Reports of narcotic diversion by EMS providers surface with sobering regularity. I don’t believe that rescuers suffer from dependency behavior any more than the rest of the population, but what we do have is ready access to controlled substances.
That situation makes it very difficult to resist the temptation for someone seeking drugs. While it is ultimately the responsibility of the provider to stay clear of the wrong path, EMS organizations have a responsibility to secure such medications beyond a simple lock box and paperwork.
Drug dependency is both a physical and psychological condition. While some argue that stealing narcotics is a choice, research would indicate that it may be much less voluntary than it might seem. For an EMS provider who is injured on the job, prescribed pain medications, and is predisposed to dependent behavior, it’s a sure fire recipe for great risk.
Certainly this happens in other parts of the health care industry; yet EMS gets demonized because of the high regard the public has for its service. Given lax controls services often have around controlled substances, we have a perfect environment for what appears in mainstream media.
Getting fired or losing a licensure is not the solution either. It might look great in the paper, but it does nothing to help the provider. Yes, there needs to be progressive discipline, alongside appropriate assistance. But we have to stop terminating people on the spot for a medical condition.
Finally – we are professionals trained to recognize addiction behavior in patients. Use that experience to help our colleagues and friends. It’s the least we can do.
