Fentanyl, the powerful opioid currently preoccupying public health authorities, isn't just a problem on the streets. About a dozen Quebec nurses have been temporarily suspended over the last decade for stealing quantities of the drug from the workplace, says a Canadian Press analysis of the Quebec Order of Nurses' disciplinary council decisions.
While 12 suspensions were handed out between 2006 and 2016, the actual number of thefts was much higher, since most cases were only detected after multiple incidents that went on for months or even years, the documents show.
In the most severe cases, patients were deprived of their medication by nurses who replaced the fentanyl in pills or drips with water or an intravenous saline solution.
“Unfortunately, drug appropriation and substitution by other substances are too frequent at this time,” the disciplinary council wrote in a 2012 decision.
“When a nurse appropriates these medicines and, in addition, substitutes water for this medication, the patient does not receive the medicine to which they are entitled and the suffering continues.”
In some cases, nurses consumed the stolen drugs on the job, with one admitting to having injected herself up to three times in a single work shift.
Male nurses were disproportionately represented, accounting for 50 per cent of the suspensions while making up only 10 per cent of the order's membership.
The nurses used different methods to outwit the security measures in place in order to obtain the fentanyl, an opioid 50 to 100 times more powerful than heroin.
Those included altering patient registries, writing false prescriptions, retrieving discarded partially-used doses and falsifying signatures.
The nurses' suspensions ranged from six months to three years. None were permanently banned from the profession.
If one adds to the list suspensions that were ordered for the theft of other powerful narcotics, such as morphine and dilaudid, the total number of cases climbs into the dozens, according to Canadian Press estimates.
The number of fentanyl thefts over the past ten years is not a cause for alarm, according to the disciplinary body.
The number of nurses with dependence problems has also remained stable over the last five years, it says.
In the year 2015-2016, the disciplinary board examined a total of 48 cases of drug theft -- not all of which involved nursing staff or powerful narcotics, according to the order's records. That compares to 47 cases the year before and 53 in 2013-2014.
Although a black market exists for reselling drugs, the order's records indicate the stolen fentanyl did not go that route, according to order of nurses spokeswoman Joanne Letourneau.
Since not all incidents of drug theft result in a suspension, the numbers cited above do not paint a full picture of the problems surrounding drug or fentanyl theft.
Some cases are resolved before the suspension stage if there is a lack of evidence, or if the council believes the act was isolated and not a danger to the public, Letourneau said. A mediation process can also be used.
The order says it can't say how many complaints about the theft of fentanyl have been substantiated, since it does not compile data on narcotic theft.