Drug Diversion Insights with Terri Vidals

What exactly counts as a "significant loss" of controlled substances? It's one of the most common questions in diversion prevention—and one the DEA intentionally leaves unanswered. That ambiguity can make reporting decisions difficult, especially for large healthcare systems with multiple facilities. In this episode of Drug Diversion Insights , Terri is joined by Calvin Parmiter , Sy...

What really happens during a DEA inspection? In this episode of Drug Diversion Insights , Terri sits down with Brennan Luke , Regulatory and Controlled Substance Pharmacy Manager at ECU Health, to discuss what he learned after building a drug diversion prevention program from the ground up—and leading it through three DEA cyclic inspections . Drawing from firsthand experience, Brennan shares pract...

Drug diversion is a global challenge, but not every country approaches it the same way. In this episode of Drug Diversion Insights , Terri welcomes Mark Jackson , whose work in the United Kingdom is roughly equivalent to the FDA's Office of Criminal Investigations in the United States. Together, they explore the similarities and differences between how the UK and US regulate controlled substan...

Think you need diversion analytics software to identify diversion risk? Think again. In this Quick Take on Diversion Insights , Terri shares a practical, structured approach to diversion monitoring using reports that most healthcare organizations already have access to through their Automated Dispensing Machines (ADMs). The key isn't more software—it's more direction. In this episode, you&...

How can healthcare organizations better support professionals in recovery—and help them seek assistance before substance use disorder impacts their lives, patients, or careers? In this episode of Drug Diversion Insights , Terri is joined by Kristin Waite-Labott and Dr. April Lenzmeier to discuss a powerful new resource designed to help healthcare organizations establish and strengthen peer support...

Most diversion analytics platforms are built to monitor controlled substance activity. That's where the regulatory focus is, and that's where most dashboards direct attention. But what if an important diversion risk is hiding in a place few people review? In this Quick Take on Diversion Insights , Terri explores the often-overlooked world of cancel transactions and why they can represent a...

What if the most effective way to fight the addiction crisis starts long before overdose—at the point of the very first prescription? In this episode of Drug Diversion Insights , Terri sits down with Dr. Paul Lynch , anesthesiologist, co-founder and CEO of US Pain Care, and founder of the Treat ’Em When You Meet ’Em Foundation, to discuss a different approach to chronic pain and addiction preventi...

What happens when the person diverting drugs in the OR is someone you trust completely—a colleague, a mentor, a friend standing right beside you at the table? In this episode of Drug Diversion Insights , Terri sits down with Carol Davis, CRNA Emeritus , to discuss the real-world impact of diversion from the perspective of someone who lived through it firsthand. Carol never diverted herself, but sh...

The most sophisticated diversion monitoring tools are only as effective as the culture surrounding them. In this Diversion Insights Quick Take , we explore why staff engagement is one of the most important—and most overlooked—components of diversion prevention. When healthcare professionals view diversion mitigation as a program designed to protect patients and support colleagues, rather than simp...

What happens when addiction is hidden within a high-trust profession? In this episode of Drug Diversion Insights , pharmacist Steve Leuck shares his personal journey through cocaine and opioid addiction while continuing to practice in healthcare. For years, he navigated systems designed to protect patients—while quietly struggling behind the scenes. This conversation offers an honest look at how s...

You don’t need expensive surveillance software to start identifying diversion risk. In this Diversion Insights Quick Take , we explore how manual auditing using ADM data can be a practical and effective way to detect early warning signs—without relying on advanced technology. This episode focuses on simple, actionable strategies that any organization can implement to strengthen accountability and...

Are anesthesia discrepancies just documentation issues—or signals of deeper risk? In this episode of Drug Diversion Insights , Terri sits down with Dr. Jenny Dolan , Division Chief of Pediatric Anesthesia and Director of Trauma Anesthesia at Johns Hopkins All Children’s Hospital, to discuss how her team challenged the status quo—and achieved measurable change. Starting with 42 discrepancies per mo...

Controlled substance waste is one of the most vulnerable points in the medication-use process—and one of the most common gaps in diversion prevention programs. In this Diversion Insights Quick Take , we explore why delayed wasting and inconsistent witnessing create opportunities for tampering and introduce uncertainty during audits. When waste processes aren’t standardized and immediate, they can...

In this episode of Drug Diversion Insights , Terri sits down with Dr. Don Teater , a leading expert in pain management and addiction medicine, for a deeper exploration of buprenorphine —through both a clinical and neuroscience lens. Together, they unpack what happens in the brain after opioid exposure and how those changes shape treatment decisions for patients with and without substance use disor...

Controlled substance drips and PCA infusions present unique challenges when it comes to maintaining a clear chain of custody. One of the most overlooked vulnerabilities occurs during handoffs —when responsibility for these medications transfers between nurses or departments. In this Diversion Insights Quick Take , we examine why consistent handoff practices are essential for both patient safety an...

Few medications in addiction treatment generate as much debate as buprenorphine . After receiving significant listener feedback describing difficult experiences with this medication—particularly around discontinuation—Terri sits down with returning guest Dr. Stuart Gitlow for a candid, science-based discussion about one of the most widely used treatments for opioid use disorder. In this episode, w...

When poor medication administration practices become routine, they create noise—noise that makes it nearly impossible to identify true drug diversion. Shortcuts, workarounds, and inconsistent documentation don’t just weaken compliance; they undermine safety and accountability. In this Diversion Insights Quick Take from Rxpert Solutions , we break down why strong medication administration fundament...

Drug diversion investigations in healthcare are among the most sensitive interviews an investigator can conduct. When handled poorly, these interviews can fail to uncover the truth—and permanently damage an innocent professional’s career. In this episode of Rxpert Solutions , I’m joined by Dave Thompson , former head of diversion investigations for a large retail pharmacy chain and current Preside...

Should a nurse or a pharmacist lead a drug diversion program? It’s a question that comes up often—and one that misses the bigger point. In this episode of Rxpert Solutions , we explore what truly matters in diversion program leadership beyond professional titles and credentials. The conversation was sparked by a real moment: a highly experienced diversion specialist questioning whether her nursing...

Propofol may not be federally classified as a controlled substance—but that doesn’t mean it’s low risk. In this Diversion Insights Quick Take from Rxpert Solutions , we explore why propofol remains one of the most challenging medications from a diversion prevention and security perspective. Despite its non-controlled status, propofol presents serious vulnerabilities related to storage, access, and...

Propofol is one of the most vulnerable medications for diversion in healthcare — not because it lacks abuse potential, but because it lacks the regulatory oversight applied to controlled substances. In this episode of Rxpert Solutions , I’m joined by Michael T. Ring and Dale M. Pfrimmer to discuss their Mayo Clinic quality-improvement study published in Critical Care Nurse : “Propofol as a Drug of...

Controlled substance waste doesn’t just impact budgets — it creates a significant and measurable burden on pharmacy teams , workflows, and staffing capacity. In this episode of Rxpert Solutions , we welcome back John Hertig and Les Louden to discuss their newest study: “Assessing Pharmacy Costs of Intravenous Push Controlled Substance Waste in Hospital-Based Areas: A Multi-Site Study” Published in...

Anticipatory compounding of controlled substances may seem like a simple operational efficiency—but it sits in a tricky regulatory space where FDA and DEA expectations don’t always align. In this Quick Take from Rxpert Solutions , we break down what hospital pharmacies need to know to stay compliant while maintaining safe and efficient sterile compounding practices. You’ll learn: - How FDA and DEA...

What if the key to preventing drug diversion isn’t more policies—but more trust ? In this episode of Rxpert Solutions , I talk with Shealee Mitchell, M.Jur., BSN, RN , a diversion specialist who’s transforming how healthcare organizations approach drug diversion prevention through a relationship-first model . With experience as a pharmacy tech, nurse, and Chief Experience Officer, Shealee explains...

Before launching your diversion monitoring software, it’s crucial to make sure the foundation is strong. In this episode of Rxpert Solutions , I’m joined by Stacy Hershman , a former diversion analyst with experience across multiple healthcare specialties, who shares her unique insights on what truly makes diversion monitoring effective . We discuss: - Why groundwork matters more than technology -...