Addict in nurse's scrubs: Drugs 'take over'

Jim Kaju had been fired from his job at the University of Minnesota's hospital, but he wasn't going to let that stop his addiction.

On a spring afternoon in 2008, he donned scrubs, strolled through the main entrance and went straight for a storage room to find narcotics.

The former nursing aide and onetime cop had the guile to pass as a nurse and the savvy to find a restricted area where he would likely find leftover painkillers.

Inside a storage bin was a vial of Fentanyl, a synthetic opioid more powerful than morphine and normally reserved for surgery. He slipped it into his pocket and went home to feed his blinding addiction to painkillers. Kaju isn't surprised at the recent rash of painkiller thefts by employees of Minnesota hospitals. He knows the desperation and ingenuity of a prescription-drug junkie inside a medical facility.

"The addiction takes over, and that medication has a tendency to get out of the hospital," he said.

Kaju, 46, an Edina High School graduate and former Minneapolis cop, agreed to tell his story of drug abuse, arrest and incarceration to shed more light on the growing national scourge of painkiller abuse.

In Minnesota this year, at least eight nurses and aides have been caught stealing narcotics at work -- sometimes directly from patients.

The trend has prompted Minnesota hospitals to join with the Drug Enforcement Administration, local police and health regulators to develop practices that better protect drug inventories and patients.

Health professionals have always been "over-represented" in trends involving prescription drug abuse, and the latest surge of thefts by nurses mirrors stark increases nationally in the abuse of painkillers, said Carol Falkowski, drug abuse strategy officer for the Minnesota Department of Human Services.

"These drugs work on the same brain receptors as heroin," Falkowski said. In 2009, she said, opiates other than heroin were reported as the primary substance problem by a record-high number of Twin Cities hospital patients -- 1,722 in all.

Cancer and migraines

Kaju said his own problem started with treatment for chronic pain that he suffered as a result of adrenal cancer and related illnesses. Health problems had led to his early police retirement in 1999 after 10 years on the job. His tenure on the Minneapolis force included work on special investigations as a Gang Unit sergeant and two medals of valor, including one for a river rescue.

In 2006, he used his police emergency medical training to get a job as a nursing assistant in the emergency room at the University of Minnesota Medical Center, Fairview.

But by then he was hooked. It started after he left police work, with OxyContin that was prescribed over a two-year period by his kidney doctor and oncologist. When he stopped taking the drug, he experienced bouts of flu-like illness that he later realized were symptoms of withdrawal. Severe headaches returned, and Kaju went from doctor to doctor for prescriptions to various opioids to kill the pain.

He said he didn't take the hospital job with an eye to stealing drugs. In fact, early in his tenure he told his supervisor that he might have a dependency problem. He was in a pattern of burning through painkiller prescriptions and suffering withdrawals so severe, he says, that he wanted to put his head through a wall.

Kaju said the hospital was understanding and signed him into one of Fairview's outpatient treatment programs. The therapy didn't work. He returned to work in the emergency room and started to augment his own pain meds with opioids he would steal from waste bins.

"I told another employee I was having severe headaches and [she] said, 'Well, give yourself a shot,'" Kaju recalled. "I think she was taking the stuff herself, and I didn't think anything of it."

Fairview declined to comment on Kaju's case or his account of drug disposal practices.

Searching through bins

The emergency room was a hectic place. When Kaju worked there in 2006 and 2007, hospital policy called for nurses to dispose of any unused drugs by "wasting" them down a drain, using a syringe, in view of another worker.

"They were supposed to flush it all, but they didn't," Kaju said. "That was my avenue. As crazy as it sounds, they just threw it away."

In slow periods on the job, Kaju said, he would slip away and scavenge through hospital waste bins. There were hundreds throughout the hospital and only some were locked, he said. Fentanyl and a liquid form of Dilaudid -- another opioid --were the two drugs he sought. "Some months I had to have it," he said.

Before long, a suspicious co-worker went to managers, and Kaju was caught on video attempting to steal in September 2007. The hospital suspended him, pending termination, but he fought it.

During the limbo period and even after he was fired, he says, he made his way back to the hospital several times for the drugs that got him high. On April 27, 2008, once again dressed in scrubs, he was spotted by an employee and the hospital called police. Officers found him in a restricted area, behind a curtain, looking through a bin filled with needles and vials.

Kaju's arrest and subsequent six-month term at the Hennepin County workhouse was the low point of his addiction.

"At first the inmates thought I was there to arrest them," the former investigator said. "Policemen think they're so high and mighty. Well, they're not. I realized how human I was."

Four-fold increase

Minnesota's problem with hospital drug thefts reflects a worsening national epidemic. Just this month, the U.S. Centers for Disease Control and Prevention reported that opioids now account for more overdose deaths than heroin and cocaine combined. Sales of the drugs quadrupled between 1999 and 2010, and 74 percent of prescription drug overdoses are now from opioid painkillers, the CDC reported.

Kaju said the emergency room manager who hired him -- and fired him -- also saved his life by steering him into more treatment. His third program incorporated buprenorphine, a drug he used to beat opioid dependency.

"These opioids are so addictive, they should be banned unless you are terminally ill," Kaju said.

Now a limousine driver who spends his days helping disadvantaged kids, Kaju said hospital and nursing home workers should be required to inform their employers when medical reasons require them to take prescription painkillers or other addictive drugs.

"If it's OxyContin or something like that, you are gonna become an addict after 30 days," he said. "Your body just attaches itself to that drug and you're going to cross the line."

He also said the health care industry should deal with job stress as a root cause of narcotics addiction and theft. He likened the nursing environment to police work.

"When you lose patients ... eventually it eats at you," Kaju said. "It callouses your personality ... you lose your humanity eventually."

Staff writer Maura Lerner contributed to this report. Tony Kennedy • 612-673-4213