In 2022, more than 73,000 people died as a result of a fentanyl overdose. While EMS providers play a pivotal role fighting against the opioid epidemic, the industry itself still faces its own issues with drug diversion and tampering cases. Left unreported, these situations can lead to catastrophic consequences for both providers and patients. This presentation will show the importance of recognizing and identifying diversion and tampering within the EMS field and Priority’s transparency in our cases.