Experiencing an internal or external theft or significant loss of controlled substances from your practice can elicit all types of emotions; from anger, to fear to betrayal. It’s hard to imagine how you can find the time or resources to deal with a controlled substance issue, when you must manage your practice, see patients, perform surgery and deal with HR issues all day long.
Unfortunately, veterinary practices can be easy targets for theft, loss or diversion of controlled substances. A national survey conducted by drugabuse.com in 2015, showed that 22.1% of drug theft is caused by employee pilferage, 6.2% is caused by armed robbery and 2.2% is caused by customer theft. We must remember that drug addiction has no societal or monetary boundaries and can affect any employee or client in your office today.

The Centers for Disease Control and Prevention states “Drug overdose deaths continue to increase in the United States. From 1999 to 2017, more than 700,000 people have died from a drug overdose. Around 68% of the more than 70,200 drug overdose deaths in 2017 involved an opioid. In 2017, the number of overdose deaths involving opioids (including prescription opioids and illegal opioids like heroin and illicitly manufactured fentanyl) was 6 times higher than in 1999. On average, 130 Americans die every day from an opioid overdose”. An article published by AAHA.net in 2013 stated that “over one-half of AAHA members surveyed said they have worked with a veterinary professional that had an addiction problem”.

Unfortunately, just being aware of the problem won’t help you during an actual theft or substantial loss, you must be prepared to take action, as there are various timelines you must meet to stay compliant with state and federal regulations. Therefore, I have complied an actionable checklist that can help you minimize your risk and protect your practice now and in the future.

How Do I Know If It’s A Theft Or A Significant Loss?

A break-in or robbery is easier to recognize but determining if you have experienced a significant loss can be more difficult to identify. The DEA provides us some critical variables to consider when determining if you have experienced a significant loss. Regulations can be found below and in 21 C.F.R. § 1301.74(c).

(1) “The actual quantity of controlled substances lost in relation to the type of business;
(2) The specific controlled substances lost;
(3) Whether the loss of the controlled substances can be associated with access to those controlled substances by specific individuals, or whether the loss can be attributed to unique activities that may take place involving the controlled substances;
(4) A pattern of losses over a specific time period, whether the losses appear to be random, and the results of efforts taken to resolve the losses; and, if known,
(5) Whether the specific controlled substances are likely candidates for diversion;
(6) Local trends and other indicators of the diversion potential of the missing controlled substance”.

The “DEA recognizes that there is no single objective standard that can be applied to all registrants–what constitutes a significant loss for one registrant may be construed as comparatively insignificant for another. The DEA strongly encourages registrants to use additional factors beyond what DEA suggests evaluating whether your loss is significant”.

The DEA goes on to say that the “registrant shall design and operate a system to disclose to the registrant suspicious orders of controlled substances. The registrant shall inform the Field Division Office of the Administration in his area of suspicious orders when discovered by the registrant. Suspicious orders include orders of unusual size, orders deviating substantially from a normal pattern, and orders of unusual frequency.” Therefore, best practice would strongly suggest keeping a very tight ordering & receiving system, accurate closed and open logs, daily current counts and a discrepancy log. To save time, increase security and reduce your risk, I would strongly suggest using an electronic recordkeeping system, such as a CUBEX to help you prevent theft and determine if your drug loss was significant.

How To Report A Theft Or Significant Loss Of Your Controlled Substances

  1. Call the police immediately to report the theft or loss. Be sure to have as much detailed information as you can for the police officer and the DEA. This includes date, time, location, suspect ID, substances and amounts lost, witnesses, etc.
  2. You have one business day to call your local DEA Field Division Office to report your theft or loss.
  3. The registrant must also complete and submit to the local Field Division Office in his or her area, DEA Form 106 regarding the theft or loss. Thefts and significant losses must be reported whether or not the controlled substances are subsequently recovered, or the responsible parties are identified, and action taken against them. Access the DEO Form 106 here.
  4. Some states require that at you notify your Veterinary Board of the theft or significant loss. Check to see if you are one of those states.
  5. Call your business insurance and/or your professional liability insurance agents to report your loss.
  6. Keep a copy of the police report, your DEA Form 106 and any other supporting documents filed, you may need them later.
  7. Educate your staff about the theft or loss, as failure to do so may cause unnecessary fear and gossip throughout your hospital. Ask your staff if they have any details about the theft or significant loss. But do not mention any details of the theft to your staff, as you do not want to compromise the integrity of the ongoing investigation. Be sure and let your staff know that you will be pressing charges to the furthest extent of the law when the intruder has been identified. This very important comment will let your staff know that you will not tolerate an internal or external theft or significant loss of any kind.
  8. If you suspect that your employee has stolen or caused a significant loss of your controlled substances immediately contact your lawyer, HR consultant and/or your EAP (Employee Assistance Program) professional.
  9. If you catch an employee in the act of stealing, causing a significant loss or diverting your controlled substances, call the police immediately and fire that employee as the police officer escorts the employee out the door. Don’t forget to document the entire event in complete detail and place that information in the employee’s file for future use. Additionally, if an employee is fired for egregious and provable reasons, most unemployment offices will not allow that employee receive unemployment benefits.

Quick Prevention Tips

1. Form a Safety Committee

Get your staff involved by forming a safety committee. Have them help you plan and execute a quick and easy safety plan to keep everybody safe. They need to know how to act, and what to do in case an intruder/active shooter enters the building while they are working. An active and well-rehearsed safety plan with identified safe rooms and a fast escape route will make everybody feel much safer.

2. Contact the Police

Most local police departments have education officers that will gladly come out and walk through your building with you to help you understand where your potential areas of risk may be. This is usually at no charge.

3. Use Local Resources

Have that same police officer talk with your staff at your next staff meeting. He/she can describe in detail what they can do to protect themselves if an intruder or active shooter enters your building in the future. From previous experience, this in-service was one of the most well-received staff meetings I held.

4. Perform Background Checks

Perform background checks on all current and future employees.

In Conclusion

These quick and easy prevention tips can give both you and your staff a feeling of well-deserved security in the event of an unfortunate incident in the future.

If you have any further questions, please feel free to contact me at jwoods@cubex.com and/or come back to this website frequently for helpful information, blogs, webinars and live speaking dates in your area.