Quality & Safety

Drug Diversion: Best Practices and Support for a Staff Assessment Process

Simran Ghuman

Katie Colleen A. Maletich

drug diversion, substance use disorder, culture of safety, case study, best practices
CJON 2020, 24(2), 195-198. DOI: 10.1188/20.CJON.195-198

The characteristics of opioid prescribing and administration in cancer centers include large quantities and less restrictive regulatory mandates governing cancer-related pain, which may increase the risk of drug diversion by staff members. The purpose of this article is to provide a framework for creating respectful investigative processes for staff suspected of drug diversion. Organizations, including cancer centers, need to engage in careful oversight of potential drug diversions while simultaneously promoting a psychologically safe work environment for individuals to successfully seek help.


  • Building an open, nonpunitive culture in cancer centers to address diversion investigation processes can assist staff to feel comfortable raising concerns about colleagues.
  • Fostering supportive processes and a culture of safety around drug diversion investigations can convey empathy from the organization related to an employee’s livelihood and well-being. 
  • Drug diversion prevention programs need to ensure patient safety within an authentic and supportive work environment for staff with alleged or established substance use disorders.
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