http://www.jems.com:80/news_and_articles/articles/jems/3501/last_word.html

December 2009 JEMS Vol. 34 No. 12

Pg. 82, Last Word (the ups & downs of EMS):

Sham Drug Shame

Three New South Wales (Australia) Ambulance Service (NSWAS) paramedics, including one who has reportedly admitted to stealing fentanyl, have been taken off duty pending internal investigation of drug tampering allegations. Paramedics at the service reported to the Emergency Medical Services Protection Agency (EMSPA) that colleagues may have been using the powerful painkiller and giving patients an unknown replacement fluid (likely saline) for up to 18 months—and that the agency’s leadership knew about it.

EMSPA spokesperson and NSWAS paramedic Grant Jennison is concerned that paramedics like himself may have unwittingly put patients at risk by administering inappropriate and possibly contaminated fluids. Those affected have been contacted and advised to get tested. 

Jennison says the tampering was able to continue for so long because the agency tried to deal with it internally and because of a longstanding problem with drug abuse by the service’s personnel coupled with the sheer availability of the drug. "The problem here is that fentanyl is supplied in such a large amount in a reusable bottle," says Jennison. "It comes 900 micrograms in a bottle, and patients usually only require 240 micrograms. It’s also one use annually, so you throw it away after using it. It’s easy to pop in your pocket and take it home." 

EMSPA is calling for all of the agency’s drug kits to be replaced with tamper-proof bottles. Jennison says they haven’t acquiesced but have rather distributed an internal document telling paramedics how to tell if a bottle has been tampered with. According to a NSWAS statement, the service is in talks with manufacturers to make the bottles tamper-proof. It also says fentanyl is being securely stored and checked twice a day. "[NSWAS] believes that the steps already taken have alleviated risk of contamination to the public," it goes on to say. But Jennison isn’t so sure, and until those bottles are replaced, neither are we.