BOSTON — Regulators are seeing more complaints about drug diversions and the theft of controlled substances from pharmacies, according to a new report.
The state Board of Registration in Pharmacy, which oversees the state's prescribers, received at least 543 "drug violation" complaints stemming from "drug losses, record keeping discrepancies and drug diversions" at drug stores and pharmacies throughout the state from 2013 through 2018.
Last year, the board logged 93 complaints for drug violations, for the first time eclipsing the number of complaints it received about failures of pharmacies to properly fill prescriptions or other regulatory violations, according to its report.
The allegations stem from complaints filed by employers, employees and law enforcement, or initiated by board investigators. They involve large, chain pharmacies such as CVS, RiteAid, Walgreens and Stop & Shop, as well as small neighborhood pharmacists.
Details of investigations weren't disclosed, and state officials declined to comment on the report.
Massachusetts is grappling with a deadly wave of opioid addiction that claimed nearly 2,000 lives last year from overdoses. Experts say many opioid addicts started with pain pills.
Pharmacists attribute the increased numbers of complaints to stepped up enforcement of drug diversion regulations and heightened awareness.
"There's a lot more attention being paid to the problem, which is leading to the increase in reported violations," said Tom Brown, executive director of the Massachusetts Independent Pharmacists Association. "For controlled substances, pharmacies have to count every pill every 10 days, so when they find a discrepancy between have and should have, they have to report it."
Brown said small, independent pharmacists are doing what they can to comply with the rules and prevent opioids and other controlled substances from finding their way onto the streets.
"They usually live in the community where they do business, so the last thing they want is to contribute to drug abuse and dependency," he said.
The issue of addictive drugs being diverted to the street from hospitals, nursing homes and pharmacies is a major concern, as highlighted by the case of a Salem woman who last fall was charged with stealing more than 18,000 pills, mostly opioids, from Beverly Hospital, Addison Gilbert Hospital in Gloucester and other locations.
Lisa Tillman, 50, faces a charge of obtaining drugs by fraud for stealing medicines such as Vicodin and OxyContin from automated dispensing machines. Tillman worked as an overnight pharmacy technician, and police say she altered computer records to mark the drugs as outdated.
The theft was the largest of its kind in more than a decade in Massachusetts, according to state officials, who've acknowledged there is no formal system to track stolen pills.
To be sure, a February report by The Salem News found a lack of state or federal databases for tracking how many prescription drugs disappear from medical facilities.
Responding to public records requests submitted by The Salem News, the Department of Public Health provided records showing two hospital drug diversion cases of more than 10,000 doses in the past decade — the Beverly Hospital incident and a case involving two nurses at Massachusetts General Hospital found in 2013 to have taken nearly 16,000 pills.
The state agency found numerous reports of thefts of more than 100 pills.
In July, a Haverhill nurse was indicted in federal court on charges of stealing a hospice patient's morphine.
Brianna Duffy, 32, is accused of tampering with morphine prescribed to a patient at Hunt Nursing and Rehab in Danvers, and a patient at the Maplewood Care and Rehabilitation Center in Amesbury, where she worked previously, according to the U.S. Attorney's Office. Prosecutors say she diverted the medication for personal use.
The cases have spurred calls for more oversight from Beacon Hill, which has yet to confront the issue of drug diversions.
"Clearly we need to tighten up the system," said state Sen. Joan Lovely, D-Salem, the Senate's assistant majority leader. "The technology exists to track medicine from the manufacturer to the point-of-sale, so why are people are still able to divert these heavily addictive drugs to the street?"
The Massachusetts Medical Society, the state's largest physician group, has called for tougher rules to limit the amount of excess opioid medication that can be diverted, including through safe disposal programs, strict adherence to prescription monitoring programs and prescribing guidelines, partial-fill prescriptions and patient and caregiver education.
"Physicians recognize that many who suffer from opioid use disorder were introduced to drugs that were not prescribed to them by a physician, perhaps from a friend or family member who, at one time, did receive a medically appropriate prescription," said Dr. Maryanne C. Bombaugh, the society's president.
Under state law, hospitals, nursing homes and pharmacies are required to report diversions to the Department of Public Health's Drug Control Program, as well as to any licensing authorities that oversee doctors, nurses or other licensed employees, such as pharmacists or pharmacy technicians. Federal rules require pharmacies to report lost medications that are on the list of controlled substances to the Drug Enforcement Administration.
But varying reporting requirements mean that cases go unreported in many states, potentially masking the size of the problem.
There is no federal database of drug thefts.
The DEA tracks controlled prescription drugs ordered from distributors, and it also collects data from states with prescription drug monitoring programs that track prescriptions. Massachusetts has such a program.
But the federal agency doesn't calculate the difference between the two figures, which would give an idea of how many pills are lost or diverted.
A recent report by Protenus, a health care compliance firm, said more than 20 million pills a year are illegally taken from medical institutions and end up on the street.
Christian M. Wade covers the Massachusetts Statehouse for The Salem News and its sister newspapers and websites. Email him at firstname.lastname@example.org.