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It’s ‘just too easy’ for doctors to steal. That’s why opioids are vanishing by the fistful in B.C.’s Lower Mainland

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He just needed a little relief.

A decade ago, Michael was one of only three doctors on call in a remote community hospital in British Columbia. As a result, he had to be available pretty much all the time.

The vast majority of narcotics that have gone missing in recent years from Lower Mainland hospitals are attributed to three incidents in 2017 and 2018 at Vancouver General Hospital, where staff were found diverting opioids for years.
The vast majority of narcotics that have gone missing in recent years from Lower Mainland hospitals are attributed to three incidents in 2017 and 2018 at Vancouver General Hospital, where staff were found diverting opioids for years.  (Illustration by Perrin Grauer)

“It was a small hospital, but it wouldn’t take much to make you busy,” Michael explained.

“If just one person came in with a stab wound requiring a chest drain and a hemothorax, that would make you busy. … One suicide attempt requiring (a patient) to go on the ventilator, that means you’re busy all night because there’s not a lot of other staff to help.”

At the same time, Michael’s marriage was beginning to fracture. Feeling he had little support to lean on, he started looking for a reprieve from the stress.

“I started taking capsules of various opiates that patients had given me over years and I had them just lying in my office,” Michael said. “I used them to sometimes give out to patients if they couldn’t afford them.”

Read more: ‘I was an impaired nurse’: Three nurses who battled addiction welcome dramatic shift in approach to discipline and treatment

The drugs that were prescribed for patients but never taken — or drugs returned to him by family members of patients who died — should have been accounted for and destroyed with witnesses, as required by the Controlled Drugs and Substances Act. Instead, they were “diverted,” the term used by the medical community to describe theft of narcotics for personal use.

“It was just too easy,” Michael said. “They were just sitting in the cupboard.”

The doctor’s real name is not being used to protect him from potential legal trouble. The Star verified his standing with the B.C. College of Physicians, which lists his medical licence as temporarily inactive; he is now in his second attempt at recovery.

“It started foolishly,” said Michael. “I promised myself I wouldn’t become addicted, but I did.”

Michael’s past shows how easy it can be for a medical professional to become addicted — but also how easy it is to steal controlled narcotics without getting caught. No one would miss a couple of pills, he thought, and he was right.

More than three years after a Vancouver General Hospital aid died of an overdose, resulting in government promises to crack down on the theft of narcotics from hospitals, Health Canada documents obtained by the Star show the problem of missing drugs persists across the Lower Mainland.

Between 2015 and April 2018, the Health Canada documents show hospitals in the region reported more than 7,800 units of various narcotics missing.

Answers are few and far between — prosecutions even more so.

Most disappearances, nearly 85 per cent of the incidents on record, were categorized as “unexplained.” Of the few cases labelled “pilferage,” or staff theft, not one has been reported to police. In fact, only four per cent of all the drug disappearances were ever reported to law enforcement.

The vast majority of the missing units — about 5,000 — are attributed to three incidents in 2017 and 2018 at Vancouver General Hospital, where staff were found to have been stealing opioids for years.

Much of the rest came from St. Paul’s Hospital, where 600 vials of hydromorphone were “lost in transit” in 2015, and the Pharmacy Distribution Centre, where about 900 missing hydromorphone tablets were recorded as a tabulation error in 2017.

The figures, encompassing a jumble of different drugs, obscure the scale of the losses. When converted into a rough measurement called “milligrams of morphine equivalent” — a benchmark used to assess potency when patients are prescribed multiple drugs at once — those five cases at Vancouver General, St. Paul’s Hospital and the Pharmacy Distribution Centre represent a loss of 71,137 milligrams of morphine. That’s equivalent to 15,800 Tylenol 3 tablets or enough morphine to knock out 49 horses.

As shocking as the numbers are, pain-management expert Dr. Owen Williamson says they likely represent only a sliver of all the drugs that actually go missing.

“They may be the tip of the iceberg,” said Williamson, president of the Pain Medicine Physicians of B.C. Society. “There are just so many ways people can divert that stuff.”

Health Canada records won’t reflect how much is actually going missing, he said, because of the way drugs are tracked. Most tracking systems assume that drugs dispensed for a particular patient are actually received by that patient. That isn’t always the case.

In operating rooms, Williamson explained, it can be easy for staff to draw more liquid narcotic than necessary, swap it into a second syringe and take it home. He’s also seen cases of staff at nursing homes dispensing used fentanyl patches to patients and keeping the fresh ones for themselves.

“Wherever you have opioids, you’ll have people who are inventive at diverting it,” he said.

Kerri O’Keefe was one of those people. The 36-year-old hospital aid died in August 2015 after injecting an anesthesia drug she stole from Vancouver General — the end of a long pattern of theft.

As reported in the Vancouver Sun, which covered the case, the Ministry of Health responded by directing health authorities across B.C. to improve the security and tracking of pharmaceuticals.

In 2017, the provincial government announced $5 million in additional funding for the B.C. Centre on Substance Use for research on addictions care. Part of that funding went toward new hospital training and monitoring programs for drugs at risk of theft.

It’s unclear what effect these changes may have had, as acts of pilferage are rarely recorded as such.

The Health Canada records contain more than 250 cases, accounting for all of the drugs known to be missing from B.C.’s Lower Mainland. Only 12 of those cases were officially reported as pilferage.

In one case, a Ridge Meadows Hospital nurse in Maple Ridge found a box of morphine vials that had its bottom cut open. The vials had been emptied, and the package was resealed and stashed on a shelf behind other similar packages. The official cause was “unexplained.”

At Chilliwack General Hospital, nursing staff found a vial of fentanyl with a needle hole in the rubber plug. Though this was considered a “potential diversion situation,” it was recorded as “unexplained.”

Surrey Memorial Hospital experienced “multiple losses” of hydromorphone, oxycodone and morphine from the in-patient medical unit over the course of 18 days. All “unexplained.”

Each Health Canada record includes a section detailing steps the hospital plans to take to prevent future losses. Some of the losses resulted in changes to security procedures, like requiring double signatures on paperwork, changing locks, installing security cameras or switching to more secure automated dispensing machines.

At Langley Memorial Hospital, for example, a nurse was removed from the workplace after admitting to repeatedly slicing open blister packs of hydromorphone, stealing the drugs and replacing the capsules with an unknown substance.

Between 2015 and April 2018, hospitals in the Lower Mainland reported more than 7,800 units of various narcotics went missing.
Between 2015 and April 2018, hospitals in the Lower Mainland reported more than 7,800 units of various narcotics went missing.  (Illustration by Perrin Grauer)

However, just as many of the records do not spell out significant changes to security practices. Often the plan is for staff to be more vigilant.

An opioid diversion expert who reviewed the documents says important precautions that could prevent these thefts aren’t being followed, in large part because the losses are being misclassified as “unexplained.”

“It’s insane,” says John Burke, president of the U.S.-based International Health Facility Diversion Association. “Almost all of these indicated diversion … It’s horrific, in my opinion.”

After a career in policing, including a decade running the Cincinnati Police Department’s Pharmaceutical Diversion Squad, Burke retired and founded Pharmaceutical Diversion Education Inc., which provides education and consulting work on drug diversion for hospitals, law enforcement and the pharmaceutical industry.

Shown a copy of the Health Canada data, Burke said it’s clear to him the majority of these cases are not accounting errors or simple discrepancies.

“Guess what? Somebody’s stealing,” Burke said.

“Somebody diverting in this scenario, this is a smorgasbord for them. They’re going to realize that as long as they don’t get caught in the act, they’re probably going to be OK.”

In a statement, Health Canada said it collects these reports from all pharmacies across the country, including from private businesses and public hospitals. The department “evaluates reports on an aggregate basis to identify trends and identify patterns of diversion.”

For example: “This could include an assessment of which products are being reported as lost or stolen, in what frequency, and if there are geographic differences in reported diversion.”

If Health Canada detects a worrying trend, it may work with hospitals to determine the root cause. It does not conduct investigations and leaves the decision to report to police to individual hospitals.

But Michael’s case, which took place outside the Lower Mainland, illustrates a problem with this approach. The narcotics he diverted would never show up in Health Canada data because they were never recorded as a loss.

“They would not have been reported missing because they would have already been dispensed to a patient,” Michael explained.

Burke said that, based on his research in the U.S., those doing the thieving are careful to cover their tracks.

Some hospital patients will be given prescriptions for painkillers on an as-needed basis, like with morphine, for example. If a patient is in pain, they can request another dose that a nurse can administer without needing to go back to a doctor for a new prescription.

“So a nurse could go in and document that they gave a patient a shot (of morphine) when they really didn’t,” Burke explained.

“Or they can do what we call splitting a shot — giving half to the patient and half to themselves … None of those are going to show up (in the data) because they’re going to make it look like everything is kosher.”

Michael said he wasn’t anywhere near that devious. He said he never lied to his colleagues about his opioid use; he just wasn’t upfront about it.

As he began to realize he was addicted, he considered confiding in his colleagues — but doing so would have required them to report him to the B.C. College of Physicians or be put in legal jeopardy for keeping his secret.

Eventually, keeping that secret himself became too much.

“I needed to get some help,” Michael said. “It was getting to the point where things were just … it didn’t feel good. I used to dream about it. I felt terribly guilty. I just needed that monkey off my back.”

In 2011, he turned himself in to the college, which he said immediately suspended his licence and launched an investigation into whether his patients’ care had been compromised.

Michael said his opioid use was relatively light — a capsule in the morning and again in the evening — and that the college’s investigation found his patients had never been put at risk. The college itself would not comment on Michael’s case nor its investigation, citing privacy concerns.

But aside from protecting his patients, Michael said the college also protected him from himself, insisting he get a lawyer and connecting him with addictions treatment and supports. He went on leave, got into recovery and began working the Narcotics Anonymous steps, all with the backing of the college.

Michael's story also shows how easy it can be for a medical professional to become addicted. Statistics Canada says opioid addiction has killed more than 9,000 Canadians in the past three years.
Michael’s story also shows how easy it can be for a medical professional to become addicted. Statistics Canada says opioid addiction has killed more than 9,000 Canadians in the past three years.  (Illustration by Perrin Grauer)

Michael said his case was never reported to the police.

Burke said that in the U.S. some hospitals actually have armed law-enforcement members as part of special opioid diversion teams. As he sees it, every instance of narcotics being stolen is a crime that should be reported to police.

But Michael questions that approach and the criminalization of addiction overall. Statistics Canada says opioid addiction has killed more than 9,000 Canadians in the past three years. For people like him, it is hard enough to come forward and seek treatment even without the threat of prosecution hanging above their heads.

The B.C. College of Physicians agrees.

“Most likely, if the college was made aware of a physician stealing narcotics for personal use, it would consider it a health matter rather than a disciplinary matter,” Susan Prins, director of communications, wrote in an emailed statement.

If a physician fails to comply with a treatment and monitoring plan laid out by the college, their status would remain “temporarily inactive,” Prins said. If they ultimately refused altogether, they would be considered for disciplinary charges and could ultimately lose their medical licence, though Prins said that has never happened in the history of the college.

“If the situation involves a theft, the decision to report to the police would be up to the victim of the theft, e.g. the clinic or health authority,” Prins wrote.

Records show that Vancouver Coastal Health (VCH), the health authority that reported the greatest losses, chose not to report any of the cases to the police — except one obvious smash-and-grab job not perpetrated by staff.

Stacy Sprague is the director of employee wellness for VCH. She said her organization takes roughly the same approach as the College of Physicians, preferring intervention over criminalization.

“We really do care about folks who are struggling with this,” Sprague said. “If people are diverting (narcotics), obviously there’s a lot going on there.”

Sprague said VCH uses a “health-care focused” program specially designed for working with people who are used to being caregivers, not someone in need of care.

That type of approach is what helped Michael. Recognizing it was OK to be both a doctor and a patient at the same time was difficult, he said, in part because society tends to put medical professionals on a pedestal.

“Anybody can fall victim to this,” he said. “There is no immunity. People who are addicted come from all walks of life. Physicians are the same as anybody else.”

Jesse Winter is an investigative reporter based in Vancouver. Follow him on Twitter: @jwints



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These US entities partnered with the Wuhan Institute of Virology — time for a criminal investigation?

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(Natural News) The Wuhan Institute of Virology from which the Wuhan coronavirus (COVID-19) is believed to have “escaped” has a number of questionable partnerships that are worth looking into in light of the pandemic.

Most of them are universities, including the University of Alabama, the University of North Texas, and Harvard University. There is also the EcoHealth Alliance, the National Institutes of Health (NIH), and the National Wildlife Federation.

While the relationships between these entities and the Wuhan Institute of Virology may be completely innocent, there is no way to really say for sure without a proper investigation. And this is exactly what Secretary of State Mike Pompeo is calling for, as is the nation of Australia.

Pompeo and the folks down under, along with millions of Americans, would really like to know the true origins of the Wuhan coronavirus (COVID-19). An increasing number of people simply are not buying the narrative that the novel virus originated in bat soup at a Chinese wet market, and this even includes mainstream media outlets like Fox News.

The only way to really determine what was going on at the Wuhan Institute of Virology, and who else might have been involved. is to open the place up for an international investigation. But communist China is against this, of course, accusing Australia of “petty tricks” and collusion with the United States.

“Overnight, I saw comments from the Chinese Foreign Ministry talking about a course of activity with respect to Australia who had the temerity to ask for investigation,” Pompeo is quoted as saying in response to China’s aggression against a proposed investigation.

“Who in the world wouldn’t want an investigation of how this happened to the world?” he added.

As the U.S. aims to get back on track economically speaking, Pompeo believes that now is the time to hold communist China, the Wuhan Institute of Virology, and whoever else may have been involved accountable for unleashing this pandemic on the world.

“Not only American wealth, but the global economy’s devastation as a result of this virus,” Pompeo further stated. “There will be a time for this. We will get that timing right.”

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New U.S. analysis finds that lab in Wuhan, China was “most likely” origin of coronavirus release

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(Natural News) While American Leftists and most of the Democrat Party continue to serve as apologists for the Chinese Communist regime over its role in creating and then perpetuating the coronavirus pandemic, a new U.S. government analysis concludes that COVID-19 “most likely” escaped from a lab near Wuhan city.

The Washington Times reports that the analysis cataloged evidence linking the outbreak to the Wuhan lab and has found that other explanations for the origins of the virus are not as credible.

The paper reported:

The document, compiled from open sources and not a finished product, says there is no smoking gun to blame the virus on either the Wuhan Institute of Virology or the Wuhan branch of the Chinese Center for Disease Control and Prevention, both located in the city where the first outbreaks were reported.

However, “there is circumstantial evidence to suggest such may be the case,” the paper says.

“All other possible places of the virus’ origin have been proven to be highly unlikely,” said the report, a copy of which was obtained by the Times.

ChiCom officials have claimed that the virus’ origin is unknown. However, Beijing initially stated that coronavirus came from animals at a “wet market” in Wuhan where exotic meats are butchered and sold in disgusting conditions.

Chinese officials claim that COVID-19 went from bats to animals sold in the market last year, then infected humans.

U.S. intelligence officials have increasingly dismissed that explanation, however, as attention has begun to focus on evidence suggesting that Chinese medical researchers were working with coronavirus in the country’s only Level 4 facility, which is in Wuhan.

U.S. Army Gen. Mark A. Milley, chairman of the Joint Chiefs of Staff, has said that intelligence agencies are investigating whether the virus escaped from a lab or was the result of a naturally occurring outbreak, but that analysts have ruled out reports that COVID-19 was manmade.

‘The most logical place to investigate the virus origin has been completely sealed off’

“At this point, it’s inconclusive, although the weight of evidence seems to indicate natural,” the general said on April 14, “but we don’t know for certain.”

The analysis said that the wet market explanation does not ring true because the first human diagnosis of coronavirus was made in someone who had no connection to the wet market in question. And according to Chinese reports, no bats were sold at that particular market.

At the same time, several questionable actions and a growing paper trail provide clues that the virus actually escaped from a lab, even as China begins to clamp down on those information streams.

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The biggest media lies about the coronavirus: Origins, treatments and vaccines

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(Natural News) If there is one thing that most everyone can agree on concerning the Wuhan coronavirus (COVID-19) pandemic, it is the fact that there is no shortage of conflicting information out there about the nature of it. And the mainstream media is certainly doing its part to steer the narrative as part of a larger agenda, using plenty of misinformation along the way.

The following are among the most commonly parroted lies about the Wuhan coronavirus (COVID-19) that aim to distort the facts and deceive you into believing falsehoods about this pandemic:

Media LIE: The virus is not man-made

From the very beginning of this thing, the official narrative was that the Wuhan coronavirus (COVID-19) came from a Chinese wet market where bats and other “exotic” animals are sold as meat. But the world later learned that it actually more than likely “escaped” from the Wuhan Institute of Virology.

The mainstream media and social media platforms went nuts trying to censor this information and even called it  “fake news.” But eventually it became undeniable that bat soup was not responsible for spreading the Wuhan coronavirus (COVID-19) around Wuhan and eventually to the rest of the world – hence why we continue to call it the Wuhan coronavirus rather than just COVID-19.

We have even seen attempts by the media machine at making the Wuhan coronavirus (COVID-19) a racial issue because there are supposedly more “people of color” coming down with it than people with fair skin, which further detracts attention away from the source of this virus.

Media LIE: Hydroxychloroquine is extremely dangerous and doesn’t work

The minute that President Donald Trump announced that hydroxychloroquine may be an effective, and very inexpensive, remedy for the Wuhan coronavirus (COVID-19), the mainstream media immediately began decrying this claim as fake news, even though Anthony Fauci himself praised hydroxychloroquine back in 2013 under Barack Obama as being some type of “miracle cure” for SARS (severe acute respiratory syndrome).

There have even been studies conducted that were designed to intentionally smear the drug as both ineffective and dangerous, though one in particular purposely left out zinc, which appears to be a critical co-factor in supporting the effectiveness of hydroxychloroquine – in other words, politics as usual.

Media LIE: Only a vaccine can save us from coronavirus

Many politicians and public health officials are parroting the lie that the only way America can come out of lockdown and go back to “normal” is to get vaccinated with some future vaccine for the Wuhan coronavirus (COVID-19) that does not even yet exist. A vaccine, we are repeatedly told, is the only thing, or perhaps some new “blockbuster” antiviral drug, that can cure the world of this scourge and make everything happy and wonderful once again.

Meanwhile, not a peep is being made about things like intravenous (IV) high-dose vitamin C, which is being successfully used in other countries to stem the tide of infections without the need for new drugs and vaccines.

By omission, nutrition is pointless

Speaking of natural approaches to overcoming the Wuhan coronavirus (COVID-19) that are being systematically ignored by the mainstream media and most in politics, have you heard anyone mention the importance of nutrition in all of this? We did not think so, and this is intentional.

Regular readers of this site over the years should know by now that the single-most important thing you need to do to stay healthy besides exercising regularly is to feed your body the nutrition it needs to naturally ward off illnesses, including those associated with the Wuhan coronavirus (COVID-19).

Research compiled by the Lewin Group reveals that nutritional remedies such as calcium, vitamin D, folate, omega-3 fatty acids, lutein, zeaxanthin, and more all play a critical role in fortifying the immune system, which, if properly nourished, should have little problem fending off disease.

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