Drug Seekers

You arrive at work to start your shift. A few weeks ago you completed the EMS agency’s orientation program and are glad to be “on the streets.”

For today’s schedule there have been a few changes. You’ll be working with Sean. You’ve never worked with him before but hear he’s good to work with. You’ll also have an EMT student.

You pick up your portable radio and sign for the ambulance narcotics. Next, you walk to the parking lot and locate your ambulance. A moment later Sean and the EMT student arrive. After brief introductions your crew completes the pre-shift check. Once the ambulance has been checked you call dispatch and let them know you’re available. Minutes later you’re dispatched to a call.

You complete the call and Sean tells you he needs to look for a special stamp for his collection. As the shift goes by you respond to several calls. Between calls Sean stops at a few stores.

Dispatch calls on the ambulance cell phone. You answer the phone and the dispatcher requests that you return to the administrative offices. As you return to the office your crew talks about the calls that you ran today. There has been a good mixture and you look forward to rest of your shift.

Sean pulls the ambulance into the main office parking lot. The three of you exit the ambulance and walk into the lobby of the office. As you enter, the EMS medical director and chief paramedic, as well as plain clothed and uniformed police officers greet you. This is not normal.

A police officer asks that you walk with them to a meeting room. Sean and the EMT student are escorted away individually.

You enter the meeting room and are greeted by two individuals wearing suits. They appear to be a bit intense. You think, “What is going on?” The individuals identify themselves as investigators for state and federal law enforcement agencies.

You are offered a seat and you sit down. A police officer then holds up what appears to be a single page from a prescription pad. The prescription paper appears to be from a local hospital. You’re asked if you recognize the paper. You answer, “Yes, I think. What is this about?”

In response to your question you find yourself answering a lot of questions about medications. The police mention several types of medications, including narcotics, various names they’re called on the street, how they’re administered, how people take or “use” them, and how accessible they are. The questions are asked in rapid-fire sequence.

A police officer then places the prescription paper directly in front of you. You’re asked if you can identify any of the writing on the prescription sheet. You notice part of your name is handwritten in the patient name section of the prescription sheet, which is dated today. “Weird,” you think to yourself. You have no idea what’s going on.

After meeting with the investigators for more than an hour you’re exhausted. The officers tell you they’re done and you’re escorted out of the room. You’re told you can return to work but, if you would like, you can take some time to unwind. You walk outside to get some fresh air. “What was that all about,” you ask yourself.

A few minutes later your supervisor joins you. The situation: During your shift Sean was driving to various stores that have a pharmacy in an effort to get a falsified narcotic prescription filled. In an effort not to get caught, Sean listed part of your name on the prescription sheet in the “patient” section. The physician’s signature on the prescription is a physician from a local emergency department—Sean forged that as well. “Not good,” you think to yourself.

You and your supervisor chat and walk back into the administrative offices. There, out of the corner of your eye, you see Sean being escorted out of the building, handcuffed. His EMS career is over.

The above situation is unfortunate for a variety of reasons. While it does involve an EMS provider being arrested, there are additional factors to consider.

• How long: Has your partner been trying to acquire medications illegally while on the job in the past? If so, how many times has this occurred? Does this just happen to be the day he/she was caught?
• Patient care: Has patient care ever been jeopardized because your partner was using substances while on the job? Has your partner ever “cheated” a patient from receiving a drug so he/she could take the drug?
• Prescription pad: Is this the first time your partner has obtained a prescription pad? If not, what other medications has your partner obtained or tried to obtain?
• Driving: Your partner was driving today. He was looking for “stamps.” Was your partner under the influence? Has your partner worked under the influence in the past?
• Physician: Is the physician that is listed on the prescription pad aware of what is happening? Is their medical license at risk? Has this physician been involved in this type of scenario in the past?
• EMS certification: Will your partner’s state certification be revoked? If he has a national certification, will that be revoked as well? Will your partner be able to find a new EMS job?
• Safety: When your partner was operating the ambulance, was the safety of people in or around the ambulance at risk?
• You knew: What if you knew your partner had a prescription pad and he/she was trying to pass the prescription as legitimate during your shift? Could you be guilty as well?
• Are you a “narc”: Even though you may not have been aware your partner was trying to obtain medications illegally, now that he/she has been caught, are you considered by some to be a “narc”? A “narc” is an individual who reports their partner for doing something they perceive is illegal, such as stealing narcotics or money from a patient’s home.
• You witnessed it: What if you witnessed your partner attempting to obtain medications and did nothing to stop or report it? Is your job, career or certification at risk?
• Narcotics: Did your partner ever steal narcotics from the EMS drug box?
• Intentions: During the investigation it’s determined that your partner had attended social events with prescription medications in the past. The investigation is now considering the possibility of distribution and selling.
• Audit: The EMS agency is auditing narcotic logs to determine if there are any incident reports that match when your partner was working.

There are only a couple of hours left in your shift. You do not have a partner. You supervisor suggests that you take the remainder of the day off. You accept the offer and start pondering the day’s events.

The above situation is unfortunate. While you may not have been aware of what was occurring during the shift, you may become involved after the fact. The outcome of these events depends on numerous factors. Individuals who decide to participate in such activities realize there is a risk. Only over time will the full impact of their actions be recognized.

Paul Murphy, MS, MA, EMT-P, has administrative and clinical experience in healthcare organizations.