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State Legislation to Prevent Diversion of Opioids in Hospice Programs

A Deeper Look Into Ohio Law

Kneuss, Tiffany G. PharmD; Protus, Bridget McCrate PharmD, MLIS, BCGP, CDP; Lovell, Amanda G. PharmD, BCGP; Kullgren, Justin G. PharmD

Journal of Hospice & Palliative Nursing: October 2019 - Volume 21 - Issue 5 - p 365–372
doi: 10.1097/NJH.0000000000000534
Feature Articles

The problem of opioid diversion and its contribution to the opioid epidemic are well known nationally, existing even within hospice care. Proper disposal of opioids may be a critical factor in reducing diversion. In 2014, Ohio implemented legislation requiring a hospice employee to destroy or witness disposal of all unused opioids within a patient’s plan of care. The purpose of this study was to determine the impact of Ohio Revised Code 3712.062 on hospice programs’ policies and procedures to prevent opioid diversion in the home. Directors of Ohio-licensed hospices were surveyed to assess the percentage of programs with a written policy in place for disposal of opioids and to calculate a compliance score based on responses to survey questions assessing compliance with legislation components. Fifty-two surveys were completed (39.4%). All survey respondents reported having a written policy in place. A 95.5% average compliance score was calculated, with the largest disparity occurring with timing of opioid disposal. While Ohio Revised Code 3712.062 requires opioid disposal at the time of patient’s death or when no longer needed by the patient, only 84% of respondents report disposing opioids upon discontinuation. Overall, a high compliance rate was seen among hospice programs indicating such regulation is manageable to meet.

Tiffany G. Kneuss, PharmD, is supportive care clinical coordinator pharmacist, Levine Cancer Institute, Atrium Health, Charlotte.

Bridget McCrate Protus, PharmD, MLIS, BCGP, CDP, is director of drug information, Optum Hospice Pharmacy Services, Westerville; and adjunct faculty, The Ohio State University College of Pharmacy, Columbus.

Amanda G. Lovell, PharmD, BCGP, is clinical pharmacist, Optum Hospice Pharmacy Services, Westerville.

Justin G. Kullgren, PharmD, is palliative care clinical specialist pharmacist, The Ohio State University James Cancer Hospital, Columbus.

Address correspondence to Bridget McCrate Protus, PharmD, MLIS, BCGP, CDP, Optum Hospice Pharmacy Services, 250 Progressive Way, Westerville, OH 43082 (

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

Online date: March 27, 2019

© 2019 by The Hospice and Palliative Nurses Association.