to her and Outpatient Surgery Magazine for authorizing us to post their article here. 

-Alton 01-30-10

2 former EMS employees in Santa Fe, TX are caught with their hands in the cookie jar.  They faked a 911 call and tried to break into the backup rigs.  This will take you to the first of two postings under Awareness/Paramedics.

-Alton 01-21-10

In the “Last Word” section of the JEMS January 2010 issue, under the sub heading, Sham Drug Shame, we learn that Three New South Wales (Australia) Paramedics were implicated in the diversion of Narcotics.  It not only happens across the USA but across the globe.  This appears to also be an example of when it is dealt with internally... it gets dealt with ineffectively. 

-Alton 01-19-10

Posted the CSFA-Firehouse World Invitation.  Use the promo code when registering to become eligible for prizes.  Hope to see you there. 

Added a case study on Clark Co., NV Fire from Cyber Lock. 

Posted the Save-the-date flyer for the Arson symposium at Hertzberg-Davis. Consider it a collateral interest.

-Alton 01-14-10

Just in, a new article out of The Journal in West Virginia.  Paramedic accused of stealing from blind patient turns self in, a hidden camera aids in the arrest.  Read about it here.

-Alton 01-13-10

New story last month in OutpatientSurgery.net that discusses a case of a Washington State RN that tampered with Demerol Ampoules.  Other stories on her can be found under here. 

-Alton 01-13-10

Happy New Year,  I’m trying to hit this new year with a renewed sense on Enthusiasm for the project.  The Holiday Hiatus is over and we’ve got a great deal of work ahead of us this year.

I was sent an article today from Pittsburgh.  What can I say, I hate it when we’re knuckle heads like this one. Ours is a nobel profession, we should protect it and our reputation, not by suppressing the ugly truth, but by strengthening the character of our members.

-Alton 01-04-10

Was sent a research paper titled, “Risk factors for alcohol and other drug use by healthcare professionals.”  Find it under Awareness, Other Industry Stories, Ethics, Etc. 

-Alton 12-18-09

Added 2 entries to Extra concerning 2 CFR’s that deal with Diversion with a brief commentary. 

-Alton 12-15-09

In Extra, there is an example of the Type IV method of tampering with a description of what to look for.  This information wasn’t meant for the internet, but since someone else published a photo of this type of tampering, we need to inform the industry of some of the things to watch out for. 

The Visitor Locations applet doesn’t quite seem to work right, will be trouble shooting it.

Save the date: 1-29-10.  Chemical Dependency in EMS with Nancy Mraz and myself at VCMC in Ventura, CA.  Details shortly.

November was the busiest month to date for traffic to this site.  Earlier today we matched last month for the number of unique visitors here.  Thank you for your interest in protecting the public we serve.

-Alton 12-13-09

Today added Visitor Locations applet below.  An Op/Ed piece on SB 1441 published in the Sac Bee can be found in the Awareness/Ethics area.  More stories in Date order are found in Awareness/Paramedics concerning PM’s that steal from patients.  Do what’s morally and ethically correct, not what feels good.

-Alton 12-11-09

Added a few more resources under Prevention/Technology.  Added more articles from the LA Times regarding Diversion in the Nursing Industry.  Those are under Awareness/MD’s, RN’s & RT’s. 

Found a Story about a Paramedic working for a large private ambulance company here in California.  He admitted to stealing pain medications from one of his patients.  Even going so far as to return to his house on several occasion to “inventory” his medications.  Find the article in Awareness/Paramedics

-Alton 12-07-09

LA to SF to SD and back to LA.  These past 4 days have been a whirlwind.  There’s a new article in the Awareness (Paramedic) section, and you’ll see the pre-edited version of that article in Extra (It’s Deja Vu All Over Again).  In Extra there’s also our agenda for 2010 as outlined before the CA EMS Commission in SF.  In San Diego, discussions were begun as to the manner, content, extent and method of disseminating information.  A balance needs to be found between too little and too much information regarding tampered-with drugs.  We’ll keep working on it.

-Alton 12-04-09

To those who are finding this website for the first time.  Welcome.  Please look around, I especially recommend the Awareness tab above, in that section you’ll find stories from EMS and Hospital based healthcare regarding narcotic diversion.  I hope you come away with a better appreciation for narcotic diversion and narcotic tampering.  This evening, a few audience members approached me after the presentation and freely recounted stories regarding patients that got little or no relief from their narcotics.  They now look back and seriously question if they were giving their patients the real deal or not. 

-Alton 12-01-09

Added a story from Louisiana about a medic that stole prescription drugs from an undercover narcotics cop posing as a patient.  Busted!  That story is the awareness section, under paramedics, dated 8/26/09.  A few days ago added more random thoughts and observations, including highlights from an interview, you can find that in the Extra section.  Tomorrow I fly to San Francisco for an SFPA presentation and various quarterly EMS meetings.  On Wednesday I’ll go to the EMS Commission meeting. 

-Alton 11-30-09

Found 2 research papers on Chemical Dependency and Substance Abuse among physicians.  Added a paper written by Mandy L. Hrobak on Narcotic Use and Diversion in Nursing.  Those can be found in the MD’s, RN’s & RT’s area under the Awareness section above.

-Alton 11-27-09

New Paramedic Articles from Oklahoma and Michigan.  Added a few more articles to the Nebraska story of 2008.  Under Awareness/Other Articles added a piece on Drug Testing written back in 2003 by Marc D. Greenwood.

Our industry won’t successfully stop narcotic tampering until we are willing to face our collective guilt and shame which unfortunately, often manifests itself as arrogance. 

-Alton 11-24-09

Updates to the site tonight.  Facebook “Share” buttons added to the header.  Also added a Facebook Badge on the Right side of this screen.  Facebook members, click on it and join us in our effort to better our industry.

-Alton 11-13-09

Added more entries under the Prevention heading, Technology & Systems.  You can now read about Raman Analysis and Refracotmetry.   If you have a Facebook account, join StopNarcoticTampering.org.

-Alton 11-10-09

Presented to the LA County EMS Governance Committee today.  Always a somber experience to talk about the dirty underbelly of our profession.  I am heartened to know that the decision makers in my community have a better understanding of what has been going on in our industry, hopefully we can keep it from happening again here.

-Alton 11-4-09

Added 4 articles regarding an ex-paramedic in Idaho that died while breaking into a Paramedic Ambulance Bay.  We’ll continue to watch how this story unfolds.  Sure want to see that toxicology report. 

-Alton 10-30-09

Added a new entry under Extra, found an exhibit at the DEA Museum in Washington, D.C.  Another reason to go back.  Also, added “Additional Resources” under Awareness. 

Scheduled to deliver our presentation “Narcotic Tampering Awareness & Detection” to the San Francisco Paramedics Association on Tuesday, December 1.  The next day the State EMS Commission is meeting as well.

-Alton 10-27-09

Great news!  The DEA approved the CSULA site for storage and testing of Scheduled Drugs.  Waiting for the paperwork to be processed.  We’ll soon meet with the Professors and LA Co DHS/EMSA to schedule the delivery of the narcotics and field test equipment.  Wish us luck in validating a scientifically supported methodology for checking narcotics in the field setting. 

-Alton 10-22-09

The DEA is scheduled to visit CSULA School of Criminology and Criminalistics on Monday, October 19.  The purpose of the visit is to essentially approve the facility to do research with Schedule I - IV drugs. 

Our first “open to all” CE class flyer was approved by LA County EMS today.  We’re holding the class at Huntington Memorial Hospital on Monday, November 16 in their East Room.  The class is sponsored by Huntington Memorial, CSFA and our Emergency Responder Substance Abuse Task Force.  Class and CE’s are FREE to Medical and Health Professionals.

-Alton 10-15-09

On 10/7/09, our 2 hour program Narcotic Tampering Awareness & Prevention was given for the Paramedic Students at UCLA/Daniel Freeman, AKA UCLA, David Geffen School of Medicine, Center for Prehospital Care. 

-Alton 10-9-09

Our ISP crashed today, all mail got bounced back as undeliverable and the website was down.  Would love to say it was because our traffic was up 500% but, it was due to some network failure in the Pacific North West.

Tonight we added two stories from 1993 in Charleston, South Carolina, involving the arrest of 4 Emergency Responders for Narcotic Diversion. 

Under the Prevention Section, Technology and Systems, we highlighted some things that Charleston County EMS did to prevent further cases of Narcotic Diversion in their system.  We’ve also got a copy of the Policies.  If there is something specific you’d like to know about their system, drop us a line.

-Alton 10-1-09

Returned from our first East Coast adventure.  Before this trip we’ve only presented in California, Hawaii and Nevada.  We can now add South Carolina and Washington, D.C.  We’ve raised the awareness levels of Professional EMS Leaders from not only S.C. and D.C., but also Colorado, Florida, Georgia, Illinois, Louisiana, Maryland, New York, New Hampshire, Iceland, and Canada.  With the inclusion of a review of our presentation in JEMS online regarding the IAEMSC inaugural leadership summit, we’ve seen a 400% increase in traffic to this site.  Thank you A.J.

Added a new article, and some extra’s, drop us a line and let us know how we’re doing.

-Alton 9-29-09

New articles in “other industry stories, ethics, etc.” under the Awareness section. 

Recently confirmed a meeting with the Chief, Personnel Division for CA EMSA.  We’ll meet in San Diego in September just prior to the EMS Commission meeting.  Discussions will include matters of mutual interest, including but not limited to Diversion in EMS, EAP, BioPsychSocial aspects of Chemical Dependency, the current state of Diversion Programs in EMS and potential models for future programs.

Scheduling more presentations on this subject.  Open to deliver the program “Narcotic Tampering Awareness & Detection” anywhere, anytime.  We can now award CE Units through A&A for scheduled presentations. 

-Alton 7-23-09

Found several more articles about narcotic abuse, diversion, tampering in EMS.  Also found an article discussing how Columbus Ohio wants to take away ALS and be strictly BLS.  See that article here.  Tom, thanks for the words of encouragement. 

-Alton 7-19-09

2 new articles in the Regarding Wellness section under the  Prevention tab above.  One is titled Substance Abuse among Healthcare Professionals and the other is titled State Monitoring Programs Provide Useful Tool to Reduce Diversion.  That second one was written by the GAO back in May of 2002.  Later today we present our work to the Cal Chiefs, EMS Section, Northern Division in the Bay Area. 

-Alton 7/16/09

Added 5 articles under the Awareness tab in the M.D./Nurses section. Including 2 taken from CSAM - the California Society of Addiction Medicine regarding AB 526.  This involves the creation of a not for profit wellness program for physicians in California, separate from the state medical board.  Should EMS look at AB 526 and the work of CSAM as a model for our industry?  Time will tell.

-Alton 7/15/09

Added 8 entries to the “Regarding Wellness Programs, Addiction and Legislation” section which can be found under the Prevention link in the header.  I’m most excited about the link to the Addiction Project at the HBO website.   Also of interest there is an analysis of Firefighter Drug Testing and the Fourth Amendment.

-Alton 7-12-09

Today is 7/7/09, I have returned to duty after a 3 week absence.  We traveled to Hawaii and Nevada in search of opportunities to share with and learn from other agencies.  We found the land of Aloha to be fruitful and discovered that while Las Vegas is famous for saying “what happens in Vegas....” isn’t necessarily so.  I’m sure that what will eventually become our model policy and procedures for the handling of controlled substances in prehospital care will be based partly on what Clark County independently researched, developed and implemented.

I was recently asked for a brief bio, this one (Alton Bio) was created by our friend Larry G. 

My final thought for tonight.  We still have a few years of work ahead of us, one step at a time, finish one project, start another, incremental change and improvement will occur. The hardest thing to fight is conventional wisdom, conventional thinking and inertia (aka apathy). We’ve made strides and this has taken on a life of its own, what this grows into will be something we will all feel proud of. 

-Alton 7-7-09

Have made numerous updates since June 1st but haven’t updated this screen.  Currently in the Kailua-Kona area of the Big Island of Hawaii.  Very beautiful island, very nice people.  We had an 2 A.M. episode with a member of our family, have been a witness to the EMS and ER system here on the Big Island.  While rural as it may be, the FD and ER staff are professional, competent and compassionate. 

Since the last update we’ve scheduled:

Narcotics Tampering Symposium at CSULA Hertzberg-Davis Forensic Science Center for Criminologists on June 29th, 2009.  A special presentation on Raman Technology will be given by John Johnson of Ahura Scientific. 

EMS Leadership Conference in South Carolina on September 25, 2009.

CSFA-Firehouse World Conference in San Diego in March 2-3, 2010.

And most importantly, we have agreed to share our groups knowledge, experience and research with Cal Chiefs, Northern Section EMS Committee, Narcotics Workgroup, as they prepare to write an FAQ for our industry on the use of Narcotics in EMS. 

-Alton 6-19-09

Today we organized the Articles into 3 categories, Paramedic Articles, Nurse Articles and Other Articles.  We changed the title of the MISC. section to Extra RT.  Hope this helps.

-Alton 5-29-09

The 20th CSFA/Northridge Hospital EMS Conference has come and gone.  Received excellent reviews from the attendees, both old friends and colleagues.  Would like to thank Karen Reid-Wright, Heidi Ruff, Donald Wright and Larry Grihalva, for all their hard work in making this Conference a success. 

-Alton 5-28-09

Fire Investigator 2B is finished, thank you to Rio Hondo Fire Academy, Instructor Gryzwa and Team 3 for making it a most enjoyable learning experience.  Final preparations for the CSFA-Northridge Conference are underway. AND, we updated the Misc. section with some public records we found from New Jersey.  This will have to do until we get the public records we requested from California.

-Alton 5-24-09

Bunch more articles added today. 

-Alton 5-17-09

Updates to Misc. regarding DCA and EMSA as well as a new Commentary by Michael Josephson.

-Alton 5-16-09

Few more articles added regarding Las Vegas in 2007.

-Alton 5-14-09

Added more articles, and on the Assistance page added a link to resources taken from the National Association of Drug Diversion Investigators.  Today I got the official word, I’ve been accepted into their organization.  On the task force page added industry links (not organized yet)

-Alton 5-11-09

The site has grown this week.  We’ve streamlined it some.  Changed the Welcome tab to Home, Removed History and replaced it with Articles.  Added a link on the task force page to a PDF file that lists the membership of the task force. 

-Alton 5-9-09

Some in Healthcare tamper with our narcotics and put our patients at risk.

Discover the subtile signs of tampering, so you never give bad narcotics to your patients.

Contact us to learn more.