Drug Diversion Insights with Terri Vidals

What if coworkers are identifying drug diversion before the monitoring software does?

In this episode of Drug Diversion Insights, Kim Harris, Manager of Controlled Substance Stewardship, and Morgan Gray, Supervisor of Drug Diversion Prevention at Mercy, share how their health system built a centralized drug diversion prevention program supporting more than 50 hospitals.

Before 2019, individual Mercy hospitals managed diversion prevention independently. Today, an 11-person team supports controlled substance oversight across acute care and retail pharmacy operations.

Kim and Morgan explain how they built the program, secured executive support, and developed practical workflows to strengthen diversion detection, investigations, and accountability.

In this episode, we discuss:

• How Mercy built a system-wide drug diversion prevention program

• Why the team modeled its structure after the 340B program

• The important role pharmacy technicians play in diversion prevention

• Why coworkers may identify potential diversion before software does

• How Mercy manages daily unreconciled controlled substance transactions

• Using Epic secure chat to address missing documentation

• Why department leaders must take ownership of practice accountability

• When to address a discrepancy immediately versus monitor for patterns

• What a comprehensive drug diversion investigation involves

• Lessons from real investigations and opportunities to improve diversion prevention

• Where organizations with limited staffing and budgets should begin

One of the biggest takeaways is that technology alone cannot prevent drug diversion.

Effective programs combine diversion monitoring software, frontline awareness, trained professionals, consistent workflows, and leadership accountability.

This conversation offers practical insights for pharmacy leaders, drug diversion specialists, pharmacy technicians, nursing leaders, compliance professionals, medication safety teams, and healthcare executives looking to strengthen controlled substance monitoring and patient safety.

Whether you're starting a diversion prevention program or improving an established one, Mercy's experience provides valuable lessons in building a sustainable, organization-wide approach.

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When did your organization last proactively identify suspected controlled substance diversion—not hear about it, but actually find it?

In this solo episode of Drug Diversion Insights, Terri Vidals shares her Top 10 considerations for healthcare executives, compliance leaders, and others responsible for controlled substance diversion prevention.

The central message: drug diversion is an enterprise risk, not simply a pharmacy responsibility.

Terri examines the leadership decisions that can determine whether a diversion program succeeds or fails—from staffing and ownership to technology, investigations, accountability, and organizational culture.

In this episode:

• Why diversion prevention is an enterprise responsibility
• Why software can identify outliers but cannot replace an investigation
• What a quiet diversion program may actually be telling you
• Why detection should be fast, but investigations should be deliberate
• How clear SOPs create consistency and defensibility
• Why accountability must apply across disciplines
• How documentation and wasting practices can create risk
• Why leadership, staffing, and reporting structures matter
• What healthcare executives should expect from their diversion programs
• Why controlled substance diversion prevention should be viewed first as a patient safety program

This episode is designed especially for healthcare executives, compliance leaders, pharmacy and nursing leaders, risk professionals, medication safety teams, and diversion program leaders who want to evaluate whether their organization is truly prepared to identify and respond to controlled substance diversion.

Because the question isn't whether your organization has policies, software, and reports.

The question is whether your program can find the problem before the problem finds you.

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If substance use disorder is a disease that affects the brain, where does personal accountability fit?

In this episode of Drug Diversion Insights, Brad Schwartz, Director of Pharmacy Services at Avita Health System and President of the Board for the Pharmacists Rehabilitation Organization (PRO) in Ohio, returns to share his own story.

Brad takes us from his early career in pharmacy to the point when his relationship with substances changed—when something he thought he was managing began managing him.

He describes what substance use disorder felt like from the inside, including the experience of making decisions that conflicted with his values and professional identity. That opens a larger conversation about disease, choice, responsibility, and accountability.

Brad also shares what happened when concerns finally surfaced at work: who noticed, what the intervention was like, what he remembers feeling in that room, and what came next.

In this episode, we discuss:

• Brad’s personal experience with substance use disorder
• When substance use shifted from manageable to controlling
• What SUD felt like from his perspective
• Disease versus personal and professional accountability
• Recognizing warning signs in healthcare professionals
• What happened when colleagues intervened
• The emotions surrounding a workplace intervention
• Recovery and professional identity

Accountability, support, and second chances in healthcare

In our previous episode, Brad explained how PRO supports pharmacy professionals navigating substance use disorder and recovery. This conversation provides the personal story behind why that work means so much to him today.

A candid discussion about substance use disorder, intervention, accountability, recovery, and what it means to rebuild after everything changes.

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What happens when a pharmacist or pharmacy professional recognizes they need help with substance use disorder? Do they have to wait for an employer or licensing board to intervene—or can they seek support on their own terms?

In this episode of Drug Diversion Insights, I’m joined by Brad Schwartz, Director of Pharmacy Services at Avita Health System and President of the board of the Pharmacists Rehabilitation Organization (PRO), Ohio’s peer recovery network for pharmacy professionals.

Brad takes us inside the work of a pharmacist recovery network and explains how PRO supports pharmacy professionals facing substance use disorder and recovery.

We explore what happens when someone reaches out for help, who PRO serves, and how peer recovery support can fit alongside professional accountability, patient safety, and formal regulatory processes.

In this episode, we discuss:

• What the Pharmacists Rehabilitation Organization (PRO) is and who it serves
• How peer recovery networks support pharmacists and pharmacy professionals
• How a pharmacist can begin seeking help for substance use disorder
• Voluntary help-seeking and early intervention
• The relationship between recovery support and professional discipline
• How PRO operates alongside the Ohio Board of Pharmacy
• Why asking for help shouldn't have to begin with a crisis
• The challenges of supporting healthcare professionals through recovery
• The realities of walking alongside someone who is struggling
• The moments that make recovery-support work worthwhile
• How the pharmacy profession can create meaningful opportunities for recovery and second chances

Brad also shares how he first became involved with PRO and what the organization has meant to him personally.

But that's only the beginning of his story.

In an upcoming follow-up episode, Brad will share his own recovery journey in his own words, including the experiences that eventually brought him to the work he does today.

This conversation raises an important question for pharmacy and healthcare leaders: Do professionals experiencing substance use disorder know where they can turn for help before the situation reaches a disciplinary or patient safety crisis?

Recovery support and accountability don't have to be opposing ideas. Understanding the resources available to healthcare professionals can help create pathways that support recovery while recognizing the responsibilities that come with caring for patients.

Whether you're a pharmacist, pharmacy technician, pharmacy leader, drug diversion specialist, medication safety professional, compliance professional, healthcare executive, colleague, or family member, this episode offers a practical and hopeful look at substance use disorder, peer support, and recovery within the pharmacy profession.

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Drug diversion software can help identify risk, analyze patterns, and prioritize potential concerns—but technology alone doesn't create an effective diversion prevention program.

In this episode of Drug Diversion Insights, Gordon Watkins of Wolters Kluwer joins us to explore what actually makes a drug diversion program work and why people, process, and technology all need to be part of the strategy.

Drug diversion often receives significant attention after a case is discovered. The harder challenge is building the systems, processes, and organizational culture needed to identify potential problems earlier.

Gordon discusses what separates a comprehensive diversion program from one that simply exists on paper—and why purchasing sophisticated diversion software doesn't eliminate the need for experienced professionals to manage the program.

In this episode, we discuss:

• Why diversion software cannot operate effectively on its own
• The importance of people, process, and technology working together
• What can happen when organizations implement software and then reduce diversion program staffing
• How technology can help identify activity that warrants further investigation
• Why every alert still requires appropriate review and follow-up
• How organizations can govern their diversion technology
• How to confirm alerts are actually being worked
• What organizations should expect during the first month of implementation versus a mature program
• Why data quality is critical to effective diversion analytics
• How incomplete or inconsistent data feeds can affect monitoring
• What diversion technology needs from the organization to perform effectively
• Machine learning versus generative artificial intelligence
• How Sentri7 uses machine learning in drug diversion monitoring
• Why human judgment remains essential even as analytics become more sophisticated
• What diversion program leaders should continually re-examine as their programs evolve

We also address an increasingly important topic in healthcare technology: machine learning and artificial intelligence.

Gordon explains the distinction between the machine learning used within Sentri7 and the generative AI technologies that have become widely discussed in recent years. Understanding that difference can help healthcare leaders better evaluate what their diversion technology is actually doing—and what it still requires from the people using it.

Another major theme is governance.

Generating an alert is only the beginning. Someone still needs to review the information, understand the clinical and operational context, determine whether additional investigation is necessary, document the outcome, and ensure potential concerns don't disappear into a queue.

The same applies to data. Even sophisticated analytics depend on the quality and completeness of the information being provided.

Ultimately, this conversation reinforces an important principle for healthcare organizations:

Buying diversion software is not the same as building a diversion program.

Technology can make monitoring and investigations more efficient, but effective diversion prevention still depends on trained people, defined processes, reliable data, appropriate governance, and organizational support.

Whether your organization already uses diversion monitoring software—from Wolters Kluwer or another vendor—or is evaluating whether to implement it, this episode offers practical questions to bring back to your diversion team.

An important conversation for drug diversion specialists, pharmacists, pharmacy leaders, medication safety professionals, compliance teams, nursing leaders, risk management professionals, healthcare executives, controlled substance committees, and healthcare technology leaders responsible for strengthening medication oversight and protecting patients.

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Buprenorphine saves lives, yet it remains surrounded by myths, stigma, and misunderstanding. Is it simply replacing one opioid with another? What happens when a patient taking buprenorphine needs surgery or treatment for acute pain? And should a positive test for another substance mean treatment has failed?

In this episode of Drug Diversion Insights, Jef Bratberg, PharmD, FAPhA, Clinical Professor of Pharmacy Practice at the University of Rhode Island, joins us for an evidence-based conversation about buprenorphine, opioid use disorder (OUD), harm reduction, pain management, and recovery.

Jef shares his journey from infectious disease and critical care pharmacy into advocacy and policy work, and how that path led him to become a nationally recognized voice in harm reduction, naloxone access, and the treatment of opioid use disorder.

From there, we tackle some of the most persistent questions surrounding buprenorphine.

In this episode, we discuss:

• What buprenorphine is and its role in treating opioid use disorder
• Why the idea that buprenorphine simply “replaces one addiction with another” misses important clinical distinctions
• Dependence versus addiction
• Why stigma continues to limit access to medications for opioid use disorder (MOUD)
• Buprenorphine's role in recovery and harm reduction
• Why buprenorphine remains underused for pain management
• Managing acute pain in patients stabilized on buprenorphine
• What clinicians should consider when a patient taking buprenorphine needs surgery
• The use of additional opioid analgesics when clinically necessary
• Whether exposure to opioids for legitimate acute pain can affect recovery
• What a positive test for another substance should mean during treatment
• Why continued substance use doesn't automatically mean treatment has failed
• Naloxone access and overdose prevention
• The role pharmacists can play in improving access to evidence-based treatment

One particularly important part of the conversation focuses on hospitalization and pain management.

Patients receiving buprenorphine still experience surgery, injuries, and acute painful conditions. Clinicians therefore need a plan that addresses both adequate pain control and continuity of opioid use disorder treatment.

We also examine what happens when someone receiving treatment tests positive for another substance. Rather than treating a test result as the entire clinical picture, the conversation explores what that result can tell the care team and why continued engagement in treatment matters.

Ultimately, this episode is about moving beyond stigma and misconceptions toward a better understanding of a treatment that can play a critical role in reducing the harms associated with opioid use disorder.

Whether you're a pharmacist, physician, nurse, addiction medicine professional, pain management clinician, healthcare leader, person in recovery, or family member, this conversation offers a practical and compassionate look at what buprenorphine actually does—and the barriers that still prevent people from receiving effective care.

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A strong drug diversion program shouldn't just help you investigate what already happened. It should help you identify risk earlier and give your team the information needed to act.

In this episode of Drug Diversion Insights, Rick Couldry, Chief Pharmacy and Clinical Officer at Omnicell, and Jay Patel, Product Manager for Diversion Management, join us to explore how healthcare organizations can move from reactive diversion investigations toward a more proactive, connected approach to diversion management.

Drug diversion programs generate enormous amounts of data, but data alone doesn't create visibility. The challenge is connecting information across medication workflows, identifying meaningful patterns, and turning those patterns into actionable insights.

Rick and Jay discuss what changes when diversion management becomes part of a broader medication-management ecosystem rather than operating as another isolated point solution.

In this episode, we discuss:

• Why healthcare drug diversion remains difficult to detect proactively
• How connected medication data can strengthen diversion monitoring
• Turning diversion data into actionable insights
• The role of technology in supporting diversion investigations
• Why integration across medication-management workflows matters
• Omnicell's approach to Diversion Management
• How Diversion Management fits into Omnicell's broader medication-management strategy
• OmniSphere and the future of connected medication management

The conversation also looks at OmniSphere, Omnicell's cloud-native platform, and what a more connected medication-management environment could mean for diversion teams.

For healthcare organizations, the goal isn't simply to collect more data. It's to make that data more useful.

Can connected systems provide the visibility needed to recognize potential diversion patterns sooner? Can analytics help teams focus limited investigative resources on the activity that matters most? And how can technology become part of a comprehensive diversion strategy that brings together people, processes, governance, and data?

This episode is for pharmacy leaders, drug diversion specialists, medication safety professionals, compliance teams, nursing leaders, risk management professionals, healthcare executives, and health system technology leaders looking for ways to strengthen controlled substance oversight and move their diversion programs from reactive to proactive.

Drug Diversion Insights is presented by Rxpert Solutions, bringing together healthcare leaders and industry experts to examine the challenges, strategies, and technologies shaping drug diversion prevention and medication safety.

Cannabis laws are changing across the United States—but what should that mean for healthcare professionals working in safety-sensitive, patient-facing roles?

In this episode of Drug Diversion Insights, Abby Migliore, COO of the Intervention Project for Nurses (IPN), and Shannon Opie, CEO, return to tackle one of the most complicated issues facing healthcare organizations today: cannabis, THC testing, workplace policy, impairment, and patient safety.

Many healthcare facilities have strong drug diversion prevention and monitoring programs, yet cannabis is often treated differently. State laws vary widely, the federal regulatory landscape continues to evolve, and employers are left trying to determine how to create policies that are fair, defensible, and centered on safe patient care.

Then there's the testing problem.

Unlike alcohol, where testing can provide information about recent use and estimated alcohol concentration, a positive THC test does not necessarily establish whether a healthcare professional is impaired at that moment. THC metabolites may remain detectable after the impairing effects have passed, creating difficult questions for employers and monitoring programs.

In this episode, we discuss:

• Why cannabis presents a unique challenge for healthcare workplace policies
• Medical versus recreational cannabis use among healthcare professionals
• The changing state and federal landscape surrounding marijuana

• How cannabis differs from alcohol in safety-sensitive workplaces
• Whether healthcare facilities should maintain cannabis-free workplace policies

• How organizations can balance employee considerations with their responsibility to protect patients

The central issue isn't simply whether cannabis is legal.

It's whether healthcare organizations have established a clear standard for professionals whose work directly affects the safety of patients.

If an adverse event occurs and a healthcare professional subsequently tests positive for THC, determining whether cannabis contributed to the event may be difficult. But the absence of a clear policy can create uncertainty for everyone involved.

What standard should healthcare adopt when the law, science, testing technology, and patient safety expectations don't align neatly?

This episode doesn't pretend there is a simple answer. Instead, Abby and Shannon help unpack what we know, what we still don't know, and why healthcare organizations need to have this conversation before an incident forces them to.

An important discussion for nurses, pharmacists, physicians, healthcare executives, HR leaders, compliance professionals, employee health teams, risk managers, diversion specialists, and anyone responsible for workplace drug and impairment policies.

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Why do we so often wait until a nurse fails, an incident occurs, or patient safety is at risk before connecting someone with help?

In this episode of Drug Diversion Insights, Terri is joined by Abby Migliore and Shannon Opie of the Intervention Project for Nurses (IPN), Florida's alternative-to-discipline program for nurses with substance use disorders and other conditions that may affect safe practice.

A national survey found that 18% of registered nurses screened positive for a substance use problem, with approximately one-third of those screening positive for a substance use disorder. Those findings raise an important question: Are we doing enough to recognize and support healthcare professionals before a problem reaches a crisis point?

Abby and Shannon take us inside the alternative-to-discipline process and explain what structured recovery and return to nursing practice actually look like.

In this episode, we discuss:

• How alternative-to-discipline programs for nurses work
• What happens when a nurse enters IPN
• Evaluation, treatment, and ongoing recovery monitoring
• Drug and alcohol testing requirements and testing cadence
• Workplace restrictions during return to practice
• The role of supervised return-to-work plans
• What neurocognitive testing evaluates before a nurse returns to practice
• Medications for opioid use disorder in safety-sensitive healthcare roles
• The balance between workplace accommodation and patient safety
• Why healthcare organizations often wait for a “smoking gun” before intervening
• The opportunity to recognize problems and connect nurses with support earlier

Alternative-to-discipline doesn't mean eliminating accountability. It's about creating a structured pathway that supports recovery while keeping safe nursing practice and patient protection at the center.

This conversation is especially relevant for nurses, nurse leaders, healthcare executives, employee health professionals, diversion specialists, compliance teams, professional monitoring programs, and anyone interested in substance use disorder among healthcare professionals.

And there's more to come. Abby and Shannon will return for another conversation focused on cannabis in patient-facing healthcare roles, including the complicated question of cannabis-free workplace policies in states where cannabis is legal.

Follow Drug Diversion Insights so you don't miss Part 2.

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What happens when a pharmacy professional experiences a substance use disorder, enters recovery, and then returns to the same workplace—with the same colleagues and access to controlled substances?

In this episode of Drug Diversion Insights, we hear both sides of that experience.

One guest shares what it was like to return to pharmacy practice after substance use disorder and rebuild trust with colleagues. The other shares the perspective of the pharmacy leader responsible for maintaining the safeguards, accountability, and support needed to make that return safe for employees and patients alike.

Together, they tackle a difficult question healthcare organizations often avoid: Can a healthcare professional in recovery safely return to a role with access to controlled substances?

We discuss:

• What returning to pharmacy practice after substance use disorder really looks like
• The challenges of rebuilding trust with coworkers
• Accountability measures and safeguards that support a safe return to practice
• How pharmacy leaders can support recovery without compromising patient safety
• The role of state pharmacy recovery and professional monitoring programs
• Why transparency about recovery can be a strength
• How stigma can discourage healthcare professionals from seeking help
• Why open conversations about substance use disorder can strengthen workplace culture
• Whether having a professional in recovery on the team can actually increase awareness and accountability around controlled substances

Supporting recovery and protecting patients don't have to be opposing goals.

With appropriate monitoring, clear expectations, accountability, and a workplace willing to have honest conversations about substance use disorder, healthcare professionals can be supported while patient and medication safety remain the priority.

This episode is for pharmacists, pharmacy technicians, pharmacy leaders, diversion specialists, compliance professionals, healthcare executives, and anyone interested in creating a safer and more supportive approach to substance use disorder in healthcare.

Sometimes the safest pharmacy isn't the one where substance use disorder is never discussed. It's the one where people feel safe enough to talk about it.

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