Opioid Seeking Behaviors and Diversion in Hospitalized Pediatric Patients: A Case Series

All nurses have a responsibility for monitoring their patients for signs of substance misuse or substance use disorder. Adolescents and young adults are at risk for substance use. Prescription medications may be used by adolescents for non-medical reasons such as to feel high, to assist with sleep, to avoid negative feelings or thoughts or to avoid withdrawal symptoms after chronic use. Some adolescents with legally prescribed medications have been asked to divert those medications by giving them to someone else. Drug diversion by employees is often reported in healthcare settings, but diversion of medications done by patients is far less commonly reported. This paper is a report of two patients with complex medical issues and chronic pain who diverted opioid medications while hospitalized. Hiring clinical staff, such as nurses, working in Drug Diversion Prevention positions will provide knowledge and expertise to facilitate investigations and to help reduce risks for diversion in healthcare settings. In addition, nurses with concerns about patient diversion should discuss these concerns with the care team. Organizational leaders need to support their teams by providing education and resources so staff feel comfortable addressing these challenging situations.