Over 2,000 doses of opiates were stolen from Vancouver General Hospital by staff last year, according to documents obtained through a freedom of information request.
Over 1,600 tabs and 853 millilitres of hydromorphone were reported stolen from the hospital in two unrelated incidents last January.
“The diversion or misuse of narcotics is rare,” spokesperson Matt Kieltyka explained in an email to Postmedia. “Vancouver Coastal Health takes this issue seriously and has several systems in place to ensure narcotics are dispensed and accounted for as prescribed.”
Kieltyka said staff were involved in both instances, but he was not able to give details on what disciplinary measures were taken.
Such theft, known as “drug diversion,” has been a rising concern in recent years.
Data from Health Canada shows 13,221 doses of opioids were reported stolen from medical facilities in 2018.
Over 3,200 of those were in B.C., which is more than any other province except Ontario, where over 9,700 were taken.
Theft of hydromorphone, which is sometimes sold under the name Dilaudid, jumped sharply in B.C. between 2017 and 2018, according to Health Canada data, with 3,211 units stolen in 2018 compared to just 12 the year before.
Mark Fan, a researcher at North York General Hospital who studies drug diversion, said data on stolen drugs is likely incomplete and that rates of diversion as “probably underestimated.”
“At any point in the medication use process, it’s possible for it to be transferred away from legitimate use,” said Fan.
He said diversion usually occurs when a staff member manipulates documentation or falsifies prescriptions to over-order medication. They also may physically steal the substances.
In such cases, the theft may not be discovered until an audit is conducted.
Drug diversion made headlines in 2015 after a VGH aide overdosed on stolen opiates. Since then, Vancouver Coastal Health and the Provincial Health Services Authority have adopted measures that Kieltyka said include “dispensing machines, vaults, locked cabinets and security cameras.”
The authority says they have also piloted use of “containers that contain a solution that renders the drugs unusable” at two units within Vancouver Coastal Health and may implement them province-wide.
Const. Steve Addision with the Vancouver Police Department says hydromorphone is fairly common in the city’s illicit drug market, and that a 2-mg pill usually sells for around $10.
But the major driver of diversion is addiction.
Dr. Shimi Kang, an addictions psychiatrist who has worked with hospital staff involved in drug diversion, said workplace stress and access to potent opioids creates a “perfect storm” for substance use.
“We have to recognize that healthcare practitioners are human too,” she said.
She said nurses often face high levels of stress and violence in the workplace and that adequate sleep, time off and support are the best ways to prevent addiction.
“We get so caught up in being the healer that we forget to heal ourselves,” said Kang.
Dr. Mark Haden, a professor at the UBC School of Population and Public Health and a supervisor with the B.C. Centre on Substance Use, said it shows the indiscriminate nature of addiction.
“Being employed by the system does not protect one from addiction,” he said.
Hydromorphone is sometimes used in opiate-replacement therapy as a substitute for stronger street-level drugs. Last month, Canada became the first country in the world to approve use of injectable hydromorphone in treating opioid use disorder.
Haden said making the drug legally accessible could prevent thefts — and deaths.
“If hospital staff who are also addicted to opiates had (open) access to them, they wouldn’t steal them,” he said. “I think the solution to the fentanyl crisis and people stealing from hospitals is the same.”