Close up view of nurses hands holding patient medications and papers.

The stress of the nursing profession and long shifts leading to fatigue, insomnia, physical and psychic pain along with nurse access to controlled substances and narcotics can lead to drug diversion and self-medication by nurses. Drug diversion by nurses can begin with a nurse misusing drugs as a pain killer followed by repeated, follow-up use as drug tolerance increases and ultimately, as an addicted user.

Prescription drug use by medical personnel and drug diversion by health care providers has risen to epidemic proportions and become a significant public health issue. Current estimates are that 6-10% of nurses are prescription drug users, suffering from Substance Abuse Disorder. The abuse of narcotics and prescription opioids has also fueled a heroin epidemic as users turn to the much cheaper street drug. Drug diversion by health care personnel also compromises patient safety when patients don’t get the pain medications they need or when patients are exposed to infectious diseases as the result of impairment on the part of providers.

Theft of controlled substances by a nurse usually occurs for personal use, to supply the drug to another user, or for financial gain.

  • Nurses may divert drugs by using false documentation, such as a medication doses not actually administered to the patient and instead used by the nurse.
  • Theft of diverted controlled substances can occur from a medication dispensary, narcotic cabinet, or pharmacy.
  • Drug diversion by a nurse can also include removing a pain patch directly from a patient’s body for personal use or even rifling through medical or hazardous waste (used syringes for example) for controlled substance residue.

Diverting Drugs: BRN Investigations

An impaired nurse, when accused of misappropriating controlled substances, can face criminal prosecution, civil malpractice actions, and disciplinary actions against his or her RN license by the California Board of Registered Nursing (BRN).

Misappropriating medications and drug diversion of controlled substances is a serious offense and a violation of the California Nursing Act. There is no statute of limitation for the filing of a disciplinary action by a California licensing board. The Nursing Practice Act is located in the California Business and Professions Code starting with Section 2700. Regulations which specify the implementation of the law appear in the California Code of Regulations.

California Registered Nurse Laws and Regulations

California Vocational Nurse Laws and Regulations


CHAPTER 6. Nursing [2700 – 2838.4] ARTICLE 3. Disciplinary Proceedings [2750 – 2765]

Section 2762 states:

In addition to other acts constituting unprofessional conduct within the meaning of this chapter it is unprofessional conduct for a person licensed under this chapter to do any of the following: 

  • Obtain or possess in violation of law, or prescribe, or except as directed by a licensed physician and surgeon, dentist, or podiatrist administer to himself or herself, or furnish or administer to another, any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code or any dangerous drug or dangerous device as defined in Section 4022.
  • Use any controlled substance as defined in Division 10 (commencing with Section 11000) of the Health and Safety Code, or any dangerous drug or dangerous device as defined in Section 4022, or alcoholic beverages, to an extent or in a manner dangerous or injurious to himself or herself, any other person, or the public or to the extent that such use impairs his or her ability to conduct with safety to the public the practice authorized by his or her license. 
  • Be convicted of a criminal offense involving the prescription, consumption, or self-administration of any of the substances described in subdivisions (a) and (b) of this section, or the possession of, or falsification of a record pertaining to, the substances described in subdivision (a) of this section, in which event the record of the conviction is conclusive evidence thereof.
  • Be committed or confined by a court of competent jurisdiction for intemperate use of or addiction to the use of any of the substances described in subdivisions (a) and (b) of this section, in which event the court order of commitment or confinement is prima facie evidence of such commitment or confinement.
  • Falsify, or make grossly incorrect, grossly inconsistent, or unintelligible entries in any hospital, patient, or other record pertaining to the substances described in subdivision (a) of this section. 

Failing to “Waste” Medications and Controlled Substances: Charting Errors and Pyxis Machine Errors

Failing to waste medications and controlled substances is another serious charge for nurses. After nurses sign out medications at a Pyxis SupplyStation, use them on patients and chart and document their use, any excess drugs must be wasted per hospital policy. The Board of Registered Nursing will otherwise assume that failure to waste is because you stole the drugs. It is up to you and your legal defense to prove that this resulted from other causes such as Pyxis machine problems or failing to chart that you wasted the drugs.

If you are a California nurse who is impaired as a result of your prescription or controlled substance use, the Law Offices of Lucy McAllister is here to help.

If you have been recently fired for drug misappropriation and/or are under investigation by the Bureau of Registered Nursing (BRN) for controlled substance abuse, you need to consult with an experienced licensing and criminal attorney IMMEDIATELY. And while you may be offered opportunities to participate in the BRN Nurse Intervention or Diversion Program, MAXIMUS, you need to understand how this could impact your ability to practice nursing in the future.

The Law Offices of Lucy S. McAllister have successfully represented a wide range of California licensed nurses and other licensed health care professionals and we are experienced in handling all types of licensing accusations and licensing issues in addition to criminal cases. Let us help you protect your professional license, your reputation, and your livelihood.

For additional information or to schedule a consultation on a professional licensing issue, please contact our law offices today at (877) 280-9944.