Parkdale CEO to Present on National Stage

Parkdale CEO, Rodrigo Garcia will address attendees at the National Organization of Alternative Programs (NOAP) in San Antonio, Texas to discuss the addiction crisis amongst health care professionals.  During the April 28-April 30 National Symposium, Mr. Garcia will present his highly regarded “Catch Me If You Can” presentation which depicts the impaired professional managing the care of patients.  Drawing from his vast professional experience in the health care industry as a board certified nurse anesthetist, his formal didactic studies in addiction and health care, his role as CEO of Parkdale Recovery Center, and his personal experience, Mr. Garcia depicts the challenges, struggles, and societal implications of the impaired health care provider.  In experts from an interview with Mr. Garcia, he stated the following:

Interviewer:  We hardly ever hear about this so how big of a problem is this really?

Mr. Garcia:  That in it self is part of the problem.  The potential fallout and publicity hospitals will receive if the news of an impaired provider got out could be detrimental to their image.  This often encourages the facilities to act swiftly and quietly although not necessarily in the best interest of all involved.  According to the National Safety Council, 1:15 people currently suffer from some form of substance use disorder.  Those numbers are estimated to be closer to 1:10 for health care workers for a variety of reasons including increased stress, accessibility to controlled substances, and expert knowledge in how to use them. 

Interviewer:  That number seems very high.  I would expect to see impaired health care providers falling over themselves in the hospitals.  How does the impaired provider typically present?

Mr. Garcia:  That is a great question.  In fact, it can be very difficult to detect unless you are looking for it specifically.  The impaired provider can present in many ways that, on the surface, may not appear significant until a sentinel event occurs.  An impaired provider can be:  A surgeon who is hung over from the night before, A radiologist suffering from withdraw symptoms and unable to concentrate, a pharmacist that is diverting pills from patients leaving them in pain, a nurse that is actively under the influences of drugs or alcohol and forgets to administer a medication, a technician who is switching out medications and infecting unsuspecting patients, or the anesthesiologist that just overdosed in the bathroom.  As you can see, the implications on the patients can be quite profound.

Interviewer:   I am still surprised as to nearly 10% of providers being “sub-optimal” due to some form of substance use.  These providers have spent years of their life and significant financial sacrifices to be accomplished professionally.  The burning questions is “WHY?” would they do this?

Mr. Garcia:  Although there are some factors that may predispose people to addiction or alcoholism, there is usually a precipitating event.  Sometimes it is increased personal stress, a prescription for pain after surgery, a chronic medical condition, or a significant life event.  The event coupled with maladaptive coping skills and a genetic predisposition creates a perfect environment for the addiction to seed it self and take root.  In other words, the addiction and subsequent addictive behaviors usually have a benign onset.  In fact, at some point most of our patients say a variation of “ I once said I would NEVER do those things yet here I am”. 

Interviewer:  If that is the case, why don’t they ask for help before they get caught or hurt someone else? 

Mr. Garcia:  Unfortunately, society does not allow that to happen so easily.  The stigma associated with the word ADDICTION or ADDICT and the common punitive response to it often dissuades people from asking for help.   It is easy to track the “scarlet letter” of addiction through work history, insurance submissions, legal fall out, and general town hall gossip.  Once the stigma is placed, it and all its’ prejudices are hard to shake.  As a result, the addict will try to stop on their own repeatedly, until the subsequently get caught.  Ill ask you a similar question, and be honest, what is the first thing you think about when you hear that your nurse is a recovering drug addict?  Furthermore, does the word “recovering” bear any weight? 

Interviewer:  Point taken, I can see how that could be a problem.  I am sure there is no simple solution but what is one thing you would suggest that we could all do about this apparent epidemic?

Mr. Garcia:  You are right; solving this problem will require the dedicated concerted efforts of many.  However, we can all start by learning more about this disease and realize that not talking about it is making it worse.  The facts are that nearly everyone is affected by addiction or alcoholism.  One in ten people live with addict or alcoholic and one in three know an addict first hand.  The only way this gets better if we all commit to talking about it with an open mind and more importantly, an open heart.

Mr. Garcia continued the interview by discussing proposed solutions for health care facilities, suggesting ways the general public could help safeguard their care, and provided resources / advice for the impaired professional. 

Rodrigo Garcia possesses an MBA with a focus in Health Care Administration; he is a Board Certified Nurse Anesthetist, Advanced Practice Nurse, and Critical Care Registered Nurse with over 20 years of patient care experience.  He is also the current CEO of Parkdale Center, a treatment center specializing in the holistic management of the impaired professional.  To contact Mr. Garcia directly or to request a speaking engagement with your facility, please email rgarcia@parkdalecenter.com

What Hospitals Don’t Know May Hurt Them: Drug Diversion In Healthcare

By: Ethan Bickelhaupt

The diversion of controlled substances from healthcare facilities is an elephant-in-the-room type of problem that no one likes to discuss.  The sad fact is that most hospitals and other facilities do not recognize that they have a diversion problem until something tragic happens.  A quick internet search will turn up dozens, if not hundreds, of articles picked up by the media regarding nurse, physician and pharmacist overdoses that were facilitated by medications stolen from the workplace.  These professionals were suffering from the disease of addiction and their disease continued to progress right under the nose of hospital administrators until it was too late. 

It is known that at least 10-15% of the general public has a problem with substance abuse.  Healthcare workers, especially pharmacists and anesthesia providers, are known to be at an even higher risk for several reasons.  Even using the lowest possible estimate, if 10% of a healthcare facility’s staff has an problem with addiction and controlled substances are readily available, it is an obvious statement of fact to conclude that diversion occurs at a significant rate.  In a recent study of over 9,000 heroin addicts, 75% admitted that their problem started after becoming addicted to legally prescribed pain medication.  They turned to heroin only after they were unable to continue using prescription drugs.  In a healthcare setting, controlled substances are readily available, diversion is *easy* without sufficient controls and accountability in place, and the result is that healthcare workers turn to diversion from the workplace.   But why would a healthcare professional resort to stealing medications from work? 

Healthcare professionals, like other Highly Accountable Professionals, have a significant amount of time, money, education and pride invested in their chosen profession.  They often are the primary source of income for their family and have jobs that are high-stress, high-responsibility and provide immediate access to highly addictive controlled substances.  Professionals with substance abuse problems are described as highly intelligent, typically graduate in the top 25% of their class, are highly respected by their peers and are often the last ones that would be suspected of having a problem.  This means that these individuals are often reluctant and unlikely to seek help for substance abuse until it is too late, for fear of significant consequences.  Job loss, legal and licensure issues, financial difficulties, loss of respect and a loss of identity are all factors cited by professionals as reasons to not seek treatment.  With so much riding on their career, professionals that become addicted to a legal prescription often feel they have nowhere to turn.  Rather than risk a loss of their livelihood by seeking professional help, they will attempt to quit on their own, only to find out it simply isn’t possible.  They become trapped, cut off from their legal prescriptions, fearful of seeking treatment with access to controlled substances taken from work.  As a result, the diversion and substance abuse often continues until ending in tragedy. 

One significant mistake made by healthcare administrators is to believe that just because a problem isn’t obvious or noticed must mean it doesn’t exist.  Administrators frequently overlook the signs, symptoms and evidence of drug diversion simply because they do not have the appropriate accountability and monitoring procedures in place.   70% of healthcare workers surveyed have stated that they believe the control systems at their facility are inadequate.  Professionals with a substance abuse problem report 75% of the time that they believe other co-workers knew of their problem but didn’t report them.  The simple fact is that this is a known problem occurring in nearly every healthcare facility across the country, but little is being done to systematically address the issue.  As a result, diversion will continue until something tragic occurs and the hospital ends up with a public relations and insurance nightmare and the addicted professional, if they survive, loses everything. 

So what can be done?

Parkdale Center can help healthcare facilities develop comprehensive policies and procedures to prevent diversion, investigate suspected diversion, satisfy legal and regulatory reporting requirements and compassionately treat the addicted professional.  Our all-star team has experience and credentials in anesthesia, pharmacy, healthcare administration, nursing, addiction medicine and diversion investigation.  We will work with your facility to comprehensively address the issue of diversion from the ground up to keep your facility, your patients and your staff safe.  No one in the industry has the ability or experience to address this significant issue on the same scope or scale as Parkdale’s staff.  Give us a call today to find out more about our Diversion Prevention Program.  Let us help your facility identify gaps in practice, perform risk management as it relates to diversion and implement changes to protect your facility as a whole.  We can help. 

The Realism Of Drug Addiction

I knew all about my craft.  I am was in total control.  How was this any different from a dietitian modifying their intake or a trainer using his background to sculpt his body?  “I’m doing this under the safest of conditions”, was my maxim.  “If I just stick with clean supplies and remember to use sterile technique then I’ll be just fine.”  These were the thoughts echoing through my opiate addled mind as I propped myself up between the toilet and the sink in the single occupancy bathroom that I had turned into my own personal opium den.

I loved everything about it.  The ritual always culminated in a wave of feel-good euphoria as I drifted further into the warm embrace of my drugs.  And it was any drug.  Anything I could get my hands on was sufficient after my initial sample platter of experimentation.  I wasn’t picky.  I was an unlikely mix of anxious and groggy but I wasn’t picky.  I’d show up to any case any time and I’d definitely stay late!  As a matter of fact I’d dread vacations.  A time to enjoy my family and friends and to relax was spent withdrawing in misery.

I was always managing.  For a type A personality like me, whether I created the chaos or not, I got a kick out of solving things.  The craving and using cycle could be quite painful but at some level it was an end in and of itself.  To slyly divert a drug, steal off into the bowls of the hospital and untangle all the knots in my stomach was a thrilling ride.  It created a solvable problem that I could manage quite adeptly.  There was something sexy about anesthetizing a patient only minutes after tying off my foot with a tourniquet and injecting myself with drugs.  After the injection I would quickly remove the tourniquet and from my thrown on the bathroom floor raise my foot in the air as if to salute the drug as gravity hastened it’s journey to my heart. 

My heart often skipped a beat.  Whether it was when the warmth of the drug hit my chest or when I almost got caught injecting while crouching beneath the surgical table pretending I was checking my various monitoring equipment.  However, like Icarus, you can only fly that close to the sun for so long before you come crashing down. 

My run at juggling addiction and medicine didn’t last very long.  In fact, the last day that I worked I knew it was the day that I would get caught.  I had a very good idea of what was to come in the form of lost licenses, court dates, and unemployment but I couldn’t stop myself.  This is what addiction looks like but there is always hope.  The journey to put the pieces back together is far from over but it helps me to revisit these memories.  Not as a euphoric recall but as a warning of where I’ve been and where I can easily go again...