Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Narrative Review

Prevention of drug diversion and substance use disorders among anesthesiologists: a narrative review

Prevenção do desvio de drogas e transtornos por uso de substâncias entre anestesiologistas: uma revisão narrativa

Michael G. Fitzsimons, Gabriel Soares de Sousa, Arpine Galstyan, Vinícius Caldeira Quintão, Cláudia Marquez Simões

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Diversion of substances from the care of the intended patient is a significant problem in healthcare. Patients are harmed by the undertreatment of pain and suffering, transmission of disease, as well as the risk associated with impaired vigilance. Healthcare providers may be harmed by the physical and mental impact of their addictions. Healthcare systems are placed in jeopardy by the legal impact associated with illegal routes of drug release including sanction and financial liability and loss of public trust. Healthcare institutions have implemented many measures to reduce diversion from the perioperative area. These efforts include education, medical record surveillance, automated medication dispensing systems, urine drug testing, substance waste management systems, and drug diversion prevention teams. This narrative review evaluates strengths, weaknesses, and effectiveness of these systems and provides recommendations for leaders and care providers.


Drugdiversion; Substanceabuse; Substanceuse disorders; Drugtesting; Healthcare professionals; Anesthesiology


O desvio de substâncias dos cuidados do paciente pretendido é um problema significativo nos cuidados de saúde. Os pacientes são prejudicados pelo subtratamento da dor e do sofrimento, pela transmissão de doenças, bem como pelo risco associado à vigilância prejudicada. Os prestadores de cuidados de saúde podem ser prejudicados pelo impacto físico e mental das suas dependências. Os sistemas de saúde são colocados em perigo pelo impacto legal associado às rotas ilegais de libertação de medicamentos, incluindo sanções e responsabilidade financeira e perda de confiança pública. As instituições de saúde implementaram muitas medidas para reduzir o desvio da área perioperatória. Esses esforços incluem educação, vigilância de registros médicos, sistemas automatizados de distribuição de medicamentos, testes de urina para drogas, sistemas de gerenciamento de resíduos de substâncias e equipes de prevenção de desvio de drogas. Esta revisão narrativa avalia os pontos fortes, fracos e a eficácia destes sistemas e fornece recomendações para líderes e prestadores de cuidados.


Desvio de drogas; Abuso de substâncias; Transtornos por uso de substâncias; Teste de drogas; Profissionais de saúde; Anestesiologia


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