Spotting and Managing Drug Diversion Risks at Your Practice

Visiting and assisting veterinary clinics coast to coast over the years, Titan Group’s teams have witnessed a number of mysteries:  where did the “good scissors” go, who heated up fish in the breakroom microwave, and who lost the billing paperwork. But there’s one mystery that’s no joke:  missing controlled substances. We’ve spent years walking into vet clinics, (and plenty of pharmacies, hospitals, and distributors also) where something “just didn’t look right”, and it turned out the warning signs for drug diversion were there all along.  The lesson learned:  if you can spot the diversion clues early, it’s a lot easier to protect yourself, your staff, your license and – ultimately – patients and clients.

A Tempting Target

Controlled substances in veterinary practices are attractive targets for theft and misuse —too often by the clinic staff themselves. In diversion cases, Titan’s investigators often discover that weeks or months before the perpetrator was sending out the warning “messages” — changes in behavior, creating record discrepancies, or taking security shortcuts that no one questioned. A little awareness by other employees could have prevented an avalanche of problems. 

Missing the Red Flags

In drug diversion cases, behavior changes can show up long before strange inventory numbers raise alarms. While no single indicator is proof of diversion, odd patterns or sudden changes in behavior should grab your attention

Titan Tip: No matter how long you’ve worked with some employees, stop thinking you know them. You likely have no idea what trauma, stress, problems or issues they’re facing in their lives. Putting aside your “familiarity bias” can improve your “problem radar”.

1. Work-Related 

• Overly eager to handle controlled substances or insisting on being in charge of ordering/receiving drugs.
• Volunteering for overtime or less-supervised shifts without clear need, especially when drug access is easier.
• Avoiding procedural safeguards, like skipping double-witness requirements for wasting.
• Changed entries, edits, or repeated mistakes in controlled substance logs or patient records.

2. Performance Changes

• Unexplained absences, tardiness, or taking unusually long breaks.
• Declining quality (e.g., disorganization in recordkeeping, trouble staying focused on tasks, or failing to complete assigned work).
• Appearing unusually tired, hyperactive, or otherwise impaired during work hours.

3. Interpersonal & Personal Signs

• Becoming defensive, hostile, or evasive when questioned about work tasks.
• Changes in hygiene and appearance 
• Unexplained lifestyle changes, rumors of financial or relationship problems 

The Numbers Don’t Lie

Some of the loudest alarm bells when diversion occurs are “ringing” in records. In Titan’s experience, when a practice is missing drugs, the paper trail holds the clues that tell the story:

• Discrepancies between inventory counts and usage logs.
• Frequent wasting of unusually large amounts of drugs or frequent “breakage” reports with vague or incomplete documentation.
• Patients receiving unusually high or frequent doses without clear medical justification or contrary to established orders.

Titan Tip: Limit access to controlled substances to the fewest staff members possible. And set up a clear, “zero tolerance” policy for chain of custody when ordering, receiving, or dispensing controlled substances.

Turning Warnings into Action

1. Verify Facts

• Conduct an immediate, documented controlled substance inventory audit.
• Compare patient charts, usage logs, and purchasing records for inconsistencies.
• Review security camera footage where available.

2. Secure the Drug Supply

• Restrict access to controlled substances to the minimum number of necessary staff.
• Change lock codes or keys immediately if diversion is suspected.
• Require two-person verification for all drug counts, dispensing, and wasting.

3. Create and Follow an Internal Protocol

• Keep a written record of all observations and investigative steps.
• If behavior-related, meet privately with the staff member, keeping the discussion fact-based.
• If diversion is confirmed, comply immediately with DEA and state reporting requirements.

4. Preventive Measures Moving Forward

• Conduct random, unannounced controlled substance counts.
• Train staff on diversion awareness and their responsibility to report suspicious activity.
• Maintain a written controlled substance policy with clear consequences.
• Use secure storage solutions and tamper-evident log systems.

The Bottom Line

Diversion doesn’t usually start with a dramatic heist — it starts with small, repeated crimes of opportunity that go unchecked. The most successful veterinary teams Titan works with are the ones that take security personally, hold each other accountable, and never assume “it could never happen here.” If you see something, document it, verify it, and act (such as calling Titan) — before a small red flag becomes a full-blown case.

Not sure if there are problems lurking at your practice? Take our FREE risk assessment or give TITAN a call at (347) 723-8019. It could mean the difference between a solvable problem and disaster.